ArticleBundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz2025
[Area-level socioeconomic deprivation, socioeconomic status, and depressive symptoms: a multilevel analysis using data from the GEDA 2019/2020 study].
Article in Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Trends in Mental Health Diagnoses Among Children and Adolescents Before and During the COVID-19 Pandemic in a Large German State.Children (Basel, Switzerland) · 2026Article
- Regional variation in healthcare utilization among patients with depression in Germany: a multilevel analysis with PopGrouper-based multimorbidity adjustment.Research in health services & regions · 2026Article
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Abstract
backgroundThe 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.
methodsRepresentative 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.
resultsThe 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.
conclusionArea-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.
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