Association between depressive symptoms and participation in influenza vaccination and health checkups: Findings from the Korea National Health and Nutrition Examination Survey

Objective: Promoting preventive healthcare service utilization is essential for disease prevention. This study explored the association between depressive symptoms and participation in influenza vaccinations and health checkups. Methods: This cross-sectional study included a nationwide sample consisting of 26,692 Korean adults. Depressive symptoms were assessed using the Patient Health Questionnaire-9 and categorized as none, mild, and moderateto-severe. Participation in influenza vaccination during the past year and routine health checkups during the past two years were assessed. Logistic regression analysis was used to determine the association between depressive symptoms and participation in influenza vaccination and health checkups, with odds ratios (ORs) and 95 % confidence intervals (CIs). Results: The prevalence of non-, mild, and moderate-to-severe depressive symptoms was 80.7 %, 14.1 %, and 5.3 %, respectively. A total of 38.5 % and 66.9 % of the individuals participated in influenza vaccination and health checkups, respectively. In the adjusted model, the ORs (95 % CIs) of the association between depressive symptoms and vaccination uptake were 0.93 (0.84-1.02) for mild and 0.78 (0.67-0.90) for moderate-to-severe depressive symptoms, compared with those for non-depressive symptoms. Additionally, the adjusted ORs (95 % CIs) of the association between depressive symptoms and health checkup participation were 0.87 (0.79-0.96) for mild and 0.76 (0.65-0.87) for moderate-to-severe depressive symptoms, compared with those for non-depressive symptoms. Conclusion: Our findings suggest that depressive symptoms are associated with the underuse of preventive healthcare services. This study underscores the need for targeted policy interventions to increase preventive healthcare utilization among individuals with depressive symptoms.