Higher socioeconomic status linked to lower odds of persistent depressive symptoms in China

A nationwide longitudinal study of 12,554 middle-aged and older adults in China found that higher socioeconomic status was associated with lower odds of belonging to a trajectory of persistently elevated depressive symptoms. The analysis used data from the China Health and Retirement Longitudinal Study collected between 2011 and 2020 and assessed depressive symptoms with the validated 10-item Center for Epidemiologic Studies Depression Scale, or CESD-10. Researchers used latent class analysis to divide participants into three socioeconomic-status groups based on education, health insurance, household consumption and occupational information.

The low-status group represented 56.97% of the sample, the medium-status group 29.45% and the high-status group 13.58%. The investigators then applied group-based trajectory modeling to characterize how depressive symptoms changed across the observation period and accommodate differences in symptom progression among participants. The modeling identified two depressive-symptom trajectories.

A stable-low trajectory, characterized by comparatively low symptom levels over time, included 52.84% of participants. The remaining 47.16% followed a persistent-elevated trajectory. After adjustment for potential confounders, participants in the medium socioeconomic-status group had lower odds of belonging to the persistent-elevated trajectory than those in the low-status group.

Their adjusted odds ratio was 0.70, with a 95% confidence interval of 0.64–0.77. Both estimates had P values below 0.001 relative to the low-status reference group. In statistical terms, the findings indicate that higher socioeconomic status was associated with reduced odds of persistent elevated symptoms in this population, not that socioeconomic status was shown to cause an individual’s symptoms to improve.

Stratified and sensitivity analyses supported the main results. The study was observational, however, and its adjusted estimates establish an association rather than a causal effect. The findings apply to the middle-aged and older Chinese adults included in the nationwide CHARLS cohort and show that nearly half of the analyzed sample was classified in the persistent-elevated symptom group.

The research appears in BMC Psychology as an open-access article; the supplied version was shared before the final version of record and was subject to further edits.

Subject of Research: Socioeconomic status and depressive symptom trajectories among middle-aged and older Chinese adults

Article Title: Association of socioeconomic status and depressive symptom trajectories among Chinese middle-aged and older adults: a nationwide cohort study from CHARLS

Article References: Zhao, D., Long, X., & Fan, H. (2026). Association of socioeconomic status and depressive symptom trajectories among Chinese middle-aged and older adults: a nationwide cohort study from CHARLS. BMC Psychology. https://doi.org/10.1186/s40359-026-05529-8

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05529-8

Keywords: depressive symptoms, socioeconomic status, CHARLS, older adults, longitudinal cohort, trajectory analysis, latent class analysis, China, Association, socioeconomic, status, depressive