Ssm-Population Health最新文献

{"title":"Effects of a large-scale participatory learning and action programme in women's groups on knowledge and behaviour related to pregnancy and childcare: a cluster-randomized controlled trial in Bihar, India","authors":"Lisa Bogler ,&nbsp;Abhijeet Kumar ,&nbsp;S.V. Subramanian ,&nbsp;Sebastian Vollmer","doi":"10.1016/j.ssmph.2025.101880","DOIUrl":"10.1016/j.ssmph.2025.101880","url":null,"abstract":"<div><h3>Background</h3><div>Participatory learning and action (PLA) programmes are promoted as effective community-based intervention to improve maternal and child health. Evidence on their impact on knowledge and behaviour related to pregnancy and childcare is limited and mixed. Between 2015 and 2016, state-supported agencies implemented a large-scale PLA intervention in women's self-help groups in rural Bihar, India, with meetings facilitated by trained agency staff. We assessed the impact of this intervention using a cluster-randomized controlled trial.</div></div><div><h3>Methods</h3><div>In one implementation district, 68 village clusters were randomly assigned to receive the intervention or not. With survey data from 1612 women who were pregnant before the intervention, we evaluate programme impact on (a) beliefs about practices of feeding newborns, (b) knowledge about malaria, (c) childcare practices, (d) quantity and quality of antenatal care, and (e) attitude towards antenatal care and pregnancy. We estimate intention-to-treat effects in linear regression models using endline data and in a difference-in-differences model.</div></div><div><h3>Findings</h3><div>With no robust statistical significance across 50 outcomes, we find no evidence that the PLA intervention in Bihar had an impact on beliefs, attitudes, knowledge, behaviour related to pregnancy or childcare, or quality of antenatal care received. Less than one percent of the sample reported to have attended at least one PLA meeting.</div></div><div><h3>Conclusion</h3><div>Our results do not discredit the effectiveness of PLA interventions in general. They highlight that PLA interventions delivered through existing women's self-help groups need to consider the particular challenges to participation faced by pregnant women.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101880"},"PeriodicalIF":3.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective, intersubjective, and objective social statuses: How do people imagine social inequality?","authors":"Naoki Sudo","doi":"10.1016/j.ssmph.2025.101878","DOIUrl":"10.1016/j.ssmph.2025.101878","url":null,"abstract":"<div><div>Previous studies have shown that although subjective social status is related to objective social status, these statuses do not necessarily coincide with each other. Consequently, the relationship between subjective social status and social inequality had not been sufficiently explored. Accordingly, this study explored how and why they are related to each other by introducing the new concept of intersubjective social status. To measure subjective and intersubjective social statuses, I analyzed data from the Stratification and Social Psychology Survey in 2022 (SSP2022) and an online survey experiment by using ordered and multi-level ordered logistic regression models. The analysis revealed that although subjective and intersubjective social statuses share basic features, they are not the same concept. Subjective social status emphasizes the social inequality of opportunities, whereas intersubjective social status emphasizes the social inequality of outcomes. Additionally, the results revealed that the association between subjective and intersubjective (or objective) social statuses might vary depending on social status groups.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101878"},"PeriodicalIF":3.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unequal distributional change in body mass index among pre-pregnant women and their male partners in northern Sweden: a quantile regression analysis","authors":"Fethi Mohammed Yusuf,&nbsp;Anni-Maria Pulkki-Brännström,&nbsp;Per E. Gustafsson,&nbsp;Anneli Ivarsson,&nbsp;Marie Lindkvist,&nbsp;Masoud Vaezghasemi","doi":"10.1016/j.ssmph.2025.101877","DOIUrl":"10.1016/j.ssmph.2025.101877","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a global public health issue with increasing prevalence and notable differences across population. Previous studies on body mass index (BMI) trends and inequalities have focused on overweight/obesity prevalence or average BMI changes, overlooking differences across the BMI distribution. This study investigates whether changes in BMI distribution are uniform or different over time and educational attainment.