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Women's status and depressive symptoms: A multilevel analysis


  • Chen, Ying-Yeh
  • Subramanian, S. V.
  • Acevedo-Garcia, Doloros
  • Kawachi, Ichiro


The effects of state-level women's status and autonomy on individual-level women's depressive symptoms were examined. We conducted a multi-level analysis of the 1991 longitudinal follow up of the 1988 National Maternal Infant Health Survey (NMIHS), with 7789 women nested within the fifty American states. State-level women's status was assessed by four composite indices measuring women's political participation, economic autonomy, employment & earnings, and reproductive rights. The main outcome measure was symptoms of depression (Center for Epidemiologic Studies Depression Scale, CES-D). The participants were a nationally representative stratified random sample of women in the USA aged between 17 and 40 years old who gave birth to live babies in 1988, were successfully contacted again in 1991 and provided complete information on depressive symptoms. Women who were younger, non-white, not currently married, less educated or had lower household income tended to report higher levels of depressive symptoms. Compared with states ranking low on the employment & earnings index, women residing in states that were high on the same index scored 0.85 points lower on the CES-D (p

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  • Chen, Ying-Yeh & Subramanian, S. V. & Acevedo-Garcia, Doloros & Kawachi, Ichiro, 2005. "Women's status and depressive symptoms: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 60(1), pages 49-60, January.
  • Handle: RePEc:eee:socmed:v:60:y:2005:i:1:p:49-60

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    References listed on IDEAS

    1. Kawachi, Ichiro & Kennedy, Bruce P. & Gupta, Vanita & Prothrow-Stith, Deborah, 1999. "Women's status and the health of women and men: a view from the States," Social Science & Medicine, Elsevier, vol. 48(1), pages 21-32, January.
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    Cited by:

    1. García-Calvente, Mar & Marcos-Marcos, Jorge & del Río-Lozano, María & Hidalgo-Ruzzante, Natalia & Maroto-Navarro, Gracia, 2012. "Embedded gender and social changes underpinning inequalities in health: An ethnographic insight into a local Spanish context," Social Science & Medicine, Elsevier, vol. 75(12), pages 2225-2232.
    2. Roberts, Sarah C.M., 2012. "Macro-level gender equality and alcohol consumption: A multi-level analysis across U.S. States," Social Science & Medicine, Elsevier, vol. 75(1), pages 60-68.
    3. Backhans, Mona Christina & Burström, Bo & Lindholm, Lars & Månsdotter, Anna, 2009. "Pioneers and laggards - Is the effect of gender equality on health dependent on context?," Social Science & Medicine, Elsevier, vol. 68(8), pages 1388-1395, April.
    4. repec:eee:socmed:v:182:y:2017:i:c:p:127-135 is not listed on IDEAS
    5. Dahlin, Johanna & Härkönen, Juho, 2013. "Cross-national differences in the gender gap in subjective health in Europe: Does country-level gender equality matter?," Social Science & Medicine, Elsevier, vol. 98(C), pages 24-28.
    6. Mullany, Britta C. & Hindin, Michelle J. & Becker, Stan, 2005. "Can women's autonomy impede male involvement in pregnancy health in Katmandu, Nepal?," Social Science & Medicine, Elsevier, vol. 61(9), pages 1993-2006, November.
    7. Propper, Carol & Jones, Kelvyn & Bolster, Anne & Burgess, Simon & Johnston, Ron & Sarker, Rebecca, 2005. "Local neighbourhood and mental health: Evidence from the UK," Social Science & Medicine, Elsevier, vol. 61(10), pages 2065-2083, November.
    8. Blight, Karin Johansson & Ekblad, Solvig & Persson, Jan-Olov & Ekberg, Jan, 2006. "Mental health, employment and gender. Cross-sectional evidence in a sample of refugees from Bosnia-Herzegovina living in two Swedish regions," Social Science & Medicine, Elsevier, vol. 62(7), pages 1697-1709, April.


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