ArticleBMC public health2026
Urban-rural differences in depressive symptoms and related factors among employed middle-aged and older adults: a national cross-sectional study in China.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGlobally, middle-aged and older adults who are employed are prone to experiencing depressive symptoms, a phenomenon particularly pronounced in China due to its significant ageing population. Despite this, there is a relative scarcity of research focusing on depressive symptoms among this community, especially in China. The purpose of this study is to explore and measure the factors contributing to variations in depressive symptoms among employed middle-aged and older adults in urban and rural areas.
methodsThe study utilized data from 3,156 employed middle-aged and older adults, derived from the fourth wave of The 2018 China Health and Retirement Longitudinal Study (CHARLS). The 10-item short version of the Center for Epidemiological Studies Depression Scale (CES-D-10) was used to assess depressive symptoms. Urban-rural differences were examined using chi-square tests and binary logistic regression analyses, while the Oaxaca-Blinder decomposition technique was applied to explore the disparities and their respective contributions.
resultsThe study comprised a sample of 783 employed individuals of middle and older age residing in urban areas, alongside 2,373 counterparts in rural areas. The gender distribution within the sample was 68.1% male and 31.9% female. The prevalence of depressive symptoms was observed in 23.2% of the urban cohort, in contrast to 30.4% of the rural cohort, a difference that was statistically significant (P < 0.001). In urban settings, significant determinants of depressive symptoms included self-assessed health status, sleep duration, and life satisfaction. In contrast, in rural areas, factors such as gender, age, education, self-assessed health status, chronic diseases, sleep duration, and life satisfaction were identified. The Oaxaca-Blinder decomposition analysis identified age, education, self-assessed health status, and sleep duration as key factors in the disparity of depressive symptoms between urban and rural areas among employed middle-aged and older adults.
conclusionsDepressive symptoms are more common in rural areas due to various factors found in these communities. It is imperative to create focused and advanced intervention plans to improve the mental well-being of this community and reducing the urban-rural disparity.
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