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Background <p>The prevalence of mental disorders in Germany is associated with socioeconomic position. International studies further indicate area-level correlations linking higher levels of socioeconomic deprivation with increased mental health burdens. However, these area-level associations have not yet been systematically examined in Germany and it is unclear whether socioeconomic disparities in mental health outcomes are contingent upon area-level socioeconomic deprivation.</p> Methods <p>Representative data from the German Health Update survey (GEDA 2019/2020-EHIS) (<i>N</i> = 21,876) are used to estimate and visualize depressive symptoms prevalence (Patient Health Questionnaire- 8 ≥ 10) via small-area estimation. Prevalence rates are analyzed stratified by socioeconomic position (education and income) and by the degree of area-level socioeconomic deprivation in the residential municipalities. Multiple logistic multilevel regression models are employed to adjust for confounding.</p> Results <p>The prevalence of depressive symptoms does not exhibit a&#xa0;systematic geographical distribution across German districts. However, risk of depression is significantly higher in highly (Odds Ratio = 3.29) and moderately (Odds Ratio = 1.86) socioeconomically deprived municipalities compared to low-deprivation municipalities. Additionally, there are clear educational and income disparities to the detriment of individuals with a&#xa0;lower socioeconomic position. These differences are more pronounced in highly deprived regions.</p> Conclusion <p>Area-level socioeconomic deprivation is a&#xa0;key risk factor for compromised mental health in Germany. Individuals with lower education and income in deprived areas are particularly vulnerable, highlighting the need for targeted interventions and policies.</p>

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Regionale sozioökonomische Deprivation, sozioökonomischer Status und depressive Symptomatik: eine Mehrebenenanalyse mit Daten der Studie GEDA 2019/2020

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  • 出版模式：

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  • 发表日期：

    2025年9月9日

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  • Lina Wollgast,
  • Christina Kersjes,
  • Claudia Hövener,
  • Niels Michalski

摘要

Background

The prevalence of mental disorders in Germany is associated with socioeconomic position. International studies further indicate area-level correlations linking higher levels of socioeconomic deprivation with increased mental health burdens. However, these area-level associations have not yet been systematically examined in Germany and it is unclear whether socioeconomic disparities in mental health outcomes are contingent upon area-level socioeconomic deprivation.

Methods

Representative data from the German Health Update survey (GEDA 2019/2020-EHIS) (N = 21,876) are used to estimate and visualize depressive symptoms prevalence (Patient Health Questionnaire- 8 ≥ 10) via small-area estimation. Prevalence rates are analyzed stratified by socioeconomic position (education and income) and by the degree of area-level socioeconomic deprivation in the residential municipalities. Multiple logistic multilevel regression models are employed to adjust for confounding.

Results

The prevalence of depressive symptoms does not exhibit a systematic geographical distribution across German districts. However, risk of depression is significantly higher in highly (Odds Ratio = 3.29) and moderately (Odds Ratio = 1.86) socioeconomically deprived municipalities compared to low-deprivation municipalities. Additionally, there are clear educational and income disparities to the detriment of individuals with a lower socioeconomic position. These differences are more pronounced in highly deprived regions.

Conclusion

Area-level socioeconomic deprivation is a key risk factor for compromised mental health in Germany. Individuals with lower education and income in deprived areas are particularly vulnerable, highlighting the need for targeted interventions and policies.