Preventing depression in high-income countries—A systematic review of studies evaluating change in social determinants
Open accessAbstract
We conducted a systematic review to examine whether changes in social determinants can contribute to the prevention of depression, in order to provide input for policy development and to highlight research gaps. Social determinants were defined as the structural conditions in which people live that shape their health and were categorized according to whether they pertained to societal arrangements, material resources distributed through these arrangements, or social resources that follow from interactions between people. To capture all relevant evidence we included studies that measured depressive disorders, depressive symptoms, psychological distress, mental health and prescription rates of antidepressants. We searched three databases (Medline, Embase and Psychinfo) from their inception till December 2022 and supplemented our search by reference and citation searching of the included studies. Studies were synthesized qualitatively and we used the Validity Assessment tool for econometric studies to assess study quality. Prospero submission number CRD42021236132 A total of 31,103 titles were identified, 135 studies met our inclusion criteria. The majority of studies were conducted in the United States (n = 45) or the United Kingdom (n = 39). Studies used longitudinal data (n = 61); repeated cross-sectional data (n = 20); or evaluated an intervention study (n = 7). Study designs included natural experiments (n = 19), while some used propensity score matching to construct a quasi-experiment (n = 11). Analysis methods included difference-in-difference approaches (n = 30) or regression analysis in varying forms. We found evidence that strategies that promote paid employment and parental leave policies can reduce risk of depression whereas reduced entitlements to social welfare (particularly when accompanied by obligations to enter employment), loss of income, instability of housing and collective insecurity increase depression risk. A number of studies examined moderation by gender, age category or ethnicity and of these gender was the most commonly observed moderator. Few studies tested underlying causal mechanisms with formal mediation analyses. These studies provide important indications of how intervening on social determinants of health can shape risk for depression. However, the included studies do not fully capture the complexity of the relationships between determinants and the mechanisms driving them. Future studies could take this into account, for instance by using systems approaches.
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Envisioning a Global Health Partnership Movement
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Social interventions: An effective approach to reduce adult depression?
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The impact of income on mental health
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Self-citationPaid Family Leave and Mental Health in the U.S.: A Quasi-Experimental Study of State Policies
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Exploring the effectiveness of an integrated exercise/CBT intervention for young men's mental health
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The impact of the UK National Minimum Wage on mental health
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Social protection spending and inequalities in depressive symptoms across Europe
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Urban regeneration and mental health
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Housing renewal and mental health: A case study
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The impact of universal child benefits on family health and behaviours
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Breedvelt, J. J. F., Kandola, A., Kousoulis, A. A., Brouwer, M. E., Karyotaki, E., Bockting, C. L. H., & Cuijpers, P. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.05.010 · Cited by 35 · see citing works
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Economic crisis and mental health during the COVID-19 pandemic in Japan
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Impact of a Dutch urban regeneration programme on mental health trends: a quasi-experimental study
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Short-term effects of the earned income tax credit on mental health and health behaviors
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Welfare Program Implementation and Parents’ Depression
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Poverty, Material Hardship, and Mental Health among Workers in Three Front-Line Service Occupations
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Trend of psychological distress in a Swedish population from 1989 to 1995
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Self-citationChange in adult health following medical priority rehousing: a longitudinal study
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Impact of aeroplane noise on mental and physical health: a quasi-experimental analysis
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The impact of increasing the United Kingdom national minimum wage on self‐reported health
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An Argument for the Foundations of Population Mental Health
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Depression and Alcohol Dependence among Poor Women: Before and after Welfare Reform
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The Aassociation Between the Basic Old-Age Pension and Depression of the Older Adults in Korea
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2 of the 174 references couldn’t be matched to a known paper.
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Incorporating Social and Cultural Assessments in Measurement-Based Care
Aggarwal, N. K. (2026) · Psychiatric Services · doi:10.1176/appi.ps.20250412 · Cited by 1 · see citing works
Lusher, L., Giesser, S. D., Groneberg, D., & Mache, S. (2025) · Healthcare · doi:10.3390/healthcare14010042
Zhang, C., Zhang, C., Hong, X., Xiao, Y., Ying, W., & Ma, W. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1686919
Precariousness and depressed mood: a network analysis in the multi-ethnic HELIUS study
Elsenburg, L. K., Stronks, K., Galenkamp, H., Lakerveld, J., Lok, A., Park, K., de Vasconcelos, V. V. L., & Nicolaou, M. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-026-03072-w
Self-citationBernabé‐Ortiz, A., Miranda, J. J., Checkley, W., & Diez-Canseco, F. (2026) · Health & Place · doi:10.1016/j.healthplace.2026.103709
ten Have, M., Tuithof, M., van Dorsselaer, S., Korteling, S., Shields‐Zeeman, L., & Luik, A. I. (2026) · BMC Public Health · doi:10.1186/s12889-026-28377-y
Self-citationPERCEPÇÃO DE PUÉRPERAS SOBRE A DEPRESSÃO PÓS-PARTO E O CUIDADO NA ATENÇÃO PRIMÁRIA À SAÚDE
da Silva, D. A., Ferreira, L. A., Silva, M. D., Ferreira, V. A. S., & Zuffi, F. B. (2026) · Revista Baiana de Enfermagem · doi:10.18471/rbe.v40.71659
- Authors
- Nicolaou, M., Shields-Zeeman, L. S., van der Wal, J. M., & Stronks, K.
- Affiliations
- Amsterdam University Medical Centers (NL)
- Corresponding author
- Nicolaou, Mary
- Venue
- PLOS One
- Publisher
- Public Library of Science (PLoS)
- Published
- 2025-05-21
- Volume
- 20
- Issue
- 5
- Pages
- e0323378
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC12094777
- OpenAlex
- W4410575210
- Cited by
- 7
- References
- 174
- Citations by year
- 2026: 6 · 2025: 1
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression prevention, social determinants of health, paid employment, parental leave, income loss, housing instability, collective insecurity, gender differences, antidepressant prescribing, mental health policy, high-income countries
- MeSH terms
- Depression, Humans, Developed Countries, Social Determinants of Health
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