Socioeconomic determinants of depression amid the anti-extradition bill protests in Hong Kong: the mediating role of daily routine disruptions

Background: Previous research has suggested a socioeconomic gradient of mental health in the face of potentially traumatic events. Nevertheless, few studies examined the intermediary mechanisms of this gradient. This study tested a hypothesised mediating effect of disruptions to daily routines (eg, eating/sleeping habits) between socioeconomic status (SES) and depression among participants and non-participants of the anti-extradition bill protests in summer 2019 in Hong Kong.

Methods: A territory-wide telephone survey was conducted during the movement in the first 3 weeks of July 2019 to collect self-report data from 1112 Cantonese-speaking Hong Kong citizens. Stratified by participation in the anti-extradition bill protests, logistic regression was conducted to examine the inverse relationship between SES and depression. Subsequently, path analysis was conducted to test the hypothesised indirect effect through daily routine disruptions.

Results: In total, 581 (52.2%) respondents participated in the anti-extradition bill protests. Logistic regression showed that higher educational attainment was protective of depression among both participants and non-participants, while the protective effect of household income level HK$40 000-HK$79 999 (compared with <HK$20 000) was only observed among participants. Path analysis showed that 50.3% of the socioeconomic gradient was explained by daily routine disruptions among participants, compared with 8.3% among non-participants.

Conclusions: Daily routine disruptions partially explain the association between low SES and depression, especially among participants of the anti-extradition bill protests. To improve population mental health, such disruptions should be mitigated.