Mediating Effect of Depression on Self-rated Health and Quality of Life of Middle-aged and Elderly in Rural Areas

농촌지역 중노년층 주민의 주관적 건강상태와 삶의 질 관계에서 우울의 매개효과

  • Received : 2020.01.13
  • Accepted : 2020.05.20
  • Published : 2020.05.28


The purpose of this study was to examine the mediating effect of depression in relation to the subjective health status and quality of life of middle-aged and elderly in rural areas. Subjective health status, depression and quality of life of 235 residents over 40 years of age in A county were collected and analyzed with t-test, ANOVA, Pearson's Correlation, and Multiple Regression, and verified with Sobel test. Depression had a mediating effect in relation to the subjective health status and quality of life of the residents. In conclusion, subjective health conditions and depression are important factors that determine the quality of life of middle-aged and elderly residents in rural areas. Various programs for improving subjective health of the residents and relieving their depression are needed to improve the quality of life of middle-aged and elderly in rural areas.


  1. T. H. Yoon & J. H. Kim. (2006). Health inequalities between rural and urban areas in South Korea. Journal of Korean Academy of Rural Health Nursing, 1(1), 11-20. DOI : 10.22715/JKARHN.2006.1.1.011.
  2. Ministry of Health & Welfare & Korea Center for Disease Control & Prevention. (2016). Korea health statistics 2016: Korea national health and nutrition examination survey (KNHANES VII-1), Available: (accessed 2019. Sep. 19).
  3. J. S. Park, S. M. Kwon & Y. J. Oh. (2009). Health promotion behavior, health problems, perceived health status and farmers' syndrome of rural residents. Journal of Agricultural Medicine & Community Health, 34(1), 47-57. DOI : 10.5393/JAMCH.2009.34.1.047.
  4. M. S. Yoon. (2007). The study on the relationship of psychosocial factors, problem drinking on quality of life for the elderly in urban and rural areas. Korean Journal of Gerontological Social Welfare, 38, 281-310.
  5. Y. J. Yi & E. J. Kim. (2015). The effects of accessibility to medical facilities and public transportation on perceived health of urban and rural elderly: Using generalized ordered logit model. Journal of The Korean Regional Development Association, 27(1), 65-88.
  6. W. J. Strawbridge & M. I. Wallhagen. (1999). Self-rated health and mortality over three decades: results from a time-dependent covariate analysis. Journal of Aging Research, 21, 402-416. DOI : 10.1177/0164027599213003.
  7. J. H. Lee & H. Y. Lee. (2016). The comparison of the influencing factors on the subjective health status of the urban-rural elderly. Journal of the Association of Korean Geographers, 22(3), 553-565.
  8. Y. J. Kim. (2010). The effect of the health status and the economic status on the mental health of the urban elderly and the rural elderly - with the focus on the comparison of the mediation model between the family life and the social life. The Journal of Rural Society, 20(1), 265-308.
  9. Y. J. Oh & Y. H. Kwon. (2012). Factors influencing perceived health status and life satisfaction in rural residents. Journal of Agricultural Medicine and Community Health, 37(3), 145-155. DOI : 10.5393/JAMCH.2012.37.3.145.
  10. M. Calvert & N. Freemantle. (2003). Use of health related quality of life in prescribing research. Part 1: why evaluate health-related quality of life? Journal of Clinical Pharmacy and Therapeutics, 28(6), 513-521. DOI : 10.1046/j.0269-4727.2003.00521.x.
  11. K. R. Shin & J. H. Yang. (2003). Influencing factors on quality of life of middle-aged women living in rural area. Journal of Korean Academy of Nursing, 33(7), 999-1007. DOI: 10.4040/jkan.2003.33.7.999.
  12. N. J. Devlin. (2017). Brooks R. EQ-5D and the EuroQol Group: Past, Present and Future. Applied Health Economics and Health Policy, 15(2), 127-137. DOI: 10.1007/s40258-017-0310-5.
  13. L S Radloff. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385-401. DOI : 10.1177/014662167700100306.
  14. M. J. Cho & K. H. Kim. (1993). Diagnostic Validity of the CES-D(Korean Version) in the Assessment of DSM-III-R Major Depression. Journal of Korean Neuropsychiatric Association, 32(3), 381-399.
  15. J. E. Ware, M. Kosinski & S. D. Keller. (1996). A 12 Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220-233. DOI: 10.1097/00005650-199603000-00003.
  16. R. M. Baron & D. A. Kenny. (1986). The moderator mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182. DOI: 10.1037//0022-3514.51.6.1173.
  17. D. H. Lew & I. S. Yeo. (2013). Relationship among subjective health recognition, activities of daily living(ADL), exercise capability and social support on the elderly. The Korean Journal of Physical Education, 52(1), 351-361.
  18. D. J. Jung. (2014). The effects of self-rated health on depression to disabled elderly: The moderating effects of psychosocial resources. Health and Social Welfare Review, 34(2), 247-275.
  19. H. W. Jeon. (2011). Depression, self-esteem, activities of daily living and life satisfaction in the community-dwelling elderly. The Korean Society of Living Environmental System, 18(6), 656-666.
  20. T. Gunzelmann, A. Hinz & E. Brahler. (2006). Subjective health in older people. GMS Psycho-Social-Medicine, 3, 1-10.
  21. K. R. Shin, J. S. Kim & M. S. Sung. (2007). Factors influencing health promoting behavior of the low-income elderly women in urban. Journal of Korean Academy of Adult Nursing, 19(5), 819-828.
  22. R. A. Miech & M. J. Shanaham. (2000). Socioeconomic status and depression over the life course. Journal of Health and Social Behavior, 41(2), 162-171. DOI: 10.2307/2676303.
  23. K. N. Park. (2004). Gender differences in the life satisfaction of elderly. Journal of Korean Gerontological Society, 24(3), 13-20.
  24. K. J. Choi et al. (2014). The development of physical fitness test battery and evaluation criteria of it for Korean elderly person. The Korean Journal of Measurement and Evaluation in Physical Education and Sports Science, 16(3), 15-30. DOI : 10.21797/ksme.2014.16.3.002.
  25. J. C. Lee, J. S. Park & G. H. Kim. (2011). The effects of stress, quality of life and family relationship of smokers and drinkers on tobacco and alcohol use: Focusing on the mediating effects of self-rated health. The Journal of The Korean Public Health Association, 37, 29-43.
  26. L. J. Liu & Q. Guo. (2008). Life satisfaction in a sample of empty-nest elderly: a survey in the rural area of a mountainous county in China. Quality of Life Research, 17(6), 823-830. DOI: 10.1007/s11136-008-9370-1.
  27. J. Chang & K. Boo. (2007). Self-rated health status of Korean older people: An introduction for international comparative studies. Korea Journal of Population Studies, 30(2), 45-69.