State-level women's status and psychiatric disorders among US women

Soc Psychiatry Psychiatr Epidemiol. 2011 Nov;46(11):1161-71. doi: 10.1007/s00127-010-0286-z. Epub 2010 Sep 19.


Purpose: Although greater gender equality at the state-level is associated with fewer depressive symptoms in women after controlling for individual-level confounders, the extent to which state-level women's status is related to psychiatric disorders in women and gender differences in psychopathology has never been examined. We examined these associations in the current report.

Methods: We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653), a national probability sample of US adults. Respondents completed structured diagnostic assessments of DSM-IV psychiatric disorders. We used generalized estimating equations to examine associations between four state-level indicators of women's status (political participation, employment/earnings, social/economic autonomy, and reproductive rights) and odds of 12-month mood and anxiety disorders among women. We also tested whether women's status predicted the magnitude of gender differences in psychiatric disorders.

Results: State-level political participation, employment/earnings, and social/economic autonomy were unrelated to odds of 12-month mood and anxiety disorders among women. However, the prevalence of major depression and post-traumatic stress disorder was lower in states where women have greater reproductive rights (OR 0.93-0.95), controlling for individual-level risk factors. None of the women's status indicators predicted gender differences in mood and anxiety disorder prevalence.

Conclusions: State-level women's status was largely unrelated to mood and anxiety disorders in women or to gender differences in these disorders. Investigation of social factors that play a role in shaping the distribution of individual-level risk factors that are associated with gender disparities in psychiatric disorders represents an important avenue for future research.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Epidemiologic Studies
  • Female
  • Health Status Disparities*
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Surveys and Questionnaires
  • United States
  • Women's Health
  • Young Adult