# Association Between Education Levels and Sedentary Behavior With Depression Among US Adults

## TL;DR

This study finds that lower education levels and long periods of sitting are linked to higher depression risk in US adults.

## Contribution

The novel contribution is identifying the combined effect of education level and sedentary behavior on depression risk.

## Key findings

- Lower education levels are associated with a 32% lower risk of depression.
- Prolonged sedentary behavior increases depression risk by 58%.
- The highest depression risk is observed in individuals with low education and high sedentary time.

## Abstract

Earlier studies have proposed the effect of education level and sedentary behavior (SB) on the incidence of depression in adults. However, the association between the combination of education level and SB and depression in adults has not yet been investigated.

This study population consisted of US adults (aged ≥18 years) who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. A multivariable logistic regression model was employed to assess the association between education level, SB, and depression.

Of the 29,822 participants (weighted mean [SE] age, 47.9[0.2] years; 51.2% male) in our study cohort. Depression was negatively linked to the higher education level (adjusted OR = 0.68 [95% CI: 0.57–0.81], Model 4) and positively correlated to higher SB (adjusted OR = 1.58 [95% CI: 1.34–1.87]). The ORs [95% CIs] for depression were 1.40 [1.13–1.74], 1.68 [1.20–2.35], and 1.78 [1.42–2.22], respectively, among lower education groups sitting < 6 h a day (h/d), 6–8 h/d and ≥ 8 h/d compared with higher education/ sitting < 6 h/d groups (Model 3). Among participants with higher education, those who engaged in SB ≥ 8 h/d had a 1.53‐fold [95% CI, 1.31–1.79] increased risk of depression compared with those who sat for <6 h/d (p < 0.0001; Model 4).

A lower education level and prolonged SB are independently and jointly associated with an increased risk of depression. Interventions that aim to reduce SB, especially among those with lower educational levels and also among those with higher educational levels who sit for more than 8 h per day, may help reduce the prevalence of depression.

Higher education is associated with lower depression risk, but excessive sedentary behavior increases that risk regardless of education level. Our study reveals a joint association of low education and prolonged sitting time with the highest depression prevalence among US adults.