Global Health
Intergenerational social mobility and mental health: evidence from a Filipino birth cohort Lucy Barrass* Lucy Barrass Maria Theresa Redaniel Lucy Riglin Nanette R Lee Laura D Howe Duleeka Knipe
Evidence suggests that associations between educational attainment and mental health may vary according to social mobility i.e. changes in socioeconomic circumstances across the life course. This evidence is largely limited to high-income countries. We aimed to assess this relationship in the Philippines, a middle-income country. Using data from an ongoing birth cohort (Cebu Longitudinal Health and Nutrition Survey), we assessed the associations with mental health for both own educational attainment and intergenerational educational mobility (i.e. the difference in educational attainment between parents during pregnancy and in adulthood (age 18 and 35) in 2,038 Filipino individuals). Primary mental health outcomes were depressive symptoms, suicidal ideation and psychological distress at age 35 years, with the former two measures used as secondary outcomes at age 18. We used logistic regression models, adjusting for sex and urbanicity at birth. Individuals with lower levels of educational attainment were associated with higher odds of depressive symptoms (Odds Ratio (OR): 1.68; 95% CI: 1.11-2.52) and psychological distress (OR: 1.54; 95% CI: 1.09-2.17), but not suicidal ideation (OR: 1.43; 95% CI: 0.91-2.26), compared to those with higher educational attainment. Participants who had experienced downward educational mobility at age 35 had higher odds of depressive symptoms compared to participants remaining in higher levels of educational attainment (OR: 3.12; 95% CI: 1.46-6.66). There was no statistical evidence of this association for the other outcomes. We also did not find statistical evidence that upward social mobility was associated with mental health outcomes. Filipino individuals who were less educated than their parents had higher levels of depressive symptoms compared to those who remained in the higher education category. We found limited evidence of this associations for other measured mental health outcomes.