Journal of Epidemiology and Public Health
Vol. 11 No. 3 (2026)

Pathways to Depression: A Multidimensional Composite Analysis of Socioeconomic Inequalities in a Population-Based Study

Wahyu Tri Sudaryanto (Study Program of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia)
Wahyuni (Study Program of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia)
Firmansyah (Study Program of Nutrition, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia)
Afif Ari Wibowo (Study Program of Geography Faculty of Geography, Universitas Muhammadiyah Surakarta, Indonesia)



Article Info

Publish Date
16 Jul 2026

Abstract

Background: Socioeconomic factors are recognized as key contributors to the risk of depression among adults and older populations. However, socioeconomic status (SES) is often measured using single indicators, which may not capture its multidimensional nature. Moreover, the mechanisms through which socioeconomic conditions influence depression remain insufficiently explored. This study aimed to examine the pathways linking socioeconomic inequalities to depression using a multidimensional composite measure of SES. Subjects and Method: A cross-sectional analysis was conducted using data from the 2023 Indonesian Health Survey, a nationally representative population-based survey. SES was constructed using principal component analysis (PCA) based on wealth index, education level, employment status, participation in government social protection programs, and provincial-level income inequality (Gini index). Path analysis was performed to assess direct and indirect relationships between SES, physical activity, comorbidity, and depression. All analyses were conducted using STATA 17. Results: Higher SES was associated with a lower risk of depression. Significant pathways were observed from SES to depression both directly (β= -0.06; 95% CI= -0.07 to -0.06; p <0.001) and indirectly through comorbidity (β= -0.03; 95% CI= -0.03 to 0.02; p <0.001). Conclusion: Socioeconomic inequalities play a critical role in shaping depression risk through multiple pathways.

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Journal Info

Abbrev

jepublichealth

Publisher

Subject

Public Health

Description

Background: Increased blood pressure for a long time can increase the risk of kidney failure, co­ronary heart disease, brain damage, and other di­seases. In 2019, it is estimated that hyper­tens­ion is experienced by 1.13 billion people in the world with most (two thirds) living in low and ...