The role of literacy in the association between educational attainment and depressive symptoms
There is a consistent association between education and depressive symptoms, but research on the mechanisms to explain this association remains limited. No study has formally evaluated the extent to which the association between education and depressive symptoms is mediated through a foundational sk...
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doaj-71d23af3485b483dba8caa59ce97d0a72020-11-24T20:41:57ZengElsevierSSM: Population Health2352-82732017-12-013C58659310.1016/j.ssmph.2017.07.002The role of literacy in the association between educational attainment and depressive symptomsThu T. Nguyen0Eric J. Tchetgen Tchetgen1Ichiro Kawachi2Stephen E. Gilman3Stefan Walter4M. Maria Glymour5Department of Epidemiology & Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco, CA 94158, United StatesDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02215, United StatesDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02215, United StatesDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02215, United StatesDepartment of Epidemiology & Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco, CA 94158, United StatesDepartment of Epidemiology & Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco, CA 94158, United StatesThere is a consistent association between education and depressive symptoms, but research on the mechanisms to explain this association remains limited. No study has formally evaluated the extent to which the association between education and depressive symptoms is mediated through a foundational skill such as literacy. Inverse odds ratio weighting (IORW) was used to estimate total, natural direct, and natural indirect effects in examining literacy as a mediator of the association between education and depressive symptoms. Health and Retirement Study participants born in the U.S. between 1900 and 1947 were interviewed biennially for up to 12 years (N = 16,718). Literacy was assessed with a brief vocabulary measure. Depressive symptoms were measured using the 8-item Centers for Epidemiologic Studies-Depression (CES-D) scale. Decomposition estimates were derived using regression analyses of repeated measures of depressive symptoms. Standard errors were obtained using a nonparametric bootstrap with the individual as the independent unit to account for dependence of observations within an individual. In a large cohort of older Americans, a one standard deviation difference in educational attainment (~ 3 years) was associated with a 0.35-point decrement in CES-D score (95% CI: -0.38, -0.32). This decrement represents a 0.22 standard deviation difference in depressive symptoms. Using IORW, the estimated effect of education on depressive symptoms mediated through literacy was -0.10 (95% CI: -0.18, -0.01), which represents 28% of the total effect. Education confers many benefits; as demonstrated by this study for depressive symptoms, one important benefit is literacy.http://www.sciencedirect.com/science/article/pii/S2352827316301197mediation analysisdepressive symptomseducational attainmentliteracy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Thu T. Nguyen Eric J. Tchetgen Tchetgen Ichiro Kawachi Stephen E. Gilman Stefan Walter M. Maria Glymour |
spellingShingle |
Thu T. Nguyen Eric J. Tchetgen Tchetgen Ichiro Kawachi Stephen E. Gilman Stefan Walter M. Maria Glymour The role of literacy in the association between educational attainment and depressive symptoms SSM: Population Health mediation analysis depressive symptoms educational attainment literacy |
author_facet |
Thu T. Nguyen Eric J. Tchetgen Tchetgen Ichiro Kawachi Stephen E. Gilman Stefan Walter M. Maria Glymour |
author_sort |
Thu T. Nguyen |
title |
The role of literacy in the association between educational attainment and depressive symptoms |
title_short |
The role of literacy in the association between educational attainment and depressive symptoms |
title_full |
The role of literacy in the association between educational attainment and depressive symptoms |
title_fullStr |
The role of literacy in the association between educational attainment and depressive symptoms |
title_full_unstemmed |
The role of literacy in the association between educational attainment and depressive symptoms |
title_sort |
role of literacy in the association between educational attainment and depressive symptoms |
publisher |
Elsevier |
series |
SSM: Population Health |
issn |
2352-8273 |
publishDate |
2017-12-01 |
description |
There is a consistent association between education and depressive symptoms, but research on the mechanisms to explain this association remains limited. No study has formally evaluated the extent to which the association between education and depressive symptoms is mediated through a foundational skill such as literacy. Inverse odds ratio weighting (IORW) was used to estimate total, natural direct, and natural indirect effects in examining literacy as a mediator of the association between education and depressive symptoms. Health and Retirement Study participants born in the U.S. between 1900 and 1947 were interviewed biennially for up to 12 years (N = 16,718). Literacy was assessed with a brief vocabulary measure. Depressive symptoms were measured using the 8-item Centers for Epidemiologic Studies-Depression (CES-D) scale. Decomposition estimates were derived using regression analyses of repeated measures of depressive symptoms. Standard errors were obtained using a nonparametric bootstrap with the individual as the independent unit to account for dependence of observations within an individual. In a large cohort of older Americans, a one standard deviation difference in educational attainment (~ 3 years) was associated with a 0.35-point decrement in CES-D score (95% CI: -0.38, -0.32). This decrement represents a 0.22 standard deviation difference in depressive symptoms. Using IORW, the estimated effect of education on depressive symptoms mediated through literacy was -0.10 (95% CI: -0.18, -0.01), which represents 28% of the total effect. Education confers many benefits; as demonstrated by this study for depressive symptoms, one important benefit is literacy. |
topic |
mediation analysis depressive symptoms educational attainment literacy |
url |
http://www.sciencedirect.com/science/article/pii/S2352827316301197 |
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