Multiple Roles and Women's Mental Health in Canada

Does having children matter? Associations between transitions in work-family role combinations and depressive symptoms among married women in Korea

Although having a variety of roles is generally beneficial for mental health, little is known about the relationships between work-family role combinations and depressive symptoms among married women in Korea, where child rearing is strongly considered a mother's responsibility. This study examines how the four types of work-family role combinations may be associated with depressive symptoms among married Korean women younger than 50 years old. Data were collected from 2012 through 2020 in five surveys by the Korean Longitudinal Survey of Women & Families. In total, 4811 married women (14,851 person-period observations) were analyzed using regression models with fixed effects. This enabled estimation of the within-person effects of transitions in work-family role combinations on depressive symptoms. Work-family role combinations were categorized as follows based on whether respondents had a job or at least one child: having both worker and mother roles, having a worker role only, having neither a worker nor a mother role, and having a mother role only. The findings indicate that married women who had only a mother role had more severe depressive symptoms than the other three groups. However, after controlling for whether respondents had a preschool-aged child, only those with both worker and mother roles had significantly lower levels of depressive symptoms compared with those with a mother role only. This study suggests that transitioning to being a working mother from a full-time mother may benefit the mental health of married Korean women. Furthermore, whether married women have a child critically impacts their mental health more than the number of roles. Raising a preschool-aged child seems to potentially be especially stressful for married Korean women. Working outside the home can protect the mental health of married Korean mothers who are affected by the social pressure to immerse themselves in child-rearing.

Effects of extreme precipitation on hospital visit risk and disease burden of depression in Suzhou, China

Background

The purpose of this study was to explore the impact of extreme precipitation on the risk of outpatient visits for depression and to further explore its associated disease burden and vulnerable population.

Methods

A quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was used to investigate the exposure-lag-response relationship between extreme precipitation (≥95th percentile) and depression outpatient visits from 2017 to 2019 in Suzhou city, Anhui Province, China.

Results

Extreme precipitation was positively associated with the outpatient visits for depression. The effects of extreme precipitation on depression firstly appeared at lag4 [relative risk (RR): 1.047, 95% confidence interval (CI): 1.005–1.091] and lasted until lag7 (RR = 1.047, 95% CI: 1.009–1.087). Females, patients aged ≥65 years and patients with multiple outpatient visits appeared to be more sensitive to extreme precipitation. The attributable fraction (AF) and numbers (AN) of extreme precipitation on outpatient visits for depression were 5.00% (95% CI: 1.02–8.82%) and 1318.25, respectively.

Conclusions

Our findings suggested that extreme precipitation may increase the risk of outpatient visits for depression. Further studies on the burden of depression found that females, aged ≥65 years, and patients with multiple visits were priority targets for future warnings. Active intervention measures against extreme precipitation events should be taken to reduce the risk of depression outpatient visits.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14085-w.

Determinants of mental and financial health during COVID-19: Evidence from data of a developing country

Mental and emotional issues are the top-level concerns of public health worldwide. These issues surged during Coronavirus (COVID-19) pandemic due to varied medical, social, and personal reasons. The social determinants highlighted in the literature mainly focus on household solutions rather than on increasing the financial wellbeing of individuals, especially for the most vulnerable groups where the psychological distress coming from the social inequalities cannot be entirely treated. Hence, this study attempts to familiarize the financial capability (the financial literacy, attitude, skills and behavior required for effective financial management) construct into public health domain in the times of COVID-19 as a determinant of psychological distress, and also explores the role of gender in it. The study uses Ordinary Least Square (OLS) regression analysis and employs mental distress questions and Organization for Economic Cooperation and Development (OECD) 2018 financial capability toolkit to collect data from a large sample of households from all over Pakistan. It is inferred that the higher the financial capability, the lower the financial and mental distress during COVID-19. Additionally, females are less financially knowledgeable, depict poor financial behaviors, and face more psychological issues than their counterparts. Age and education are also linked to mental stress during COVID-19. Finally, gender plays a moderating role in financial behavior, and financial and mental stress of households. As evident, COVID-19 is not going away soon hence the findings are relevant for policymakers to proactively plan for the pandemic's upcoming waves and help people be better financially equipped to fight against this or any upcoming crisis, and achieve better mental and physical health.

