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Monday, March 11, 2013

Biggest Risk Factor for Depression: Low Income

While the debate rages as to whether depression is genetic and why antidepressant usage in the U.S. went up 400% in a recent ten-year period, it seems health-care experts are ignoring the single most obvious risk factor in depression: financial hardship.

A 2011 report from the Centers for Disease Control gives some of the most solid evidence yet that depression has less to do with "genetic predisposition" and other speculative causal factors than with real-world problems. The accompanying graphic (below) from CDC's report shows that income level correlates very strongly, in an inverse fashion, with depression.

The numbers show that if you are living below the poverty level ($11,490/yr if you're single) and you're between the ages of 20 and 64, you're at roughly five times greater risk of depression than if you're making 400% or more of poverty level income ($45,960/yr, if you're single).

Latest (2011) CDC data on the demographics of depression. Taken
from http://www.cdc.gov/nchs/data/hus/hus11.pdf.

The numbers also show that you're at much greater risk of depression if you're 45 to 64 years old than if you're under 45 or over 64, particularly if you're earning less than twice the poverty level. This suggests that the stressors of middle age are qualitatively different than the stressors of old age or of young adulthood.

The main takeaway: Money may not buy happiness, but it sure as hell buys freedom from depression.

The policy implications are clear. We now have strong evidence that a reliable and effective way to reduce the incidence of depression (and concomitant medical spending) in the U.S. is to reduce poverty and increase income levels generally.

14 comments:

  1. " We now have strong evidence that a reliable and effective way to reduce the incidence of depression (and concomitant medical spending) in the U.S. is to reduce poverty and increase income levels generally."

    No, we don't. You don't know if low income causes depression, if depression causes low income, or if something else causes both. You cannot make a statement like "money buys freedom from depression" willly-nilly. Think of all the possible ways in which depression could cause low income: you lose your job because you can't get out of bed, you're not motivated to work and you get fired, etc. Think of all the things that could cause both: a crippling accident that leaves you unable to do your job, and of course makes you depressed.

    All you know is that depression and low income are correlated, but your conclusion is downright irresponsible.

    ReplyDelete
    Replies
    1. Anonymous11:54 AM

      Exactly what I came to say.

      Delete
    2. Look, we can generally contextualize this debate under three frameworks: Is it a decision, a hypothesis, or a principle?

      The criticism regarding the author's faux-pas of correlation=causation may be valid, but that depends on whether or not he is making a hypothesis. Scientists typically make hypotheses proper. Philosophy tend to discover principles of "right reasoning." Politics usually dabble with decisions.

      Nevertheless, "money buys freedom from depression" obviously is not a scientific statement, nor does it feign to be. So I believe the correlationship=/=causation points are absolutely and irresponsibly irrelevant.

      The OP is either discussion a philosophical principle or a political decision we must make.

      This isn't a fact dispute party. We could spend all year wining about how "correlation doesn't imply causation" and that Hume is turning in his grave. In fact, we have been doing that for nearly two centuries.

      You understand basic concepts of metaphysics. Great. Let's step up our intellectual endeavor. -- The world is constituted by not only natural facts buy also human facts, which consist of the decisions we've made in the past which determine the history of future events.

      Delete
  2. Anonymous11:23 AM

    Unknown is quite right. The first rule of stats is "Correlation is not causation".

    ReplyDelete
  3. Anonymous11:44 AM

    I second that. Wrong conclusion made in the article.

    ReplyDelete
    Replies
    1. Gallup found much the same thing, with depression not only correspnding to income but also to unemployment status: http://www.mayoclinic.org/diseases-conditions/depression/basics/risk-factors/con-20032977

      Delete
  4. Anonymous11:45 AM

    As stated above, correlation is not causation. People with higher incomes also tend to seek treatment sooner, and have more options available to them. Heck, I'm above the poverty line and I still wait until I feel like death to go to the clinic because I can barely afford a copay on my budget.

    The wealthy have always had more attentive healthcare. It is very easy to pay someone to sit on a couch for an hour when you're not relying on that hour for $9. And that is, for lack of a better term, depressing.

    ReplyDelete
    Replies
    1. Read the Gallup report on this as well. http://www.mayoclinic.org/diseases-conditions/depression/basics/risk-factors/con-20032977

      Delete
  5. Anonymous12:35 PM

    People are quick to attack correlation as poor evidence. It has become the new "badge" of rationality in all discussions.

    Correlation is still a strong tool to discover potential causality down the line. If a correlation exists, it improve our intuition of the subject and prods us to discover something new. Being supported by intuition is a strong factor in moving from correlation to causality. (unlike say correlation between the shape of clouds vs. which football team wins the match, which seems to be supported poorly by reasoning.)

    In this case, I don't see why low income can't be linked to depression (for further investigation and maybe a discovery of a causal link). It doesn't seem unreasonable at all. Certainly almost everybody here has felt the stress that comes with lack of money even if we are not clinically depressed. Chronic financial pain can easily be seen to lead to depression.

    I wouldn't dismiss this correlation so easily - as curious minded folks, it can point to something useful (or lack of it.).

    ReplyDelete
    Replies
    1. Anonymous3:06 PM

      Sure, but the opposite case is equally true. As someone who has personally struggled with depression, I can attest to how difficult it is to hold a steady job with the illness. In my case, I was fortunate enough to be working for a company that was willing to be flexible, but if I hadn't, I could have easily lost my job on multiple occasions.

      Correlation is a strong tool to discover causality further down the line, but you must remember that the causality may flow in *either* direction. OP isn't doing that. He's saying, "If you want to stop depression, raise people's incomes." I'm saying that low income maybe caused by depression, rather than the opposite. If I'm correct, raising people's incomes wouldn't necessarily help their depression, so all the same health-care spending would still be there, in addition to the extra spending and taxation needed to redistribute wealth.

      Delete
  6. Anonymous12:39 PM

    I'd get out of bed if I had a job to go to.

    ReplyDelete
  7. Anonymous3:24 PM

    Living in a 3. world country, with a pretty low income and general miserable situation, its pretty easy to see a causality in this blogpost. Dealing with every day problems, unable to change fundamentally anything in your live is pretty much a permanent load. You don´t need a strong academical bs-evidence, to see how your miserable life affects the psyche, and i strongly suspect, its not much different for a rich country like yours, with a attitude of a consumer-oriented society.

    ReplyDelete
  8. Anonymous5:14 PM

    Regardless of what causes depression, I definitely agree with this: "reduce poverty and increase income levels generally."

    ReplyDelete
  9. Anonymous1:01 PM

    There are multiple factors for depression: genetic, economic, class differences, accidents, war, lack of effective medical and social services, etc. But if you think economic mobility is not high on the list. 1. Seal up your bank account for a month 2. Come and live on the streets with me for that time. I'm sure i won't get any takers.

    ReplyDelete

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