Journal of Preventive Medicine and Public Health

Original Articles

The Role of Family Interaction Frequency on Depressive Symptoms in Korean Older Adults Aged ≥80 and Living Alone: Horim A. Hwang, Bo Yung Bae, Hyunsuk Jeong, Minsun Yun, Jungeun Choi, Yujin Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2026;59(1):86-94. Published online December 1, 2025; DOI: https://doi.org/10.3961/jpmph.25.222

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Abstract Summary PDF Supplementary Material: Objectives
Korea is one of the fastest-aging societies, and a large proportion of its older population lives alone. This study examined the impact of family interaction frequency on the association between living alone and depressive symptoms among older adults aged ≥80 years using nationally representative survey data.
Methods
Among the 229 099 participants of the 2019 Korea Community Health Survey, 15 672 participants aged ≥80 years who either lived with close family or lived alone were included in the analysis. Participants living alone were classified according to the frequency of family interaction, ranging from less than once a month to more than once a week. The outcome variable was moderate to severe depressive symptoms, defined as a Patient Health Questionnaire-9 score of ≥10.
Results
The prevalence of depressive symptoms was higher among older adults living alone (9.4–14.1%, depending on the frequency of family interaction) than among those living with close family (6.5%). Older adults living alone who interacted with family less than once a month were more likely to report depressive symptoms compared with those living with close family (adjusted odds ratio [aOR], 1.71; 95% confidence interval [CI], 1.36 to 2.15). Weekly family interaction mitigated the impact of living alone on the prevalence of depressive symptoms (aOR 1.10; 95% CI, 0.84 to 1.42). The influence of family interaction on the association between living alone and depressive symptoms remained consistent across subgroups of men, women, and those with difficulty in daily activities.
Conclusions
Encouraging regular interaction among family members could serve as an effective strategy to protect the mental health of older adults.; Summary

Korean summary
본 연구는 2019년 지역사회건강조사에 참여한 만 80세 이상의 노인 15,672 명의 자료를 활용하여, 가족과의 정기적인 소통이 독거로 인한 우울증상 유병률의 증가에 미치는 요인을 확인하고자 하였다. 가까운 가족인 배우자 또는 자식과 동거하는 노인들과 비교해 보았을 때, 주 1회 이상의 소통을 하는 독거 노인들의 우울증상 교차비는 유의하게 높지 않았다. 가족과의 정기적인 소통의 보호효과는 성별 또는 일상생활에 어려움에 따른 층화 분석을 한 경우에도 일관된 효과를 보였다.

Key Message
This study explored whether sufficiently frequent family interactions mitigate the increased odds of reporting depressive symptoms due to living alone among older adults aged ≥80. Family interaction of once a week or more frequent mitigated the impact of living alone among the older adults. The protective effect of family interaction remained consistent across gender and difficulty in daily activities.

Prevalence and Severity of Depression Among Patients With Anemia Attending a Rural Outpatient Clinic in Faridabad, India: A Cross-sectional Study: Prince , Urvashi , Rajat Sharma, Jubair Shamsi, Satya Vir Singh; J Prev Med Public Health. 2025;58(6):629-634. Published online August 9, 2025; DOI: https://doi.org/10.3961/jpmph.25.363

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Abstract Summary PDF: Objectives
This study was performed to determine the prevalence and severity of depression among patients previously diagnosed with anemia and to explore associated clinical and socio-demographic factors.
Methods
This cross-sectional study was conducted from October 2024 to February 2025, among 300 patients with anemia attending the outpatient clinic at the Rural Health Training Centre, Amrita School of Medicine, Faridabad, Haryana. Data on socio-demographic and clinical variables were collected using a structured questionnaire. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Associations of anemia severity with depression presence and severity were analyzed using the chi-square test, logistic regression, and ordinal logistic regression, with adjustment for potential confounders.
Results
The prevalence of depression (PHQ-9 score>9) among patients with anemia was 31.3%. Severe anemia was significantly associated with higher odds of depression (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.13 to 8.07; p=0.027) and more severe depression (aOR, 2.87; 95% CI, 1.14 to 7.27; p=0.026). Symptoms such as weakness (aOR, 3.57) and shortness of breath (aOR, 2.71) were also significantly associated with depression. Moderate anemia displayed a non-significant trend.
Conclusions
Severe anemia is independently associated with both the presence and severity of depression. Routine mental health screening should be integrated into anemia management protocols, especially in rural healthcare settings.; Summary

Key Message
Anemia is a common problem in India, whereas there is a growing awareness about mental health issues like depression. This study was conducted at a Rural Health Training Centre in India, to estimate the prevalence and severity of depression among patients with anemia. The prevalence of anemia was found to be 31.3% (PHQ-9 score > 9), and severe anemia was associated with higher odds of depression and more severe depression. Our study indicated a need of routine mental health screening in patients with anemia.