Stress and coping mechanism among women workers in the tobacco sector - A mixed method study

The objective of study is to determine the level of stress and the mechanisms used by women working in the tobacco sector. This study used Mixed-methods procedures. A quantitative approach was conducted to know the level of stress and coping mechanisms. Whereas a qualitative approach was conducted to explore the stress management. Respondents: 100 women working in the tobacco sector. The results are 75% of the respondents have moderate stress levels, and 2% of subjects have high-stress levels. 55% of respondents use emotional-focused coping mechanisms, and the other 45% use problem-focused coping. There is no significant correlation between the level of stress and the mechanisms used (p=0.261). Women working in the tobacco sector are experiencing stress and excessive burden due to their multiple roles. Most of respondents have moderate stress levels and use emotional-focused coping. Accepting the consequences and responsibilities of their multiple roles is one of the most important factors in stress management.

Valuation of health losses of women with multiple roles using a well-being valuation approach: Evidence from Japan

Unpaid housework among married working couples is largely done by women in Japan, causing health losses due to work-to-family conflict. However, monetary values for the poor health condition of working mothers with multiple roles have not been explored. The purpose of this study is to examine the impacts of health conditions on life satisfaction (LS) among middle-aged Japanese men and women and attach a monetary value to self-assessed poor health (SAPH). The well-being valuation approach applied monetary values to health losses among middle-aged working persons, using a total of 6,779 married workers drawn from a nationwide 6 wave (2007, 2009, 2011-2014) longitudinal data from the Japanese Life Course Panel Survey of Middle-aged Persons. Female workers having multiple roles as employees and housewives, who spent at least 35 hours per week on market work are defined as women with multiple roles. LS was used as a proxy of individuals' subjective well-being. Considering the endogeneity between SAPH and LS, I used the two-stage residual inclusion approach with generalized residuals. Major findings are (1) health losses of women with multiple roles were 1.47 times of the equivalent household income; larger than those of men with multiple roles, and (2) health losses of women with multiple roles can be reduced by around 9.5% of the equivalent household income if the spouse shares the housework by engaging in frequent cleaning of the house. Taking health losses of women with multiple roles into consideration, middle-aged men should reconsider the allocation of work attributable to the attitudes toward gender roles.

Sex × Gender and Sexual Orientation in Relation to Stress Hormones and Allostatic Load

In this selective review, emerging literature linking biological sex, sociocultural gender, and sexual orientation to stress hormone functioning and multisystemic physiological dysregulations are summarized. Beyond sex as a binary biological variable, continuums of sex hormones, gender roles, gender identity, and sexual orientation each uniquely help delineate pathways and mechanisms linked to stress-related disease trajectories. This implicates glucocorticoid functioning and allostatic load, the “wear and tear” of chronic stress in synergy with unhealthy behaviors. Clinical considerations are also discussed for the field of gender medicine.

A cross-sectional examination of the mental health of homeless mothers: does the relationship between mothering and mental health vary by duration of homelessness?

OBJECTIVES

This study draws on baseline data from the At Home/Chez Soi demonstration project to examine the association between parenting status and mental health among homeless women and whether the association varies by duration of homelessness.

SETTING

Structured interviews were conducted with participants in five cities across Canada including Moncton, Montreal, Toronto, Vancouver and Winnipeg.

PARTICIPANTS

Eligibility criteria included those with legal adult status, with a mental illness, and who lacked a regular, fixed shelter. All 713 women who participated in the larger project were selected for inclusion in this analysis.

MEASURES

The mental health conditions of interest include depression, post-traumatic stress disorder (PTSD), alcohol dependence and substance dependence.

RESULTS

The relationship between parenting status and depression, as well as PTSD, varied by duration of homelessness. Among women who had been homeless for less than 2 years, no relationship was found between parenting status and depression, or PTSD. However, among women who had been homeless for 2 or more years, the odds of depression was twice as high among parenting women compared with others (aOR=2.05, p≤0.05). A similar relationship was found between parenting status and PTSD (aOR=2.03, p≤0.05). The odds of substance dependence was found to be 2.62 times greater among parenting women compared with others and this relationship did not vary by duration of homelessness (aOR=2.62; 95% CI 1.86 to 3.69). No relationship was found between parenting and alcohol dependence.