</div></div><div><h3>Methods</h3><div>This study is based on repeated cross-sectional surveys in Västerbotten, Sweden. Study participants were expectant parents visiting antenatal care (2010–2019) as part of the Salut Programme. During early pregnancy, 18,215 women and 17,890 male partners completed questionnaires. Quantile regression analyses were conducted to assess BMI distribution changes over time and by education for men and women.</div></div><div><h3>Results</h3><div>The BMI distribution for women showed a sharper increase in the upper tail in 2018/19 compared to 2010/11, whereas for men, the upper tail showed a gradual rise over years. Similar changes in BMI distributions were observed over time across both educational groups, with a notable increase in the higher BMI segments.</div></div><div><h3>Conclusion</h3><div>The study revealed weight gain inequalities, with higher BMI segments experiencing a disproportionately higher rise compared to others. Identifying high-risk groups in vulnerable settings will better equip decision-makers to design and implement targeted intervention strategies to reduce overweight and obesity.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101877"},"PeriodicalIF":3.1,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion and division: A spatial analysis of surrogacy policy determinants in the United States","authors":"Jingjing Gao ,&nbsp;Muinat Abolore Idris ,&nbsp;Gabriela A. Gallegos ,&nbsp;Bryan Colby Griffin ,&nbsp;Sharon V. Munroe ,&nbsp;Jason H. Windett","doi":"10.1016/j.ssmph.2025.101876","DOIUrl":"10.1016/j.ssmph.2025.101876","url":null,"abstract":"<div><h3>Background</h3><div>Advancements in reproductive technologies have made surrogacy an increasingly attractive option for individuals and couples facing fertility challenges. In 2022, the global commercial surrogacy market was valued at approximately $14 billion, with the United States contributing a significant share due to its robust healthcare and legal infrastructure. However, surrogacy policy in the United States remains highly fragmented—some states have permissive legal frameworks, others prohibit surrogacy entirely, and many have no formal statutes. This study examines how states’ political ideology, religiosity, and socioeconomic factors influence the adoption of surrogacy policies across the United States.</div></div><div><h3>Methods</h3><div>We conducted a spatial analysis using data from the United States Census Bureau, World Population Review, and the United States Surrogacy Law Map. States were categorized based on the permissiveness of their surrogacy policies. Spatial lag regression model and ordered logistic regression models were employed to assess associations between policy status and independent variables, including religiosity, political affiliation, income, and racial demographics.</div></div><div><h3>Results</h3><div>Moran's I indicated significant positive spatial clustering of surrogacy law permissiveness across states (I = 0.206, p &lt; 0.05), suggesting geographic diffusion of policy environments. Spatial lag regression results showed that higher religiosity was associated with more restrictive policies, although this effect attenuated after adjusting for socioeconomic and political factors. Ordered logistic regression models confirmed these associations while explicitly accounting for the ordinal outcome structure: higher religiosity significantly decreased the odds of permissive policies (Model 1: β = −0.124, p &lt; 0.05), whereas racial diversity predicted greater policy permissiveness. In fully adjusted models, the percentage of White, Black, and Hispanic residents remained positive and significant predictors of permissive surrogacy laws, while religiosity trended negative but fell just short of statistical significance (p = 0.07).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that a combination of religiosity, racial composition, and spatial proximity to like-minded states shapes state-level surrogacy policy in the United States. Higher religious adherence is linked to more restrictive policies, while a greater proportion of White residents correlates with increased permissiveness when broader structural factors are considered. The findings underscore the importance of accounting for sociopolitical and geographic context in reproductive policy analysis. To promote equitable access to assisted reproductive technologies, public health efforts and legal reforms must consider these underlying sociocultural and spatial dynamics.