Does the level of wealth inequality within an area influence the prevalence of depression amongst older people?

Abstract

This paper considers whether the extent of inequality in house prices within neighbourhoods of England is associated with depressive symptoms in the older population using the English Longitudinal Study of Ageing. We consider two competing hypotheses: first, the wealth inequality hypothesis which proposes that neighbourhood inequality is harmful to health and, second, the mixed neighbourhood hypothesis which suggests that socially mixed neighbourhoods are beneficial for health outcomes. Our results are supportive of the mixed neighbourhood hypothesis, we find a significant association between neighbourhood inequality and depression with lower levels of depression amongst older people in neighbourhoods with greater house price inequality after controlling for individual socio-economic and area correlates of depression. The association between area inequality and depression is strongest for the poorest individuals, but also holds among the most affluent. Our results are in line with research that suggests there are social and health benefits associated with economically mixed communities.

Keywords: Area effects; Depression; Inequality; Mix; Neighbourhood.

Figure 1

Distribution of neighbourhood inequality (Gini of house prices), median house price and Indices of Multiple deprivation score (MSOAs in England). Source: Indices of Multiple Deprivation (2004) and Land Registry house price sales (2003/4) a: The greater the neighbourhood IMD score the greater the level of deprivation within that area

Figure 2

Relationship between area house price inequality and area median house price and between area median house price and deprivation Source: Indices of Multiple Deprivation (2004) and Land Registry house price sales (2003/4)

Figure 3

Prevalence of depression by quintiles of area inequality (house price Gini), area median house price, area deprivation (IMD) and individual wealth. Source: ELSA (wave 1), Indices of Multiple Deprivation (2004) and Land Registry house price sales (2003/4)

Figure 4

Model probabilities of depression from model including interactions between, i. quintiles of neighbourhood inequality and tertiles of individual wealth. Source: ELSA Wave 1, Indices of Multiple Deprivation (2004) and Land Registry house price sales (2003/4) Notes: Calculation of the model probabilities assume that all other variables assume the reference category or, for continuous variables, the mean value. Only significant interaction terms were included in the predictions There are some issues associated with interpretation of logit coefficients across groups in this way (Allinson 1999). However, our conclusions are identical in an OLS model framework using ces-d score as a continuous dependent variable suggesting the findings reported are valid.