CONCLUSIONS

Overall, the findings from this study suggest that there is a relationship between long-term homelessness and mothers' risk of poor mental health. Given the multiple demands mothers face, a failure to recognise their unique needs is likely to contribute to intergenerational legacies of homelessness and mental health problems.

TRIAL REGISTRATION NUMBER

World Health Organization's International Clinical Trials Registry Platform (ISRCTN66721740 and ISRCTN57595077).

Sex-specific interaction effects of age, occupational status, and workplace stress on psychiatric symptoms and allostatic load among healthy Montreal workers

Socio-demographics and workplace stress may affect men and women differently. The aim of this cross-sectional study was to assess sex-specific interactions among age, occupational status, and workplace Demand-Control-Support (D-C-S) factors in relation to psychiatric symptoms and allostatic load levels representing multi-systemic "wear and tear". It was hypothesized that beyond main effects, D-C-S factors would be moderated by occupational status and age in sex-specific directions predictive of subjective psychiatric symptoms and objective physiological dysregulations. Participants included healthy male (n = 81) and female (n = 118) Montreal workers aged 20 to 64 years (Men: M = 39.4 years, SD = 11.3; Women: M = 42.8 years, SD = 11.38). The Job Content Questionnaire was administered to assess workplace D-C-S factors that included psychological demands, decisional latitude, and social support. Occupational status was coded using the Nam--Powers--Boyd system derived from the Canadian census. Psychiatric symptoms were assessed using the Beck Anxiety Scale and the Beck Depression Inventory II. Sex-specific allostatic load indices were calculated based on fifteen biomarkers. Regression analyses revealed that higher social support was associated with less depressive symptoms in middle aged (p = 0.033) and older men (p = 0.027). Higher occupational status was associated with higher allostatic load levels for men (p = 0.035), while the reverse occurred for women (p = 0.048). Women with lower occupational status but with higher decision latitude had lower allostatic load levels, as did middle-aged (p = 0.031) and older women (p = 0.003) with higher psychological demands. In summary, age and occupational status moderated workplace stress in sex-specific ways that have occupational health implications.

Internal conflicts of Iranian first-time mothers in adaptation to maternal role

BACKGROUND

Studies indicate that becoming a mother is accompanied by prominent physical, social, and psychological changes which can affect not only mother's psychological healthiness, but also all other aspects of her personal and family life. The purpose of this research was to explore the struggles experienced by Iranian first-time mothers in adapting to their maternal role between 0 and 1 year after giving birth.

MATERIALS AND METHODS

A qualitative design was used in this study. Twenty-one first-time mothers with diverse ethnic backgrounds were recruited in their home or healthcare centers in Tehran and Ahwaz. Data collected through in-depth interviews were analyzed by qualitative content analysis.

RESULTS

THE ANALYSIS PRODUCED FOUR THEMES: "Unpreparedness," "lack of control," "incomplete maternal feelings," and "unstable relations." The main theme, "internal conflict," integrates all other categories and encapsulates the major changes to which women are subjected, as well as the factors distressing this experience.

CONCLUSION

Discrepancies between subjective expectations and postnatal experiences take an influential role in causing postpartum conflict and strain. The more accurate information mothers and families have about this transitory stage, the better they can get prepared to deal with it. This specifies the pivotal role of midwives, midwifery educators, and healthcare policy makers in incorporating these concepts into training programs and protocols of healthcare and support services in due time, form, and content that is in accordance with mothers' mental and psychological needs.

Mental health in Ecuadorian migrants from a population-based survey: the importance of social determinants and gender roles

PURPOSE

To describe the prevalence of and the risk factors for poor mental health in female and male Ecuadorian migrants in Spain compared to Spaniards.

METHOD

Population-based survey. Probabilistic sample was obtained from the council registries. Subjects were interviewed through home visits from September 2006 to January 2007. Possible psychiatric case (PPC) was measured as score of ≥5 on the General Health Questionnaire-28 and analyzed with logistic regression.