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101876"},"PeriodicalIF":3.1,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is objectively measured exposure to built and natural environment associated with population-level cardiovascular disease mortality in Great Britain?","authors":"Laura Macdonald ,&nbsp;Natalie Nicholls ,&nbsp;Fiona Caryl ,&nbsp;Jonathan R. Olsen ,&nbsp;Daniela Fecht ,&nbsp;Richard Mitchell","doi":"10.1016/j.ssmph.2025.101875","DOIUrl":"10.1016/j.ssmph.2025.101875","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) causes one-third of global mortality, with modifiable risk factors such as unhealthy diet, sedentary behaviour, tobacco/alcohol use contributing to 80 % of CVD deaths. The built environment (BE) can influence CVD risk indirectly by shaping health behaviours and directly through environmental exposures like air pollution. While research has established connections between isolated environmental features and CVD, this study addresses significant research gaps in understanding how multiple BE characteristics influence CVD mortality across socioeconomic contexts, aiming to inform neighbourhood design to reduce both CVD and inequalities.</div></div><div><h3>Methods</h3><div>We modelled, for small areas across GB, tree cover, air pollution, walkability, densities of health-detrimental amenities (‘bads’) (e.g. fast-food outlets) and health-promoting amenities (‘goods’) (e.g. gyms), and income deprivation. Generalised linear models were used to assess associations between small area features and (sex-stratified) age-standardised CVD mortality rates (i.e. ICD-10 codes I00–I99), controlling for deprivation, urban-rural, country, and local authority. Combined models (i.e. models mutually adjusted for all BE features) identified the unique contribution of each feature while accounting for those that ‘co-located’. Interaction analysis was performed to examine variations by income deprivation.</div></div><div><h3>Results</h3><div>A slight increase in CVD mortality risk was associated with greater ‘goods’ densities (female mortality ratio (MR):1.005 (CIs:1.003–1.007), p &lt; 0.001, male MR:1.005 (CIs:1.003–1.006), p &lt; 0.001), and higher air pollution (female MR:1.006 (CIs:1.003–1.009), p &lt; 0.001, male MR:1.008 (CIs:1.005–1.009), p &lt; 0.001). A slight decrease in CVD mortality was associated with higher walkability for females (MR:0.996 (CIs:0.992–0.999), p = 0.034) and tree cover for males (MR:0.999 (CIs:0.998–0.999), p = 0.007). Higher air pollution levels and ‘bads’ were associated with higher male CVD mortality in deprived areas.</div></div><div><h3>Conclusion</h3><div>Findings have clear policy implications, suggesting prioritisation of reductions in air pollution—particularly in deprived areas—while promoting walkability and tree cover to reduce health inequalities. Unexpected positive associations between ‘goods’ and mortality highlight that complex neighbourhood effects warrant further study.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101875"},"PeriodicalIF":3.1,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of violence exposure in a life-course perspective and associations to mental and physical health problems and health-related risk behaviors among women and men in Sweden: A latent class analysis","authors":"Rickard Pettersson ,&nbsp;Steven Lucas ,&nbsp;Mattias Strandh","doi":"10.1016/j.ssmph.2025.101874","DOIUrl":"10.1016/j.ssmph.2025.101874","url":null,"abstract":"<div><h3>Background</h3><div>Individual histories of abuse characteristics and other adversities must be considered to understand poly-victimization and its impact on ill-health, which suggests the importance of understanding how experiences of violence are interconnected over a life-course.</div></div><div><h3>Objective</h3><div>To explore gendered patterns of lifetime poly-victimization—physical, emotional, and sexual—and examine how distinct exposure profiles relate to adult health outcomes. The analysis is guided by the Trauma-Informed Theory of Individual Health Behavior (TTB) framework to deepen understanding of gendered trauma trajectories and their long-term effects.</div></div><div><h3>Methods</h3><div>10 337 Swedish women and men aged 18–74 participated in a combined online and postal survey. Attrition bias was controlled for based on official registry information. Latent Class Analysis (LCA) was used for identification of groups. Associations between mental and physical health indicators and health-related risk behaviors were analyzed using logistic regression, adjusting for background variables including age, self-reported parental immigrant status, and parental educational attainment.