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

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.