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Cultural/ethnic differences in the prevalence of depressive symptoms among middle-aged women in Israel: the Women’s Health at Midlife Study

Blumstein, Tzvia MA1; Benyamini, Yael PhD2; Hourvitz, Ariel MD3,4; Boyko, Valentina MSc1; Lerner-Geva, Liat MD, PhD1,4

doi: 10.1097/gme.0b013e318258b1dd
Original Articles

Objective The aim of this study was to assess the prevalence and correlates of depressive symptoms among Israeli midlife women from different cultural origins and to identify sociodemographic, lifestyle, psychosocial, health, and menopause status characteristics that could explain cultural differences in depressive symptoms.

Methods Data were collected for the Women’s Health in Midlife National Study in Israel, in which women aged 45 to 64 years were randomly selected according to age and ethnic/origin group strata: long-term Jewish residents (n = 540), immigrants from the former Soviet Union (n = 151), and Arab women (n = 123). The survey instrument included a short form of the Center for Epidemiological Studies–Depression Scale dichotomized according to a <10/≥10 cutpoint.

Results The crude prevalence of depressive symptoms was 17%, 39%, and 46% for long-term residents, immigrants, and Arabs, respectively. Among women aged 45 to 54 years, 46% were postmenopausal. After adjustment for sociodemographics, health and menopause status, and lifestyle and psychosocial characteristics, immigrants and Arab women were at a significantly higher risk of depressive symptoms as compared with native-born/long-term Jewish residents (odds ratio, 2.97 and 2.79, respectively). Perimenopause status, numbers of medical symptoms, being unmarried, and negative attitude to aging were positively associated with depressive symptoms, whereas social support and perceived control were associated with lower odds of depressive symptoms. These associations differed across cultural groups when analysis was stratified by study group.

Conclusions Our findings demonstrate that the high level of depressive symptoms among Israeli women is related to cultural/minority status. The high risk for depressive symptoms in these minority groups calls for intervention policy to improve their mental health.

From the 1Women and Children’s Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research Ltd, Tel Hashomer, Israel; 2Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel; 3Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel; and 4Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Received December 29, 2011; revised and accepted April 3, 2012.

Funding/support: This study was funded by the Israel National Institute for Health Policy and Health Services Research, grant number 63/02.

Financial disclosure/conflicts of interest: None.

Address correspondence to: Tzvia Blumstein, MA, Women and Children’s Health Research Unit, The Gertner Institute for Epidemiology and Health Policy Research Ltd, Tel Hashomer, 52621, Israel. E-mail:

©2012The North American Menopause Society