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Original Article
Exploring the Role of Social Welfare Expenditures in Depressive Symptoms Among Older Adults in Korea
Ji-Su Lee, Eun Sil Yoon, Yeongchae Song, Seowoo Park, Young Kyung Do
J Prev Med Public Health. 2025;58(4):370-378.   Published online February 18, 2025
DOI: https://doi.org/10.3961/jpmph.24.403
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AbstractAbstract AbstractSummary PDF
Objectives
This study aimed to explore the role of community-level social welfare expenditures in depressive symptoms among older adults in Korea, with a particular focus on living arrangements.
Methods
Multi-level data—comprising individual-level data from the 2019 Community Health Survey and regional-level data from the Korean Statistical Information Service—were analyzed using multi-level ordered logistic regression. The dependent variable was the severity of depressive symptoms as measured by the Patient Health Questionnaire-9 score, and the primary independent variables were per capita social welfare expenditure, living arrangements, and their cross-level interaction term.
Results
Older adults living alone exhibited more severe depressive symptoms compared to those living with others (odds ratio [OR], 1.22; p=0.006). Higher community social welfare expenditure was significantly associated with reduced depressive symptom severity (OR, 0.73; p=0.019). Moreover, the protective effect of social welfare expenditure was more pronounced among older adults living alone than among those not living alone (OR, 0.92; p=0.046). Social welfare expenditure was highly correlated with social cohesion, which weakened its independent association with depressive symptoms.
Conclusions
This study highlights the potential of community-level social welfare expenditure to mitigate depressive symptoms among older adults, particularly those who live alone. In light of the rising number of older adults living alone, these findings suggest that non-medical interventions, such as enhanced social welfare programs, may help alleviate depression in this vulnerable population. The strong positive correlation between social welfare expenditure and social cohesion also raises further research questions regarding their interrelationship.
Summary
Korean summary
자치단체의 일인당 사회복지 지출이 증가할수록 해당 지역에 거주하는 노인의 우울 증상이 전반적으로 감소하는 결과를 보였고 이러한 연관성은 특히 독거 노인에게서 더 뚜렷하게 나타났다. 이 결과는 노인인구 규모 및 독거 노인 비율의 증가가 초래할 수 있는 노인 정신 건강의 부정적 영향을 비의료적, 사회적 개입을 통해 완화할 수 있음을 시사한다.
Key Message
Higher community-level social welfare expenditure was associated with lower severity of depressive symptoms among older adults, with this association more pronounced among those living alone. Given the rising number of older adults living alone, these findings highlight the potential of non-medical, social interventions to alleviate depression in this vulnerable population.

Citations

Citations to this article as recorded by  
  • Social Isolation and Suicidal Ideation Among Older Adults in Korea: The Role of Community Welfare Spending and Community Trust
    Bomi Choi, Susanna Joo, Hyoun K. Kim
    Research on Aging.2026;[Epub]     CrossRef

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