RESULTS

Of 1,122 subjects (50% Ecuadorians, and 50% women), PPC prevalence was higher in Ecuadorian (34%, 95% CI 29-40%) and Spanish women (24%, 95% CI 19-29%) compared to Ecuadorian (14%, 95% CI 10-18%) and Spanish men (12%, 95% CI 8-16%). Shared risk factors for PPC between Spanish and Ecuadorian women were: having children (OR 3.1, 95% CI 1.4-6.9), work dissatisfaction (OR 4.1, 95% CI 1.6-10.5), low salaries (OR 2.5, 95% CI 1.1-5.9), no economic support (OR 1.8, 95% CI 0.9-3.4), and no friends (OR 2.2, 95% CI 1.1-4.2). There was an effect modification between the nationality and educational level, having a confidant, and atmosphere at work. Higher education was inversely associated with PPC in Spanish women, but having university studies doubled the odds of being a PPC in Ecuadorians. Shared risk factors for PPC in Ecuadorian and Spanish men were: bad atmosphere at work (OR 2.4, 95% CI 1.3-4.4), no economic support (OR 3.5, 95% CI 1.3-9.5), no friends (OR 2.5, 95% CI 0.9-6.6), and low social support (OR 1.6, 95% CI 0.9-2.9), with effect modification between nationality and partner's emotional support.

CONCLUSIONS

Mental health in Spanish and Ecuadorian women living in Spain is poorer than men. Ecuadorian women are the most disadvantaged group in terms of prevalence of and risk factors for PPC.

The relationship between social roles and self-management behavior in women living with HIV/AIDS

BACKGROUND

The social roles that women perform can be complicated and may affect their health. While there is some evidence describing traditional social roles of women, there is little evidence exploring the impact of those roles on how a woman manages a chronic condition. The purpose of this paper is to identify and examine the main social roles of 48 HIV infected women, and to explore how these roles relate to their self-management of HIV/AIDS.

METHODS

Forty-eight HIV infected, adult women were recruited from HIV clinics and AIDS service organizations in Northeast Ohio. All participants participated in one of 12 digitially recorded focus groups. All data were analyzed using qualitative description methodology.

RESULTS

The participants were predominantly middle-aged (mean = 42 years), African American (69%), and single (58%). Analysis revealed six social roles that these women experience and which affect their self-management. These social roles are: Mother/Grandmother, Believer, Advocate, Stigmatized Patient, Pet Owner, and Employee. These roles had both a positive and negative effect on a woman's self-management of her HIV disease and varied by age and time living with HIV.

CONCLUSION

Women living with HIV/AIDS struggle to manage the many daily tasks required to live well with this disease. The social context in which this self-management happens is important, and the various social roles that women perform can facilitate or hinder them from completing these tasks. Healthcare and social service providers should learn about these roles in their individual patients, particularly how these roles can be developed to increase HIV/AIDS self-management.

Social roles and alcohol consumption: a study of 10 industrialised countries

The empirical evidence as regards the precise associations between alcohol use and social roles, and these associations across genders and cultures is heterogeneous. The literature tends to focus on two central but conflicting theories. The first - classic role theory - assumes that a higher number of social roles is associated with a more structured life and thus fewer opportunities to drink heavily. The second - the multiple burden hypothesis - posits that the increasing complexity of multiple social roles leads to higher stress levels, and thus to increased alcohol use. Survey data on 25-54-year olds in 10 western industrialised countries which participate in the Gender, Alcohol and Culture: An International Study (GenACIS) project were used to test whether holding the three main social roles - partnership, parenthood, and paid labour - had a more protective or a more detrimental association with problematic alcohol use than holding fewer roles. Age and education were included as possible confounders, while the outcome variables were risky single occasion drinking (RSOD) and heavy-volume drinking. For both men and women and in almost all countries, the study found that those who had all three roles were least likely to drink heavily or engage in RSOD, thus supporting the assumptions of classic role theory. It also found that the protective effect of multiple roles was more consistent for RSOD. There were a few countries where a two-role model gave a better fit. Results for Germany (RSOD), Switzerland, and the Unites States (heavy-volume drinking) indicate that the role of paid labour appears to be particularly relevant for risky alcohol use among women. Despite some variability in the association between paid labour and heavy drinking or RSOD among women, in almost all countries the greater the number of roles a person held, the lower their risk of this type of alcohol use was.

