Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2025 Sep 9. doi: 10.1007/s00103-025-04123-4. Online ahead of print.
ABSTRACT
BACKGROUND: The prevalence of mental disorders in Germany is associated with socioeconomic position. International studies further indicate area-level correlations linking higher levels of socioeconomic deprivation with increased mental health burdens. However, these area-level associations have not yet been systematically examined in Germany and it is unclear whether socioeconomic disparities in mental health outcomes are contingent upon area-level socioeconomic deprivation.
METHODS: Representative data from the German Health Update survey (GEDA 2019/2020-EHIS) (N = 21,876) are used to estimate and visualize depressive symptoms prevalence (Patient Health Questionnaire- 8 ≥ 10) via small-area estimation. Prevalence rates are analyzed stratified by socioeconomic position (education and income) and by the degree of area-level socioeconomic deprivation in the residential municipalities. Multiple logistic multilevel regression models are employed to adjust for confounding.
RESULTS: The prevalence of depressive symptoms does not exhibit a systematic geographical distribution across German districts. However, risk of depression is significantly higher in highly (Odds Ratio = 3.29) and moderately (Odds Ratio = 1.86) socioeconomically deprived municipalities compared to low-deprivation municipalities. Additionally, there are clear educational and income disparities to the detriment of individuals with a lower socioeconomic position. These differences are more pronounced in highly deprived regions.
CONCLUSION: Area-level socioeconomic deprivation is a key risk factor for compromised mental health in Germany. Individuals with lower education and income in deprived areas are particularly vulnerable, highlighting the need for targeted interventions and policies.
PMID:40925961 | DOI:10.1007/s00103-025-04123-4
Recent Comments