The mental health gender-gap in urban India: Patterns and narratives

Women report significantly higher levels of mental distress than men in community studies around the world. We provide further evidence on the origins of this mental health gender-gap using data from 789 adults, primarily spousal pairs, from 300 families in Delhi, India. These data were collected between 2001 and 2003. We first confirm that, like in other studies, women report higher levels of mental distress and that gender differences in education, household expenditures and age do not explain the mental health gender-gap. In contrast, women report significantly higher levels of distress than men in families with adverse reproductive outcomes, particularly the death of a child. Controlling for adverse reproductive outcomes sharply reduces the mental health gender-gap. Finally, mental health is strongly correlated with physical health for both men and women, but there is little evidence of a differential response by sex. We complement this empirical description with anthropological analysis based on ethnographic interviews with 100 men and 100 women. With the help of these ethnographic interviews we show how adverse life events for women are experienced as the inability to maintain the domestic, which seems to be at stake within their life worlds. We raise issues for further research on the apparent finding that the mental health of women and men are differentially affected by adverse reproductive events in the family in this sample.

► Combines quantitative and qualitative methodologies to analyzes the gender-gap in mental health in urban India. ► Uses a unique dataset: Mental health scores of spouses in urban India combined with data on reproductive and health outcomes. ► Shows that cumulative reproductive losses are associated with high levels of mental distress and depression in women—but not men. ► Result traced to lack of support from husband and natal kin for women dealing with adverse reproductive events. ► Argues for treating the household as a relevant unit of analysis for understanding mental health outcomes.