A Stanford-led study has found that experiencing gender discrimination was associated with depressive symptoms in women who had young children.
The research, published recently in EClinicalMedicine, is the first population-based study to look for links between gender discrimination and impaired mental health. It is noteworthy not just for its findings, but also as part of a larger effort to document the health effects of gender inequality on a global scale.
"We need to be investing, as a society, in calling out the impacts of gender discrimination and putting a stop to it," said Stanford global health expert Gary Darmstadt, MD, senior author of the new study and an accompanying commentary. Darmstadt has been leading an effort by scientists across the world to build an evidence base documenting health harms linked to gender inequality. The researchers hypothesize that gender inequality operates like many other kinds of stress, getting "under the skin" and causing damaging biological changes.
Their main approach has been to use existing untapped data: measures that were previously collected in large studies but were not analyzed before. Their work includes packages of papers on the impact of gender inequality in science and medicine and gender norms and adolescent health. Another collection of research, in the Journal of Global Health, will address how policies to promote gender equity -- such as laws against child marriage and in favor of parental leave -- can have positive effects for women's health.
Although girls, women and gender minorities bear the brunt of gender discrimination, men and boys are hurt by it, too, Darmstadt said: "None of us are winners when we set up an unequal system." For instance, another new paper in EClinicalMedicine shows that greater female participation in education and the work force is linked with greater life expectancy for men and women.
To understand whether experiencing gender discrimination may influence susceptibility to depression, Darmstadt's team analyzed existing data from child-bearing women who had been included in the European Longitudinal Cohort Study of Pregnancy and Childhood in the Czech Republic. The women were followed for more than a decade, beginning when they were pregnant. In general, women are about twice as likely to develop depression as men, the study notes.
During pregnancy, the more than 4,600 women in the study answered questions about their symptoms of depression and whether they felt someone had recently treated them unfairly because of their gender. The same women answered these questions again seven and 11 years later.
At baseline, about 10% of the women reported that they had experienced gender discrimination. Over the course of the study, these women were more likely than other study participants to show signs of depression, even after adjusting for variables among them.
"Depressed women tended to have more financial stress and more experience of childhood neglect and sexual abuse," Darmstadt said. But such factors did not fully explain the discrimination-depression link, he added. In addition, the study found that having more social support and having a partner who shared in stereotypically "female" household and caregiving tasks were protective against depression, meaning women were less likely to experience depressive symptoms if these factors applied to them.
The concept of connection between trauma and worsened health is not new; an extensive body of work shows biological links between a variety of adverse childhood experiences and such health problems as cancer and cardiovascular disease. Experiencing racial discrimination has been shown to harm health, too. But this is the first time the phenomenon has been documented for gender discrimination.
"The underlying idea is that discrimination is a stressor, and that it's getting under the skin," Darmstadt said. "We think increased depression may be a way in which discrimination based on gender gets translated to biological changes." Darmstadt believes the research findings indicate a need for more programs to support the mental health of people who experience gender discrimination.
In addition to continuing to publish research on the health effects of gender inequality, Darmstadt and his colleagues around the world are working with large organizations to help people figure out how to rectify the problem. For instance, the team has a grant to work with the Ethiopian government to help integrate principles of gender equality into their priorities and practices.
"Unless we're intentional about addressing something like gender discrimination, people tend to gloss over it and feel like, 'That's not really my issue to deal with,'" Darmstadt said. "What's encouraging is that there is so much action and momentum around these issues all around the world. I think that's unprecedented. It's going to remain a struggle, but I do think there is a much greater momentum than we've seen before."
Photo by Jake Melara