Public assistance program and depressive symptoms of the recipient: A cross-sectional Japan Gerontological Evaluation Study

Abstract Background Health inequality between public assistance recipients and non-recipients has been reported. However, it is not clear whether this is due to the participants’ income inequality or because of other socioeconomic and psychosocial factors. We aimed to examine whether older recipients of public assistance were more likely to have depressive symptoms compared to non-recipients. Methods Data were obtained from the Japan Gerontological Evaluation Study, a 2016 community-based study of older adults. Poisson regression analyses with a robust error variance using fixed effects were conducted to examine the relationship between receiving public assistance and depressive symptoms controlling for sociodemographic factors. Depressive symptoms were assessed by the Geriatric Depression Scale 15. Results We found that the recipients of public assistance were 1.57 times (95%CI: 1.47, 1.67) more likely to have depressive symptoms compared to non-recipients. When additionally adjusting for indicators of social participation, this relationship was slightly attenuated; however, the recipients still had worse mental health (Incidence rate ratio: 1.33; 95%CI: 1.25, 1.42). Conclusions Even after controlling for sociodemographic factors, older recipients of public assistance were more likely to have depressive symptoms than non-recipients. However, social participation could slightly attenuate the negative relationship between receiving public assistance and depressive symptoms. Therefore, the public assistance program needs to consider inclusion of other healthcare supports in addition to financial support.