Abstract
Background: With ageing populations and increasing labour force participation among women over 50, their mental health and psychological well-being require attention. The multifactorial etiology of depression has been extensively studied at both the individual and societal levels. Longitudinal analyses exploring socioeconomic and political determinants and whether they influence depression severity across European countries are lacking. Objective: The objective of this study was to examine a possible correlation between socioeconomic and political factors with depression severity in women aged 50 and older in Europe and to what extent these possible correlations vary across countries. Methods: This longitudinal observational study was conducted using data from 47,426 women aged 50-89 years across 15 European countries, drawn from seven waves (2004-2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE). Depression symptoms were measured by the validated European Depression Scale (EURO-D). The Andersen Model of Health Service Utilization was applied to contextualize twelve macro-level predictors of depression. These were organized into four overarching domains-health, education/employment/finance, equality, and security. Mean EURO-D scores were calculated with respect to age group and country. Correlations between predictors and depressive symptoms were assessed using Pearson's and Adjusted Pearson's correlation coefficients to determine the strength and rank of associations. Results: Significant correlations between predictor variables and depression were identified in nine countries, especially among women aged 80-89 years. Spain and Estonia showed strong predictors across several age groups. Eastern European countries exhibited the broadest range of significant correlations. Italy and France, despite high depression levels, revealed few significant predictors. Sweden, the Netherlands, and Switzerland had lower depression scores and demonstrated clearer correlations. Factors related to LGBTQ+ rights, perceived corruption, and peace indices emerged as influential. Conclusions: Country-specific historical, cultural, and sociopolitical factors appear to shape severity of depression in older women, with the strongest effects in the oldest age groups. Predictors of EURO-D scores varied by country and age group, with differences in explanatory power. The importance of predictors varied across age groups; listing them without context misrepresents the findings. The interplay between objective indicators and public perception, especially concerning minority rights and governance, highlights the need for culturally sensitive interventions. Future prevention efforts should incorporate these determinants to improve mental health across Europe.