The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)

IntroductionPrevious studies have identified socioeconomic inequalities in the treatment of depression. However, these studies often take a narrow approach, focusing on a single treatment type and lacking a comprehensive theoretical framework. Moreover, income and education are frequently used inter...

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Main Authors: Lisa Colman, Katrijn Delaruelle, Piet Bracke
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Sociology
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Online Access:https://www.frontiersin.org/articles/10.3389/fsoc.2025.1204794/full
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author Lisa Colman
Katrijn Delaruelle
Piet Bracke
author_facet Lisa Colman
Katrijn Delaruelle
Piet Bracke
author_sort Lisa Colman
collection DOAJ
description IntroductionPrevious studies have identified socioeconomic inequalities in the treatment of depression. However, these studies often take a narrow approach, focusing on a single treatment type and lacking a comprehensive theoretical framework. Moreover, income and education are frequently used interchangeably as indicators of disadvantage, without distinguishing their unique impacts. This study argues that relying solely on income to explain treatment inequalities is overly simplistic, suggesting instead that education influences treatment through two distinct pathways. The study’s objectives are twofold: first, to investigate the presence of a social gradient in depression treatment, and second, to examine how this gradient is manifested.MethodsThis study utilizes data from the Belgian Health Interview Survey (BHIS), covering four successive waves: 2004, 2008, 2013, and 2018. The weighted data represent a sample of the adult Belgian population. Multinomial regression models are used to address the research aims, and models are plotted to detect trends over time using marginal means post-estimation.ResultsFindings indicate that income is not significantly related to depression treatment, while persistent educational inequalities in treatment are observed over time. Individuals with longer educational attainment are more likely to use psychotherapy alone or a combination treatment, whereas individuals with shorter educational attainment are more likely to use pharmaceutical treatment alone.DiscussionThis study demonstrates that education plays a critical role in fostering health-related knowledge and reasoning, making individuals with longer education more likely to engage in rational health behaviors and choose more effective treatments, even when these treatments require more effort and competencies. The findings underscore the importance of considering education as a key determinant of depression treatment inequalities.
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spelling doaj-art-6a6a9eda215d41efa9ffcc12933b80f72025-08-20T02:02:13ZengFrontiers Media S.A.Frontiers in Sociology2297-77752025-03-011010.3389/fsoc.2025.12047941204794The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)Lisa ColmanKatrijn DelaruellePiet BrackeIntroductionPrevious studies have identified socioeconomic inequalities in the treatment of depression. However, these studies often take a narrow approach, focusing on a single treatment type and lacking a comprehensive theoretical framework. Moreover, income and education are frequently used interchangeably as indicators of disadvantage, without distinguishing their unique impacts. This study argues that relying solely on income to explain treatment inequalities is overly simplistic, suggesting instead that education influences treatment through two distinct pathways. The study’s objectives are twofold: first, to investigate the presence of a social gradient in depression treatment, and second, to examine how this gradient is manifested.MethodsThis study utilizes data from the Belgian Health Interview Survey (BHIS), covering four successive waves: 2004, 2008, 2013, and 2018. The weighted data represent a sample of the adult Belgian population. Multinomial regression models are used to address the research aims, and models are plotted to detect trends over time using marginal means post-estimation.ResultsFindings indicate that income is not significantly related to depression treatment, while persistent educational inequalities in treatment are observed over time. Individuals with longer educational attainment are more likely to use psychotherapy alone or a combination treatment, whereas individuals with shorter educational attainment are more likely to use pharmaceutical treatment alone.DiscussionThis study demonstrates that education plays a critical role in fostering health-related knowledge and reasoning, making individuals with longer education more likely to engage in rational health behaviors and choose more effective treatments, even when these treatments require more effort and competencies. The findings underscore the importance of considering education as a key determinant of depression treatment inequalities.https://www.frontiersin.org/articles/10.3389/fsoc.2025.1204794/fulldepressiondepression treatmentmental health care useincome inequalitieseducational inequalities
spellingShingle Lisa Colman
Katrijn Delaruelle
Piet Bracke
The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)
Frontiers in Sociology
depression
depression treatment
mental health care use
income inequalities
educational inequalities
title The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)
title_full The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)
title_fullStr The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)
title_full_unstemmed The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)
title_short The role of education as a socialization mechanism in addressing the social gradient in depression treatment in Belgium (2004–2018)
title_sort role of education as a socialization mechanism in addressing the social gradient in depression treatment in belgium 2004 2018
topic depression
depression treatment
mental health care use
income inequalities
educational inequalities
url https://www.frontiersin.org/articles/10.3389/fsoc.2025.1204794/full
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