Social class and depression: A study of older women with functional limitations living in the community

Drawing upon the well-known conceptual framework that links social class to depression through stress and social support, this research utilizes measures tailored to older women, including health indicators (performance-based health, chronic disease conditions, social activities, and recent stress), perceived physical difficulties, and several dimensions of social support. The methodology is a secondary analysis of a sample of age-stratified, community-dwelling women 65 years of age and older with functional limitations taken from the Women\u27s Health and Aging Study. The data were collected during the years 1992 and 1995 in Baltimore, Maryland. A notable strength of the data set is the availability of performance-based tasks conducted by a trained observer. The findings highlight the major role of performance-based health and social activity variables in mediating the social class-depression relationship. The results are consistent with sociological arguments linking education and income to better physical health and greater social involvement, the latter a dimension of social support, which, in turn, promotes improved mental health. Although recent stress, perceived physical difficulties, and instrumental support directly affect depression, they do not mediate the social class-depression relationship. Performance-based health and social activity variables also play a role in the age-depression relationship. In bivariate analysis, age and depression have no relationship. But, once performance-based health and social activity variables are controlled for in multivariate analysis, those aged 75-84, and particularly the oldest old group, those aged 85+, are less depressed than those aged 65-74. The major role that performance-based health and social activity variables play in this work has direct applications to future work and policy. In terms of future work, longitudinal studies are needed to test the causal order of performance-based health and social activity variables in the social class-depression relationship. Applying the findings to policy suggests the implementation of programs that decrease the functional limitations of older women. Such programs would promote both physical health and social activities and contribute to better mental health