</div></div><div><h3>Results</h3><div>Patterns of lifetime poly-victimization were more complex among women (7 classes) than men (4 classes). Among men, exposure was primarily characterized by childhood physical and emotional violence, as well as adult non-partner physical violence. In contrast, women's profiles often included childhood sexual violence and partner violence in adulthood, with stronger associations to multiple health problems and risk behaviors, and generally higher odds ratios compared to men. Among women, three unique clusters were identified, one of which may reflect more advanced resilience capacities compared to other clusters with similar trajectories of childhood violence exposure.</div></div><div><h3>Conclusions</h3><div>Gendered patterns of poly-victimization and their health-related consequences underscore the importance of early intervention to prevent revictimization. The identification of unique and resilient clusters among women, despite similar childhood violence exposure, highlights the need for further research into protective mechanisms and trauma-to-benefit pathways, as conceptualized within the TTB framework.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101874"},"PeriodicalIF":3.1,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The decline in the physical stature of the U.S. population parallels the diminution in the rate of increase in life expectancy","authors":"John Komlos","doi":"10.1016/j.ssmph.2025.101872","DOIUrl":"10.1016/j.ssmph.2025.101872","url":null,"abstract":"<div><div>The U.S. healthcare and food-provisioning systems have failed to create an environment in which the human biological organism can flourish. Consequently, key health outcomes, most notably life expectancy, have consistently lagged those of other high-income populations since the Reagan era, coinciding with the adoption of economic policies that increased inequality and precarity across the population. We estimate the trends in physical stature, another omnibus indicator of a population's biological well-being that reflects not only nutritional intake, inequality, and stress experienced by the population, but also the overall health environment—using a sample of 44,322 adults from the NHANES surveys, stratified by gender and three ethnic groups. We find that the height of Americans began to decline among those born around or before the early 1980s in parallel with the diminution in the rate of increase of life expectancy. The decline in adult height ranged from 0·68 ± 0.36 cm among white women to 1·97 ± 0.50 cm among Hispanic men and is statistically significant across all six demographic groups considered. This decline in heights serves as corroborating evidence that the U.S.‘s laissez-faire approach to healthcare and food provisioning delivers suboptimal population health outcomes. Public health priorities urgently need to be refocused.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101872"},"PeriodicalIF":3.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unpacking rural Heterogeneity: A proof-of-concept study of how varying rural contexts shape breast cancer screening behaviors","authors":"Jennifer L. Cruz ,&nbsp;Destiny A. Jackson ,&nbsp;Sarah L. Johns ,&nbsp;Shoba Ramanadhan ,&nbsp;Douglas A. Luke ,&nbsp;Karen M. Emmons ,&nbsp;Rachel M. Ceballos","doi":"10.1016/j.ssmph.2025.101873","DOIUrl":"10.1016/j.ssmph.2025.101873","url":null,"abstract":"<div><h3>Purpose</h3><div>Rural women in the U.S. experience persistent inequities in breast cancer (BrCa) screening access, yet rural populations are often treated as a monolith in research and practice. This study serves as a proof of concept by examining how contextual heterogeneity across rural settings in South-Central Washington shapes screening behaviors and access, emphasizing the intersection of structural, cultural, and environmental factors through a community-informed lens.</div></div><div><h3>Methods</h3><div>Guided by the Community Capitals Framework, we conducted focus groups with women in two demographically and economically distinct rural communities in South-Central Washington. Participants discussed how barriers to BrCa screening manifest across seven domains of community capital—natural, cultural, human, social, political, financial, and built—offering a multidimensional understanding of health access in context.</div></div><div><h3>Findings</h3><div>Participants across both rural settings identified overlapping community barriers, but also revealed unique, context-specific barriers. Four emergent themes captured these dynamics: (1) seasonality and competing resource demands; (2) distance as a resource-dependent constraint; (3) gendered expectations shaping care access; and (4) race and place influencing resource distribution. These findings illustrate how overlapping systems of power and community assets interact to shape health behavior and access.