Welfare State Regimes, Gender, and Depression: A Multilevel Analysis of Middle and High Income Countries

International Journal of Environmental Research and Public Health

Haejoo Chung⁴  Edwin Ng²  Selahadin Ibrahim²  Björn Karlsson³  Joan Benach¹  Albert Espelt⁵ 

[1] Health Inequalities Research Group (GREDS), Employment Conditions Network (EMCONET), University of Pompeu Fabra, Barcelona 08003, Spain; E-Mail:;Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 1P8, Canada; E-Mails:;Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg 405 30, Sweden; E-Mail:;Department of Health Care Management, Korea University, Seoul 136-703, Korea; E-Mail:;Public Health Agency of Barcelona (ASPB), Barcelona 08023, Spain; E-Mail:

关键词: welfare state regime;    multilevel;    global mental health;    depression;    gender;   

DOI  :  10.3390/ijerph10041324

来源: mdpi

【 摘 要 】

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.

【 授权许可】

CC BY   
© 2013 by the authors; licensee MDPI, Basel, Switzerland.