A new study by researchers at the University of Cincinnati has found that patients seeking depression treatment who have lower income and education tend to have worse treatment outcomes, according to Science Daily.

The study, published in the journal Psychiatric Services, also found that patients seeking treatment for depression who are members of minority populations tend to have worse treatment outcomes even after receiving equal access to treatment.

Lead author Dr. Jeffery Strawn said that previous research has concluded that lower-income and less education affect the treatment response due to a lack of access to quality health care, “but it is hard to isolate socioeconomic factors as they are often intertwined.”

Dr. Strawn noted the study findings are still preliminary. However, he was particularly interested to find that patients without a college degree had 9.6% less improvement compared to college graduates.

“We think about these things in terms of access, we think about them in terms of income inequality, and I realize that education does track with those, but just having a college degree while controlling for all of these other factors still had a significant impact,” he said.

Another lead author Dr. Jeffrey Mills said the researchers also examined the effect of the combination of socio-economic factors, as the individual factors are often correlated.

He said that the findings do not negate the fact that a lack of access makes an impact on treatment outcomes, but it does show the importance of including a patients’ home environment when analyzing the effectiveness of treatment, according to Science Daily.

Dr. Mills said, “If you’re going home to a wealthy neighborhood with highly educated parents or spouse, then you’re arguably in a much better environment for the treatment to be effective than if you’re going to a poor neighborhood with other problems.”

Dr. Strawn said the study findings have the potential to impact clinical trials by designing studies that pay better attention to socioeconomic variables that may have been previously overlooked.

“When we don’t control for these variables, which we often do not in our clinical trials because of differences in populations, we may miss detecting an effective treatment because its effect is obscured, he said. “So it can potentially jeopardize our treatment development by not accounting for these factors.”

The article first appeared in Science Daily.