Socioeconomic Status and Depression Among Older Adults with Disabilities in Korea: The Mediating Role of Social Support and the Moderating Effects of Self-Esteem and Public Service Utilization

Background/Objectives: Depression among older adults with disabilities represents a significant public health concern, with well-documented socioeconomic disparities. However, the mechanisms through which socioeconomic status (SES) is associated with depression in this population remain insufficiently specified. Guided by the Reserve Capacity Model (RCM), this study examines whether social support is statistically associated with the SES–depression relationship and whether this association varies according to psychosocial and structural resources. Methods: Data were drawn from the 18th wave (2023) of the Korea Welfare Panel Study (KoWePS) and its supplementary disability survey (N = 845). Moderated mediation analyses were conducted using the PROCESS macro with 5000 bootstrap samples to estimate indirect and conditional associations. Results: SES was negatively associated with depressive symptoms and positively associated with social support. Social support demonstrated a statistically significant indirect association between SES and depression, consistent with a partial mediation pattern, although the direct association remained significant. Self-esteem did not significantly moderate the indirect association. In contrast, public service utilization significantly moderated the association between social support and depression, such that the indirect association between SES and depression was attenuated at higher levels of service utilization. Conclusions: The findings indicate that depression among older adults with disabilities is associated with both socioeconomic disadvantage and variations in social and structural resources. These results underscore the relevance of considering both psychosocial and structural dimensions of resources when examining mental health disparities.