Assessing the relative contribution of social exclusion, income-poverty, and financial strain on depressive symptoms among older people in Hong Kong

Objectives: The role of social exclusion in depressive symptoms in older people has not been examined systematically. This study examines the associations of social exclusion, income poverty, and financial strain with depressive symptoms and evaluates the moderating effect of social support in the link between social exclusion and depressive symptoms.

Method: Our sample consisted of 850 older people (65 years old or above) in Hong Kong randomly selected through a household survey. We used a logistic regression to evaluate the associations of social exclusion, income poverty, and financial strain with depressive symptoms, controlling for social support and social network variables, health indicators, and socio-demographic variables. 

Results: We found that social exclusion, income poverty, and financial strain are positively associated with depressive symptoms, but only social exclusion (OR: 2.13, 95% CI: 1.51–2.99, p < 0.001) and financial strain (OR: 1.54, 95% CI: 1.16–2.03, p < 0.01) maintain their significance after all other covariates are adjusted. Moreover, perceived social support negatively moderates the relationship between social exclusion and depressive symptoms.

Conclusion: Social exclusion is significantly associated with depressive symptoms in older people, but this association can be moderated by social support.