The association between water source and depressive symptoms in China: A cross-sectional and longitudinal study

Abstract

Background: This study investigates the associations between residential water sources and symptoms of depression and the relationships between switching residential water sources and symptoms of depression in middle-aged and elderly people in China.

Methods: The cross-sectional study included 12,713 participants and the longitudinal study included 8,286 participants. Symptoms of depression were evaluated using the Center for Epidemiologic Studies Depression Scale. Multiple logistic and Cox regression analyses were used to identify associations between water sources and symptoms of depression.

Results: Participants without tap water were more likely to have depressive symptoms than participants with tap water (odds ratio (OR): 1.30; 95% confidence interval (CI): 1.19-1.42) (hazard ratio (HR): 1.18; 95% CI: 1.09-1.28). The lack of access to tap water in residence was positively related to the prevalence and incidence of symptoms of depression in almost all subgroups. Changing the water source from non-tap to tap water decreased the risk of depressive symptoms (HR: 0.69; 95% CI: 0.60 - 0.79).

Limitations: The results may not be generalizable to the whole population.

Conclusions: These results suggest that no tap water in residence is a risk factor for depressive symptoms. Therefore, providing tap water in residence may help prevent depression.

Keywords: Chinese; Cross-sectional study; Depressive symptoms; Longitudinal study; Water source in residence.