Socioeconomic status, psychosocial stress, and depressive symptoms in wome

The high prevalence of depression, combined with its disproportionate burden on women and many long term consequences, underscores the need to continue exploration of risk factors for depressive symptoms in women. One of the strongest observed risk factors for depression is experiencing psychosocial stress, and women residing in areas especially vulnerable to disaster may be at increased risk of environmental-associated psychosocial stress. The goal of the following research was to examine how socioeconomic status (SES) and the psychosocial stressors, oil spill exposure and neighborhood environment, affect risk of depressive symptoms in a population of female residents of a region affected by the Deepwater Horizon Oil Spill (DHOS). Data collected in the Women and their Children's Study and the United States Census were used to achieve this goal in three stages.;First, analytic approaches to estimate the construct of depressive symptoms when using the Center for Epidemiologic Studies Depression Scale were evaluated by applying latent profile analysis. Results supported the conventional use of continuous CES-D scores to estimate depressive symptom severity. Additionally, associations between depressive symptom severity and both, DHOS exposure and greater economic vulnerability were found.;Secondly, neighborhood economic disadvantage and physical disorder effect modification of DHOS exposure on depressive symptoms using cross-sectional and longitudinal data was explored. DHOS exposure and neighborhood physical disorder were independently associated with increased depressive symptoms, but there was no evidence of effect modification. However, after stratification by neighborhood physical disorder, the positive association between DHOS exposure and depressive symptoms was observed only among women exposed to physical disorder.;Thirdly, a potential biologic pathway through dehydroepiandrosterone sulfate (DHEA-S) from the risk factors identified in the prior stages to depressive symptoms was explored. An association between low SES and low DHEA-S was observed among older postmenopausal women; however, DHEA-S was not associated with depressive symptoms after adjustment.;In summary, the results of this study support associations between SES, psychosocial stress and depressive symptoms among women in areas affected by disaster. These results could potentially guide targets for post-disaster mental health interventions. Future studies should continue to explore the biologic processes driving these associations.