Rich sociological literature invokes both individual life course and macro-institutional perspectives to explain gender disparities in depression. While life course theories suggest that women’s mental health is more vulnerable to adverse childhood socioeconomic status (SES), institutional theories highlight macro-level drivers of gender disparities. Integrating these perspectives, I argue that female-friendly macro-institutional contexts ameliorate gendered health disparities by reducing the gendered effects of childhood SES on adult depression. Empirically, I employ data from the European Social Survey, which is the largest cross-nationally comparable dataset containing rich information on childhood experience and health. These data thus allow me to decompose the two-way association between gender, childhood SES, and depression across countries with varying gender regimes. The empirical evidence is largely consistent with my intervention. Women experience more pernicious mental health effects from adverse childhood SES than men, but this gender inequality, and the overall harmfulness of childhood adversity among women, is smaller in countries with more female-friendly gender regimes. I conclude by implicating these findings in broader debates about the interplay between childhood SES, gender, institutional contexts, and mental health.
AlbertPR (2015) Why is depression more prevalent in women?Journal of Psychiatry and Neuroscience40(4): 219–221.
2.
AnderssonMAWilkinsonLRSchaferMH (2023) The long arm of childhood: Does it vary according to health care system quality?Journal of Health and Social Behavior64(1): 79–97.
3.
AngeliniVHowdonDDMierauJO (2019) Childhood socioeconomic status and late-adulthood mental health: Results from the survey on health, ageing and retirement in Europe. The Journals of Gerontology: Series B74(1): 95–104.
4.
BeckfieldJBambraCEikemoTA, et al. (2015) An institutional theory of welfare state effects on the distribution of population health. Social Theory & Health13(3): 227–244.
5.
BøeTBalajMEikemoTA, et al. (2017) Financial difficulties in childhood and adult depression in Europe. The European Journal of Public Health27(suppl. 1): 96–101.
6.
BolzendahlCBrooksC (2007) Women’s political representation and welfare state spending in 12 capitalist democracies. Social Forces85(4): 1509–1534.
7.
BorgmannL-SKrollLEMütersS, et al. (2019) Work-family conflict, self-reported general health and work-family reconciliation policies in Europe: Results from the European Working Conditions Survey 2015. SSM-population Health9: 100465.
8.
BrackePDelaruelleKDereuddreR, et al. (2020) Depression in women and men, cumulative disadvantage and gender inequality in 29 European countries. Social Science & Medicine267: 113354.
9.
BradyDGuerraCKohlerU, et al. (2022) The long arm of prospective childhood income for mature adult health in the United States. Journal of Health and Social Behavior63(4): 543–559.
10.
BryanMLJenkinsSP (2016) Multilevel modelling of country effects: A cautionary tale. European Sociological Review32(1): 3–22.
11.
BukodiEPaskovM (2020) Intergenerational class mobility among men and women in Europe: Gender differences or gender similarities?European Sociological Review36(4): 495–512.
12.
ConnellyJO’ConnellM (2022) Gender differences in vulnerability to maternal depression during early adolescence: Girls appear more susceptible than boys. Psychology in the Schools59(2): 297–315.
13.
CrystalS (2020) Linking the levels: Integrating individual trajectories, historical contingency, and social policy choices in cumulative advantage and disadvantage research. The Journals of Gerontology: Series B75(6): 1245–1248.
14.
CsajbókZKagstromAKåreholtI, et al. (2021) Sex differences in the association of childhood socioeconomic position and later-life depressive symptoms in Europe: The mediating effect of education. Social Psychiatry and Psychiatric Epidemiology56: 1091–1101.
15.
Cukrowska-TorzewskaEMatysiakA (2020) The motherhood wage penalty: A meta-analysis. Social Science Research88: 102416.
16.
ElderGHJohnsonMKCrosnoeR (2003) The Emergence and Development of Life Course Theory. Boston, MA: Springer.
17.
