By Kathleen Raven
NEW YORK (Reuters Health) - American women face a greater risk of depression in states where personal income levels vary widely, according to a new study covering 50 U.S. states.
Huge income gaps in a community can make people feel impoverished, even when they are not poor by economic standards - and blaming themselves for their "failure" may add to depression risk, researchers said.
The effect was stronger for women than for men, they report in the Journal of Epidemiology and Community Health.
"Mental health has some individual components to it, but there are also powerful social forces that can act on it," said Nancy Beauregard, from the University of Montreal in Canada, who was not involved in the research.
The current study shows that "where you live matters, unfortunately," Beauregard told Reuters Health.
Past research has found similar trends on the local scale, but Roman Pabayo, a researcher at Harvard University's School of Public Health in Boston, and his colleagues wanted to get a broader national picture.
The researchers analyzed data from a previous national mental health survey that included 34,653 adults. They also used a formula to calculate levels of income inequality in each state, and then divided the states into five groups, from the most equal to the least.
They found that women living in states with the broadest income ranges, like New York and the District of Columbia, are nearly twice as likely to experience depression compared to those in more equal states such as Utah and Alaska.
In states with the greatest income differences, an average of 14 percent of the population lived in poverty compared to 9 percent in the more equal states.
To rule out other personal factors that could explain a person's depression risk, the researchers adjusted for family history of depression, poor physical health, unemployment, education, age, gender and other variables. They also looked at whether a person lived in an urban, suburban or rural environment.
After the adjustments, the link between state-level income inequality and depression remained strong for women in the study, but was not seen among men.
The drive to ‘keep up with the Joneses' and pursue the American dream despite low-paying jobs could build up frustration and disappointment, the study authors speculate in their report.
Pabayo told Reuters Health women should demand better access to mental health services by voting or talking to local and state representatives.
Paradoxically, "during tough economic times, the response is to cut taxes for the wealthy and cut back on social programs," he said.
On top of fraying social programs, jobs traditionally filled by women, like teaching and home care aid, generally do not get paid what they are worth to society, said Naoko Muramatsu of the University of Illinois in Chicago.
"Women are more likely than men to have jobs where even if they work harder, they cannot change the situation," said Muramatsu, who was not part of the study.
"We need to have social policies in place to protect vulnerable populations," she said, pointing to recent efforts by fast food workers to raise minimum wage as one example.
"It's important to think about what society can do, and not just women," Muramatsu added.
SOURCE: bit.ly/1bAWu7V Journal of Epidemiology and Community Health, online September 24, 2013.