Mental Disorders Mediate the Relationship Between Adverse Childhood Experiences and Suicidal Behavior in a High-risk Population: A Counterfactual Analysis From Jeju Island: Yeon Woo Oh, Dongkyu Lee, Young-Eun Jung, Sun Jae Jung; J Prev Med Public Health. 2025;58(5):505-515. Published online May 7, 2025; DOI: https://doi.org/10.3961/jpmph.25.120

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Abstract Summary PDF Supplementary Material: Objectives
Jeju Island, Korea, is characterized by a significantly higher prevalence of adverse childhood experiences (ACE, 32.4%), elevated rates of mental disorders (34.6 vs. 22.9%), and lifetime suicidal thoughts (20.6 vs. 10.7%) compared to national averages. We investigated the mediating role of mental disorders in the pathway from ACE to suicidal behavior in Jeju.
Methods
Data from the Jeju Special Self-Governing Province Mental Health Survey 2023 (n=703) were analyzed. Exposure was defined as experiencing at least one ACE from the 10-item Adverse Childhood Experience International Questionnaire. Depressive disorder, anxiety disorder, and alcohol use disorder were diagnosed using the Korean-Composite International Diagnostic Interview. Suicidal behavior was defined as experiencing suicidal ideation, planning, or attempts. A counterfactual mediation model was used to evaluate the natural direct effect and natural indirect effect (NIE) of mental disorders.
Results
The total effect of ACE on suicidal behavior showed a risk difference of 35.3 percntage points (%p). When considering all three mental disorders simultaneously, the NIE was 27.6%p, accounting for 78.1% of the total effect. Stratification analyses revealed stronger total effects in women and older adults, while the proportion mediated was higher in women and younger adults.
Conclusions
In this ACE-prevalent population, mental disorders collectively mediated approximately three-quarters of the pathway from ACE to suicidal behavior. These findings, derived through robust counterfactual analysis, suggest that strengthening screening and management protocols for mental disorders among adults with a history of ACE may effectively prevent suicide in populations with high ACE prevalence.; Summary

Korean summary
이 연구는 제주도 성인 인구를 대상으로 아동기 역경 경험(ACE)이 자살 행동에 미치는 영향 중 정신질환(우울, 불안, 알코올 사용장애)이 약 78%를 매개한다는 것을 확인했다. 이는 ACE가 높은 지역사회에서 정신질환 대한 체계적인 선별검사와 관리가 자살 예방에 효과적일 수 있음을 시사한다.

Key Message
This study found that mental disorders(depression, anxiety, and alcohol use disorders) mediate approximately 78% of the pathway from adverse childhood experiences (ACE) to suicidal behavior in Jeju Island's adult population. The findings suggest that systematic screening and management of mental disorders could effectively prevent suicide in communities with high ACE prevalence.

Exploring the Role of Social Welfare Expenditures in Depressive Symptoms Among Older Adults in Korea: Ji-Su Lee, Eun Sil Yoon, Yeongchae Song, Seowoo Park, Young Kyung Do; J Prev Med Public Health. 2025;58(4):370-378. Published online February 18, 2025; DOI: https://doi.org/10.3961/jpmph.24.403

