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Association between area deprivation and major depressive disorder in British men and women: a cohort study
  1. Olivia Remes,
  2. Louise Lafortune,
  3. Nick Wainwright,
  4. Paul Surtees,
  5. Kay-Tee Khaw,
  6. Carol Brayne
  1. Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  1. Correspondence to Olivia Remes; or260{at}


Objective Studies have shown area-level deprivation can increase the risk for mental disorders over and above individual-level circumstances, such as education and social class. The objective of this study is to determine whether area deprivation is associated with major depressive disorder (MDD) in British women and men separately while adjusting for individual-level factors.

Design Large, population study.

Setting UK population-based cohort.

Participants 30 445 people from the general population aged 40 years and older and living in England consented to participate at study baseline, and of these, over 20 000 participants completed a structured Health and Life Experiences Questionnaire used to capture MDD. Area deprivation was measured in 1991 using Census data, and current MDD was assessed in 1996–2000. 8236 men and 10 335 women had complete data on all covariates.

Primary outcome measure MDD identified according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).

Results In this study, 3.3% (339/10 335) of women and 2.1% (177/8236) of men had MDD. Men living in the most deprived areas were 51% more likely to have depression than those living in areas that were not deprived (OR=1.51, 95% CI 1.01 to 2.24; p=0.043), but the association between deprivation and MDD was not statistically significant in women (OR=1.24, 95% CI 0.93 to 1.65; p=0.143).

Conclusion This study shows that the residential environment differentially affects men and women, and this needs to be taken into account by mental health policy-makers. Knowing that men living in deprived conditions are at high risk for having depression helps inform targeted prevention and intervention programmes.

  • mental health
  • public health
  • epidemiology

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  • Contributors OR (corresponding author) had the idea for and conducted the analysis, and wrote the article, along with CB, K-TK, LLF, PS and NW. All authors provided feedback into the analysis and critically reviewed drafts of the manuscript. All authors have seen and approved the final version.

  • Funding This work was supported by the Medical Research Council UK (grant number SP2024-0201 and SP2024-0204) and Cancer Research UK (grant number G9502233).

  • Competing interests None declared.

  • Ethics approval The study has ethics committee approval from Norfolk Ethics Committee (Rec Ref: 98CN01).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

  • Patient consent for publication Not required.