Low socioeconomic status and depression: A double jeopardy for cardiovascular disease?

Abstract

Few population-based cohort studies have examined the combined association of low socioeconomic status (SES) and depression with the incidence of cardiovascular disease (CVD) despite growing evidence on the importance of these two risk factors. The recognition that traditional health and lifestyle factors do not entirely explain CVD risk is growing, with the acknowledgement that treatment and prevention strategies for CVD should also emphasize the role of psychosocial factors (e.g. depression) and social determinants of health (e.g. SES). While these factors have not yet been incorporated in cardiovascular risk scoring systems, there have been several calls for the recognition of SES and depression on CVD risk [1-3].

The individual and combined associations of depression and socioeconomic status with risk of major cardiovascular events: a prospective cohort study

“…Our results are in keeping with previous studies highlighting a high risk of CVD associated with each of depression and low SES individually [1-6, 13, 15]. As highlighted by Sullivan and Vaccarino [22], a comparison of findings of existing studies on the combined association of depression and SES on risk of CVD is complicated since these studies did not present all information required to assess effect modification and interaction [28]. Nonetheless, our results are largely consistent with existing studies.…”

“…As recommended by Sullivan and Vaccarino [22], we tested for effect modification, additive and multiplicative interaction, following established reporting guidelines for these measures [28]. The effect modification and interaction analyses were performed in keeping with the code of the interactionR package [29].…”

“…Due to the inconsistent findings and methodological shortcomings of existing studies, a recent paper highlighted the need for further studies investigating the individual and combined effect of depression and SES on incidence of cardiovascular events [22]. Advancing in our understanding of the relationship between depression, SES and risk of MCVE might allow the identification of individuals that are particularly vulnerable to the adverse effects of depression which in turn might aid tailoring of resources and preventive measures.…”

Prevalence and risk factors associated with depressive mood in Korean patients with fecal incontinence

“…In addition to that, individuals with low socioeconomic status are exposed to more stress, social challenges, and adversity, but have fewer interpersonal resources to cope with these stressful events [ 29 ]. There's also compelling evidence that low social status affects multimodality and increases depressive symptoms in general medical conditions [ 30 ]. However, the exact mechanism by which social status can affect the risk of depression in FI was not fully understood and need to be investigated.…”

Measuring and Modifying Psychological Distress in CKD: New Insights and Next Steps

“…Though financial instability is common among patients with CKD, whether measures of economic strain are associated with psychological distress in CKD is unknown. 8,9 Thus, there is a need for additional evidence to support the development of interventions and policy changes to improve the financial strain of patients with CKD and ultimately help alleviate their psychological distress.…”