Social Determinants of Depression in a Small-Scale Subsistence Population
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background: In industrialised societies, it is well-documented that mental health has social determinants. Yet, these factors remain understudied in small-scale subsistence populations.Methodology: We quantified variation in depression sum-scores among T simane forager-farmers (n = 2665) at the level of households (n = 1098) and communities (n = 68), after adjusting forindividual-level factors. Subsequently, we investigated whether specific features of these social levels — distance to market town, community size, and household size — explained observed variation in sum-scores.Results: Depression sum-scores showed modest household (ICC ~ 0.07) and community (ICC ~ 0.07) variation. While there was moderate evidence of weak associations between lower depressionsum-scores and larger community & household sizes, this did not explain higher-level variation. However, follow-up item-level analyses revealed that these results differed between depressivesymptoms. For instance, feeling useless (ICC ~ 11%) and mistrust (ICC ~ 10%) exhibited more community-level variation than other symptoms while increased market town distance associated withdecreased rumination, but increased mistrust.Conclusions and Implications: Our results suggest that depressive symptoms may vary at social-organizational levels, though the specific determinants remain unknown. Some symptoms havehigher sensitivity to socio-ecological factors, which can be obscured by sum-score analyses.
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
OpenAlex ID: W7170136113
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