EngsterDStensötaHO (2011) Do family policy regimes matter for children’s well-being?Social Politics18(1): 82–124.
18.
FerraroKFShippeeTP (2009) Aging and cumulative inequality: How does inequality get under the skin?The Gerontologist49(3): 333–343.
19.
FerraroKFSchaferMHWilkinsonLR (2016) Childhood disadvantage and health problems in middle and later life: Early imprints on physical health?American Sociological Review81(1): 107–133.
20.
FerreraM (1996) The “southern model” of welfare in social Europe. Journal of European Social Policy6(1): 17–37.
21.
FujishiroKAhonenEQWinklerM (2021) Poor-quality employment and health: How a welfare regime typology with a gender lens illuminates a different work-health relationship for men and women. Social Science & Medicine291: 114484.
22.
GkioulekaAHuijtsTBeckfieldJ, et al. (2018) Understanding the micro and macro politics of health: Inequalities, intersectionality & institutions—A research agenda. Social Science & Medicine200: 92–98.
23.
HarariLLeeC (2021) Intersectionality in quantitative health disparities research: A systematic review of challenges and limitations in empirical studies. Social Science & Medicine277: 113876.
24.
HeisigJPSchaefferM (2019) Why you should always include a random slope for the lower-level variable involved in a cross-level interaction. European Sociological Review35(2): 258–279.
25.
HessSPollmann-SchultM (2020) Associations between mothers’ work-family conflict and children’s psychological well-being: The mediating role of mothers’ parenting behavior. Journal of Child and Family Studies29: 1561–1571.
26.
HomanP (2019) Structural sexism and health in the United States: A new perspective on health inequality and the gender system. American Sociological Review84(3): 486–516.
KorpiW (2000) Faces of inequality: Gender, class, and patterns of inequalities in different types of welfare states. Social Politics: International Studies in Gender, State & Society7(2): 127–191.
29.
KorpiW (2010) Class and gender inequalities in different types of welfare states: The Social Citizenship Indicator Program (SCIP). International Journal of Social Welfare19: S14–S24.
30.
KorpiWFerrariniTEnglundS (2013) Women’s opportunities under different family policy constellations: Gender, class, and inequality tradeoffs in western countries re-examined. Social Politics20(1): 1–40.
31.
KowalewskaH (2023) Gendered employment patterns: Women’s labour market outcomes across 24 countries. Journal of European Social Policy33(2): 151–168.
32.
KuehnerC (2017) Why is depression more common among women than among men?The Lancet Psychiatry4(2): 146–158.
33.
KuhDShlomoYB (2004) A Life Course Approach to Chronic Disease Epidemiology. Oxford: Oxford university press.
34.
LeeCParkS (2020) Examining cumulative inequality in the association between childhood socioeconomic status and body mass index from midlife to old age. The Journals of Gerontology: Series B75(6): 1264–1274.
35.
LeeCRyffCD (2019) Pathways linking combinations of early-life adversities to adult mortality: Tales that vary by gender. Social Science & Medicine240: 112566.
36.
LeeCRyffCDCoeCL (2018) Gender, early life adversity, and adult health. In: RyffCDKruegerRF (eds) The Oxford Handbook of Integrative Health Science. New York: Oxford University Press, pp. 63–74.
37.
McEwenCAMcEwenBS (2017) Social structure, adversity, toxic stress, and intergenerational poverty: An early childhood model. Annual Review of Sociology43: 445–472.
38.
MahutgaMCJorgensonAK (2016) Production networks and varieties of institutional change: The inequality upswing in post-socialism revisited. Social Forces94(4): 1711–1741.
39.
MaldonadoLCNieuwenhuisR (2015) Family policies and single parent poverty in 18 OECD countries, 1978–2008. Community, Work & Family18(4): 395–415.
40.
MínguezAM (2017) The role of family policy in explaining the international variation in child subjective well-being. Social Indicators Research134: 1173–1194.
