Depression in the house: The effects of household air pollution from solid fuel use among the middle-aged and older population in China
Graphical abstract
Section snippets
Background
Depression is one of the most common mental health problems nowadays. It results from a complex interaction of biological, physical, psychological, and social factors (Fuller-Thomson et al., 2016, Kessler and Bromet, 2013, Paykel, 2008). Depression has been experienced by a large number of elderly worldwide, which contributes to a high risk of disability, substantial expenditure on health services, decreased labor productivity, and thus, low quality of life which may even lead to suicide (Ekman
Data source
We obtained our data from the China Health and Retirement Longitudinal Study (CHARLS, website: http://charls.pku.edu.cn/zh-CN), a nationally representative longitudinal survey of more than 17,000 persons in China aged 45 years or older, covering 150 counties in 28 provinces. The study is biennially conducted by the National School of Development at Peking University. Ethical approval for the study was granted by the Ethical Review Committee of Peking University, and all participants provided
Summary of characteristics
A total of 9107 participants in wave 2015 were included in our study. Table 1 summarizes the characteristics of the study population across different fuel types. Over half (53.5%) were female with a mean age of 62.6 years old (SD: 9.33). The average CES-D score was 7.35 (SD: 6.06) and 9.07 (SD: 6.70) for current clean and solid fuel users, respectively. Compared with solid fuel users, participants who use clean fuel were more likely to suffer from a depression episode (28.4% and 39.4%). Two
Discussion
By using a matching method, household solid fuel use was found to have a significant effect on depression among the middle-aged and older population in China. This effect remained significant even after controlling for confounders like demographics, socioeconomic status, and health-related covariates. To our knowledge, this study is the first to employ a nationally representative data and matching technology to explore the relationship between HAP from solid fuel combustion and depression in
Conclusions
Depression is a common and costly mental disorder worldwide. Using matching data, we first provided evidence of significant associations between HAP from solid fuel use and depression among a representative sample of middle-aged and older population in China. Results show that long usage of solid fuel had major impacts on depression, considering the different groups classified by gender, age, BMI, and chronic disease presence. Women, individuals aged 65 years old and above, individuals
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgements
Financial supports from National Natural Science Foundation of China (Grant Nos. 71572013, 71602009, 71872013, and 71432002), Beijing Municipal Social Science Foundation (Grant No: 18JDGLB040), Special Fund for Joint Development Program of Beijing Municipal Commission of Education, the James Tobin Research Fund at Yale Economics Department, Yale Macmillan Center faculty research award (2014-2016; 2017-2019), the U.S. PEPPER Center Scholar Award (P30AG021342), and two NIH/NIA grants (K01AG053408
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