Association of socioeconomic status with depression and anxiety among older adults in China

Depression and anxiety are common mental health problems in later life, and their distribution is strongly shaped by socioeconomic inequalities. However, evidence on how detailed indicators of socioeconomic status (SES) relate to mental health among older adults in China remains limited. We conducted a secondary analysis of a large nationwide social survey in China. The analytic sample included 875 respondents aged ≥65years with complete data on SES indicators and mental health measures. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and anxiety symptoms using the 7-item Generalized Anxiety Disorder Scale (GAD-7). SES indicators comprised hukou type, residence type, education, monthly income per capita, occupation, marital status, and number of properties owned. Descriptive statistics, Kendall’s tau-b correlations and logistic regression models were used to examine associations between SES and mental health. Older adults with agricultural hukou, rural residence, lower education, lower income, fewer properties, unmarried or widowed status, and manual or unemployed occupations generally reported higher PHQ-9 and GAD-7 scores and were more likely to experience depressive or anxiety symptoms ‘almost every day.’ Perceived stress tolerance showed a strong negative correlation with both depression and anxiety scores. Multiple indicators of socioeconomic disadvantage are associated with more severe depressive and anxiety symptoms among older Chinese adults. These findings highlight the need for mental-health promotion strategies that take into account hukou and residence-based inequalities, material deprivation, and stress-coping resources when designing interventions for older populations.