Pathways to Depression: A Multidimensional Composite Analysis of Socioeconomic Inequalities in a Population-Based Study

Authors

  • Wahyu Tri Sudaryanto Study Program of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
  • Wahyuni Study Program of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
  • Firmansyah Study Program of Nutrition, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia
  • Afif Ari Wibowo Study Program of Geography Faculty of Geography, Universitas Muhammadiyah Surakarta, Indonesia

DOI:

https://doi.org/10.26911/

Abstract

Background: Socioeconomic factors are recognized as key contributors to the risk of depression among adults and older populations. However, socioeconomic status (SES) is often measured using single indicators, which may not capture its multidimensional nature. Moreover, the mechanisms through which socioeconomic conditions influence depression remain insufficiently explored. This study aimed to examine the pathways linking socioeconomic inequalities to depression using a multidimensional composite measure of SES.

Subjects and Method: A cross-sectional analysis was conducted using data from the 2023 Indonesian Health Survey, a nationally representative population-based survey. SES was constructed using principal component analysis (PCA) based on wealth index, education level, employment status, participation in government social protection programs, and provincial-level income inequality (Gini index). Path analysis was performed to assess direct and indirect relationships between SES, physical activity, comorbidity, and depression. All analyses were conducted using STATA 17.

Results: Higher SES was associated with a lower risk of depression. Significant pathways were observed from SES to depression both directly (β= -0.06; 95% CI= -0.07 to -0.06; p <0.001) and indirectly through comorbidity (β= -0.03; 95% CI= -0.03 to 0.02; p <0.001).

Conclusion: Socioeconomic inequalities play a critical role in shaping depression risk through multiple pathways.

Keywords:

depression, socioeconomic inequalities, gini index, household wealth index, social protection program, principal component analysis

Published

2026-07-16

Issue

Vol. 11 No. 3 (2026)

Section

Articles

How to Cite

Pathways to Depression: A Multidimensional Composite Analysis of Socioeconomic Inequalities in a Population-Based Study. (2026). Journal of Epidemiology and Public Health, 11(3). https://doi.org/10.26911/

How to Cite

Pathways to Depression: A Multidimensional Composite Analysis of Socioeconomic Inequalities in a Population-Based Study. (2026). Journal of Epidemiology and Public Health, 11(3). https://doi.org/10.26911/

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