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Abstract Summary PDF: Objectives
This study aimed to explore the role of community-level social welfare expenditures in depressive symptoms among older adults in Korea, with a particular focus on living arrangements.
Methods
Multi-level data—comprising individual-level data from the 2019 Community Health Survey and regional-level data from the Korean Statistical Information Service—were analyzed using multi-level ordered logistic regression. The dependent variable was the severity of depressive symptoms as measured by the Patient Health Questionnaire-9 score, and the primary independent variables were per capita social welfare expenditure, living arrangements, and their cross-level interaction term.
Results
Older adults living alone exhibited more severe depressive symptoms compared to those living with others (odds ratio [OR], 1.22; p=0.006). Higher community social welfare expenditure was significantly associated with reduced depressive symptom severity (OR, 0.73; p=0.019). Moreover, the protective effect of social welfare expenditure was more pronounced among older adults living alone than among those not living alone (OR, 0.92; p=0.046). Social welfare expenditure was highly correlated with social cohesion, which weakened its independent association with depressive symptoms.
Conclusions
This study highlights the potential of community-level social welfare expenditure to mitigate depressive symptoms among older adults, particularly those who live alone. In light of the rising number of older adults living alone, these findings suggest that non-medical interventions, such as enhanced social welfare programs, may help alleviate depression in this vulnerable population. The strong positive correlation between social welfare expenditure and social cohesion also raises further research questions regarding their interrelationship.; Summary

Korean summary
자치단체의 일인당 사회복지 지출이 증가할수록 해당 지역에 거주하는 노인의 우울 증상이 전반적으로 감소하는 결과를 보였고 이러한 연관성은 특히 독거 노인에게서 더 뚜렷하게 나타났다. 이 결과는 노인인구 규모 및 독거 노인 비율의 증가가 초래할 수 있는 노인 정신 건강의 부정적 영향을 비의료적, 사회적 개입을 통해 완화할 수 있음을 시사한다.

Key Message
Higher community-level social welfare expenditure was associated with lower severity of depressive symptoms among older adults, with this association more pronounced among those living alone. Given the rising number of older adults living alone, these findings highlight the potential of non-medical, social interventions to alleviate depression in this vulnerable population.

The Trajectory of Depressive Symptoms Across Years of Community Care Utilization Among Older Adults: A 14-Year Follow-up Study Using the ‘Korean Welfare Panel Survey’: Il-Ho Kim, Cheong-Seok Kim, Min-Hyeok Jeong; J Prev Med Public Health. 2023;56(6):495-503. Published online October 6, 2023; DOI: https://doi.org/10.3961/jpmph.23.022

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Abstract Summary PDF

Objectives
While older adults using community care services are known to be vulnerable for depression, community care utilization (CCU) may help to improve the mental health of these elderly. To date, however, it is much less clear how CCU affects depressive symptoms in the elderly population. This study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea.
Methods
Using the 2006-2019 Korean Welfare Panel Survey, this study is focused on elderly born in 1940 or earlier and selected 3281 persons for baseline interviews in 2006. This consisted of 35 800 person-year observations during a period of 14 years. Panel data analysis were employed to construct years of CCU.
Results
After controlling for covariates, linear term of years using community care was negatively associated with depressive symptoms, but a quadratic term was positively significant. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased. The level of depressive symptoms at the 14th year of using community care remains significantly lower than the level at the outset of its utilization.
Conclusions
This finding implies that CCU could be beneficial for improving mental health among older adults.

Summary

Korean summary
한국복지패널조사(2006-2019년)를 활용하여 지역사회 돌봄서비스의 이용기간(14년 간)에 따른 우울변화궤적을 분석하였다. 분석결과, 지난 14년간 돌봄서비스 이용기간에 따른 우울증상의 궤적은 U자형을 따랐다. 즉 노인은 돌봄서비스를 이용한 첫 해에 가장 높은 우울 수준을 보고하였으며, 이후 9년간 지속적으로 감소하였다가, 점차 증가하는 추세를 보였다.

Key Message
Using the 2006-2019 Korean Welfare Panel Survey, this study focuses on the trajectory of depressive symptoms across years of CCU among older adults in Korea. The trajectory of depressive symptoms across the years of CCU follows a U-shaped curve. Older adults in the first year of using community care reported the highest level of depressive symptoms. However, a significant and steady decrease in depressive symptoms was observed during the following 9 years of CCU, which then gradually increased.

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Home- and community-based elderly care reform and mental health: evidence from China’s middle-aged and older adults
Shuni Zhang, Cui’e Zhang
Applied Economics.2026; : 1. CrossRef

Postpartum Depression in Young Mothers in Urban and Rural Indonesia: Alifa Syamantha Putri, Tri Wurisastuti, Indri Yunita Suryaputri, Rofingatul Mubasyiroh; J Prev Med Public Health. 2023;56(3):272-281. Published online May 7, 2023; DOI: https://doi.org/10.3961/jpmph.22.534

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