Original article
A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: does school context matter?

https://doi.org/10.1067/S0022-3476(03)00456-6Get rights and content

Abstract

Objective

To determine whether the socioeconomic context of the school environment is associated with adolescent depressive symptoms independent of individual household income.

Study design

Data were drawn from a 1995 nationally representative study of 7th to 12th grade students. Multivariable linear regression at the school and individual levels assessed the relation between income and depressive symptoms. Multilevel modeling techniques were then used to understand how these factors are jointly associated with adolescent depressive symptoms.

Participants

Adolescents (n = 13,235) in grades 7 through 12 from 132 schools whose parent provided income information.

Results

Linear regression analyses indicated that lower household income, average school income, and increasing school-level income inequality were significantly (P<.001) associated with depressive symptoms. Further examination of these relations through multilevel modeling indicated that both household income (P<.01) and average school income (P<.05) were significantly related to depressive symptoms after adjusting for covariates, with evidence for an interaction between the two. The impact of lower household income on depressive symptoms was approximately 2-fold greater for students attending a poor versus a rich school.

Conclusions

School context is associated with adolescents' depressive symptoms, even after adjusting for individual-level factors. The school environment may partially buffer the adverse influence of lower household income on adolescent depressive symptoms.

Section snippets

Sample descriptions

This study uses data collected as part of Wave 1 (1995) of the National Longitudinal Study of Adolescent Health (Add Health). Add Health is a comprehensive, nationally representative, school-based study of US adolescents in grades 7 through 12.20 The hierarchical nature of our research questions and these data create two samples, one sample of individuals who are nested within a second sample of schools. There were 13,285 youths in the weighted, in-home interview, whose parents provided income

Description of the samples

Table I provides descriptive statistics related to both the individual adolescent and the school-level samples. The majority of adolescents were white, but the distribution is comparable to that of 1995 US Census data. Two thirds came from families without a college-educated parent. Almost 1 in 10 adolescents (9.2%) had a CES-D score above the cut-point predictive of major depressive disorder.27 The individual-level median household income was $40,000, close to the median school-level income.

Discussion

These data indicate that even when controlling for individual household income, school-level income measures are associated with depressive symptoms among youth. Our data support prior studies that have shown significant effects of individual-level SES indicators on adolescent depressive symptomatology.19., 28., 29., 30. To our knowledge, however, no prior studies have assessed contextual effects of SES on adolescents' depressive symptoms. Although the effects were small, we found that

Acknowledgements

We thank Jack P. Shonkoff, Ardythe L. Morrow, and Robert C. Whitaker for comments on earlier versions of this paper. This research uses data from the Add Health project, a program project designed by J. Richard Udry (PI) and Peter Bearman and funded by grant P01-HD31921 from the National Institute of Child Health and Human Development to the Carolina Population Center, University of North Carolina at Chapel Hill, with cooperative funding from 17 other agencies. Persons interested in obtaining

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