41.
MorrisseyKKindermanP (2020) The impact of childhood socioeconomic status on depression and anxiety in adult life: Testing the accumulation, critical period and social mobility hypotheses. SSM - Population Health11: 100576.
42.
MorrisseyTW (2009) Multiple child-care arrangements and young children’s behavioral outcomes. Child Development80(1): 59–76.
43.
MortonPMFerraroKF (2020) Early social origins of biological risks for men and women in later life. Journal of Health and Social Behavior61(4): 503–522.
44.
NordenmarkM (2021) How family policy context shapes mental wellbeing of mothers and fathers. Social Indicators Research158(1): 45–57.
OrloffAS (1993) Gender and the social rights of citizenship: The comparative analysis of gender relations and welfare states.American Sociological Review.JSTOR58(3): 303–328.
47.
PalènciaLDe MoortelDArtazcozL, et al. (2017) Gender policies and gender inequalities in health in Europe: Results of the SOPHIE project. International Journal of Health Services47(1): 61–82.
48.
PalènciaLMalmusiDDe MoortelD, et al. (2014) The influence of gender equality policies on gender inequalities in health in Europe. Social Science & Medicine117: 25–33.
49.
RadloffLS (1977) The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement1(3): 385–401.
50.
SainsburyD (1999) Gender and Welfare State Regimes. Oxford: Oxford University Press.
51.
SantiniZIKoyanagiAStewart-BrownS, et al. (2021) Cumulative risk of compromised physical, mental and social health in adulthood due to family conflict and financial strain during childhood: A retrospective analysis based on survey data representative of 19 European countries. BMJ Global Health6(3): e004144.
52.
SchefferJ (2002) Dealing with Missing Data. Palmerston North: Massey University.
53.
SieberSChevalBOrsholitsD, et al. (2020) Do welfare regimes moderate cumulative dis/advantages over the life course? Cross-national evidence from longitudinal SHARE data. The Journals of Gerontology: Series B75(6): 1312–1325.
54.
StierHLewin-EpsteinNBraunM (2001) Welfare regimes, family-supportive policies, and women’s employment along the life-course. American Journal of Sociology106(6): 1731–1760.
55.
ThévenonO (2011) Family policies in OECD countries: A comparative analysis. Population and Development Review37(1): 57–87.
56.
Van de VeldeSBrackePLevecqueK (2010) Gender differences in depression in 23 European countries. Cross-national variation in the gender gap in depression. Social Science & Medicine71(2): 305–313.
57.
Van de VeldeSHuijtsTBrackeP, et al. (2013) Macro-level gender equality and depression in men and women in Europe. Sociology of Health & Illness35(5): 682–698.
58.
VerropoulouGSerafetinidouE (2019) Childhood and adulthood circumstances predicting affective suffering and motivation among older adults: A comparative study of European welfare systems. European Journal of Ageing16(4): 425–438.
59.
VerropoulouGSerafetinidouETsimbosC (2021) Decomposing the effects of childhood adversity on later-life depression among Europeans: A comparative analysis by gender. Ageing & Society41(1): 158–186.
60.
WalsemannKMGoosbyBJFarrD (2016) Life course SES and cardiovascular risk: Heterogeneity across race/ethnicity and gender. Social Science & Medicine152: 147–155.
61.
Widding-HavneraasTPedersenSH (2020) The role of welfare regimes in the relationship between childhood economic stress and adult health: A multilevel study of 20 European countries. SSM - Population Health12: 100674.
62.
WolfovaKCsajbokZKagstromA, et al. (2021) Role of sex in the association between childhood socioeconomic position and cognitive ageing in later life. Scientific Reports11(1): 4647.
63.
YangLHuYSilventoinenK, et al. (2020) Childhood adversity and depressive symptoms among middle-aged and older Chinese: Results from China health and retirement longitudinal study. Aging & Mental Health24(6): 923–931.
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