Welfare state regimes, gender, and depression: A multilevel analysis of middle and high income countries

Haejoo Chung, Edwin Ng, Selahadin Ibrahim, Björn Karlsson, Joan Benach, Albert Espelt, Carles Muntaner

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Using the 2002 World Health Survey, we examine the association between welfare state regimes, gender and mental health among 26 countries classified into seven distinct regimes: Conservative, Southeast Asian, Eastern European, Latin American, Liberal, Southern/Ex-dictatorship, and Social Democratic. A two-level hierarchical model found that the odds of experiencing a brief depressive episode in the last 12 months was significantly higher for Southern/Ex- dictatorship countries than for Southeast Asian (odds ratio (OR) = 0.12, 95% confidence interval (CI) 0.05-0.27) and Eastern European (OR = 0.36, 95% CI 0.22-0.58) regimes after controlling for gender, age, education, marital status, and economic development. In adjusted interaction models, compared to Southern/Ex-dictatorship males (reference category), the odds ratios of depression were significantly lower among Southeast Asian males (OR = 0.16, 95% CI 0.08-0.34) and females (OR = 0.23, 95% CI 0.10-0.53) and Eastern European males (OR = 0.41, 95% CI 0.26-0.63) and significantly higher among females in Liberal (OR = 2.00, 95% CI 1.14-3.49) and Southern (OR = 2.42, 95% CI 1.86-3.15) regimes. Our results highlight the importance of incorporating middle-income countries into comparative welfare regime research and testing for interactions between welfare regimes and gender on mental health.

Original languageEnglish
Pages (from-to)1324-1341
Number of pages18
JournalInternational Journal of Environmental Research and Public Health
Volume10
Issue number4
DOIs
Publication statusPublished - 2013 Apr 1

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Keywords

  • Depression
  • Gender
  • Global mental health
  • Multilevel
  • Welfare state regime

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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