Psychological costs of low wealth in midlife: Lower socioeconomic status carries greater disadvantage for depressive symptoms in the United States than Europe and China

OBJECTIVES: Socioeconomic inequalities in depressive symptoms are well documented, yet little is known about how these inequalities unfold during midlife and whether they vary across national and historical contexts. METHODS: Using harmonized longitudinal data spanning 1992 to 2022 from 16 countries (United States, England, France, Austria, Belgium, Germany, Switzerland, Israel, Italy, Spain, Greece, Denmark, Netherlands, Sweden, South Korea, and China), this study modeled trajectories of depressive symptoms among adults aged 45 to 65 across four wealth-based socioeconomic strata: Low (1st to 15th percentile), Lower-middle (16th to 45th), Upper-middle (46th to 75th), and High (76th to 100th). RESULTS: Results revealed cross-national disparities: midlife adults in the United States reported higher depressive symptoms than their peers in most other nations, and this difference was most pronounced among lower SES groups. In most nations, later-born cohorts reported more depressive symptoms, with Upper-middle SES individuals exhibiting the largest historical increases. Beyond these mean-level patterns, lower SES groups were found to exhibit greater heterogeneity across three trajectory features of depressive symptoms (i.e., mean-levels at age 50 as well as linear and quadratic changes in depressive symptoms). This may suggest that under socioeconomic disadvantage, depressive symptoms are less tightly structured by SES alone and more strongly shaped by other contextual and individual factors. DISCUSSION: Collectively, findings highlight that mental health inequalities in midlife are deeply embedded in societal and historically changing structures. Policies that strengthen social protections and promote economic security may reduce these disparities and enhance well-being across the life course.