Hidden Heroines: Lone Mothers Assessing Community Health Using Photovoice

Between 2005 and 2007, a small group of lone mothers in Moncton, New Brunswick, carried out participatory action research within a university—community agency partnership. Applying the method of photovoice, the women took pictures within their community context on topics that they considered important to their health, health promotion, and quality of life. Eight themes that emerged from the process were represented with pictures and captions and presented in numerous public venues and conferences. Themes included finances, stress, support, personal development, violence and abuse, place, and transportation. The visual images and accompanying captions bring to the public arena the voices of those who are often most affected by public policy but have little, if any, input into its creation. Nurses and other health professionals can play a critical role in working toward gender and economic justice, while accompanying marginalized populations in ways that respect their beliefs, perceptions, and experiences.

The effect of social roles on mental health: a matter of quantity or quality?

The effect of social roles (partner, parent, worker) on mental health may depend on the total number or the quality of the individual occupied social roles. With longitudinal data from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), the effect of the number and quality of occupied social roles on mental health over three years was examined among 2471 men and women aged 25-55 years without mental disorders at baseline. Mental health was assessed using 3-year change in the SF-36 mental health scale as well as using the 3-year incidence of anxiety and depressive disorders defined by DSM-III criteria. The quality of social roles was assessed by the GQSB (Groningen Questionnaire Social Behavior). The number of social roles had no significant effect on the risk of developing depressive and anxiety disorders, but particularly the partner-role had a significant positive effect on mental health (beta of mental health=1.19, p=0.01; HR of incident disorders=0.75, 95% CI:0.51-1.00, p=0.05). A good quality of each of the three social roles was associated with higher levels of mental health and lower risks of incident disorders over 3 years. More than the number of social roles, knowledge about social role quality might provide opportunities for prevention of depressive and anxiety disorders.

The mental health effects of multiple work and family demands. A prospective study of psychiatric sickness absence in the French GAZEL study

BACKGROUND

Individuals who experience work stress or heavy family demands are at elevated risk of poor mental health. Yet, the cumulative effects of multiple work and family demands are not well known, particularly in men.

METHODS

We studied the association between multiple work and family demands and sickness absence due to non-psychotic psychiatric disorders in a longitudinal study conducted among members of the French GAZEL cohort study (8,869 men, 2,671 women) over a period of 9 years (1995-2003). Work stress and family demands were measured by questionnaire. Medically certified psychiatric sickness absence data were obtained directly from the employer. Rate ratios (RRs) of sickness absence were calculated using Poisson regression models, adjusting for age, marital status, social support, stressful life events, alcohol consumption, body mass and depressive symptoms at baseline.

RESULTS

Participants simultaneously exposed to high levels of work and family demands (> or =2 work stress factors and > or =4 dependents) had significantly higher rates of sickness absence due to non-psychotic psychiatric disorders than participants with lower levels of demands (compared to participants exposed to 0-1 work stress factors and with 1-3 dependents, age-adjusted rate ratios were 2.37 (95% CI 1.02-5.52) in men and 6.36 (95% CI 3.38-11.94) in women. After adjusting for baseline socio-demographic, behavioral and health characteristics, these RRs were respectively reduced to 1.82 (95% CI 0.86-3.87) in men, 5.04 (95% CI 2.84-8.90) in women. The effect of multiple work and family demands was strongest for sickness absence due to depression: age-adjusted RRs among participants with the highest level of work and family demands were 4.70 (1.96-11.24) in men, 8.57 (4.26-17.22) in women; fully adjusted RRs: 3.55 (95% CI 1.62-7.77) in men, 6.58 (95%CI 3.46-12.50) in women.

CONCLUSIONS

Men and women simultaneously exposed to high levels of work stress and family demands are at high risk of experiencing mental health problems, particularly depression.