</div></div><div><h3>Conclusions</h3><div>Addressing rural BrCa screening inequities requires more than generic rural interventions; this study demonstrates that inequities may manifest differently across rural types, with distinct underlying dynamics shaping barriers. By showing how contextual variation influences health behaviors, this proof-of-concept study underscores the importance of disaggregating rural populations in health research and tailoring interventions to the specific mechanisms and resources operating within each context.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101873"},"PeriodicalIF":3.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden by national averages: Unveiling the complex dynamics of ethnic disparities in under-five survival across sub-Saharan Africa","authors":"Vincent Bio Bediako","doi":"10.1016/j.ssmph.2025.101870","DOIUrl":"10.1016/j.ssmph.2025.101870","url":null,"abstract":"<div><div>Under-five mortality in sub-Saharan Africa has declined markedly, yet ethnic gaps persist and may even widen despite overall gains. This study uses two consecutive rounds of Demographic and Health Surveys (2007–2022) from twelve countries to trace how child characteristics, maternal education, household wealth, and urban-rural residence drive ethnic differentials in child survival. Country-specific total births ranged from 23,109 to 127,545 per survey round. Employing survey-weighted quasi-Poisson models with person-year offsets and a sequential Shapley-value decomposition, the study estimates crude and adjusted rate ratios for pairwise ethnic comparisons. It predicts mortality rates under counterfactual socioeconomic conditions. Results show enduring disparities, for example, among the Luo versus the Kalenjin in Kenya (adjusted RR 2.15, 95 % CI 1.83–2.51) and the Hausa versus the Yoruba in Nigeria (adjusted RR 1.39, 95 % CI 1.22–1.56), with maternal education accounting for roughly one-quarter to one-third of inequality. At the same time, the role of household wealth varies by context. Sensitivity analyses examining administrative boundary effects revealed that geographic mediation accounts for 15.4 % of ethnic disparities in Ghana's centralized system and 35.1 % in Nigeria's decentralized federal structure, suggesting that apparent ethnic disparities substantially reflect differential healthcare access across administrative units rather than intrinsic cultural factors. In Ghana, targeted policies combining fee removal and culturally tailored maternal care have noticeably narrowed ethnic gaps. These findings underscore that eliminating preventable child deaths by 2030 requires interventions that address both the socioeconomic and cultural determinants of ethnic disadvantage.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101870"},"PeriodicalIF":3.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of negative wealth shock on depressive symptoms and major depressive episode among older adults","authors":"Weidi Qin ,&nbsp;Jiao Yu ,&nbsp;Belinda L. Needham ,&nbsp;Stephanie A. Robert","doi":"10.1016/j.ssmph.2025.101871","DOIUrl":"10.1016/j.ssmph.2025.101871","url":null,"abstract":"<div><div>A negative wealth shock (i.e., a sudden large loss in wealth) represents a stressful life event that threatens older adults' mental health. This study examines whether a negative wealth shock is associated with both 12-month major depressive episodes and 1-week depressive symptoms over time among older adults, compared to positive wealth without a shock. This study also examines whether baseline net worth moderates the association between a negative wealth shock and depressive symptoms. The study utilized a national sample of 15,660 individuals from six waves of the Health and Retirement Study (2008–2018). We estimated mixed-effects models based on respondents’ self-reported wealth and depressive symptoms. A negative wealth shock was defined as a loss of 75 % in total wealth compared to the previous wave. We applied inverse probability weighting to account for potential selection bias. A negative wealth shock was associated with 1.30 times higher odds of having major depressive episodes compared to positive wealth. Both a negative wealth shock (incidence rate ratio [IRR] = 1.30, 95 % Confidence Interval [CI]: 1.06–1.60) and baseline negative wealth (IRR = 1.05, 95 % CI: 1.01–1.09) were associated with a higher rate of depressive symptoms compared to positive wealth. No interaction effects between baseline net worth and a negative wealth shock on depressive symptoms were observed. A negative wealth shock in mid-to-late life has detrimental effects on both 12-month and past-week depressive symptoms, providing implications for mental health programs for older adults at financial risk.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"32 ","pages":"Article 101871"},"PeriodicalIF":3.1,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}