Low socioeconomic status, insulin resistance, asthma, and depression: A syndemic framework in Brazilian adolescents.
Adolescence is a critical developmental stage during which environmental, metabolic, and psychosocial factors co-occur and may interact, influencing health and creating a syndemic context that remains insufficiently explored.
We analyzed a syndemic model, considering socioeconomic determinants and metabolic risk associated with asthma and depression in adolescents.
This population-based study (n = 2515) utilized data from the RPS Brazilian Consortium Cohorts at follow-up of 18-19 years in São Luís, Brazil. A theoretical model analyzed the association among socioeconomic determinants, metabolic risk, asthma, and depression using Structural Equation Modeling (SEM). Low Socioeconomic Status was a distal determinant. The metabolic risk included the TG/HDL ratio, as an insulin resistance marker, as well as obesity. Asthma was a latent variable based on wheezing, asthma history, medical diagnosis, and frequency of wheezing. Depression was diagnosed based on major and recurrent episodes using the M.I.N.I.
Low socioeconomic status was associated with higher insulin resistance precursor (TG/HDL ratio) (standardized coefficient, SC = 0.064; p = .027) and with higher levels of depression (SC = 0.084; p = .001). Higher insulin resistance precursor was associated with asthma (SC = 0.069; p = .042). Asthma was associated with depression (SC = 0.078; p < .001). Lower insulin resistance precursor levels were observed in girls (SC = -0.254; p < .001); meanwhile, obesity (SC = 0.124; p < .001) and depression (SC = 0.165; p < .001) had higher values for them.
Our findings underscore interconnected issues of low socioeconomic status, metabolic risk, asthma, and depression in adolescents. Recognizing the syndemic framework can lead to more effective health policies to prevent long-term physical and mental health consequences.
We analyzed a syndemic model, considering socioeconomic determinants and metabolic risk associated with asthma and depression in adolescents.
This population-based study (n = 2515) utilized data from the RPS Brazilian Consortium Cohorts at follow-up of 18-19 years in São Luís, Brazil. A theoretical model analyzed the association among socioeconomic determinants, metabolic risk, asthma, and depression using Structural Equation Modeling (SEM). Low Socioeconomic Status was a distal determinant. The metabolic risk included the TG/HDL ratio, as an insulin resistance marker, as well as obesity. Asthma was a latent variable based on wheezing, asthma history, medical diagnosis, and frequency of wheezing. Depression was diagnosed based on major and recurrent episodes using the M.I.N.I.
Low socioeconomic status was associated with higher insulin resistance precursor (TG/HDL ratio) (standardized coefficient, SC = 0.064; p = .027) and with higher levels of depression (SC = 0.084; p = .001). Higher insulin resistance precursor was associated with asthma (SC = 0.069; p = .042). Asthma was associated with depression (SC = 0.078; p < .001). Lower insulin resistance precursor levels were observed in girls (SC = -0.254; p < .001); meanwhile, obesity (SC = 0.124; p < .001) and depression (SC = 0.165; p < .001) had higher values for them.
Our findings underscore interconnected issues of low socioeconomic status, metabolic risk, asthma, and depression in adolescents. Recognizing the syndemic framework can lead to more effective health policies to prevent long-term physical and mental health consequences.
Authors
Falcão Falcão, Ladeira Ladeira, Costa Costa, Batista Batista, Alves Alves, Thomaz Thomaz, Ribeiro Ribeiro
View on Pubmed