Gender inequity needs to be regarded as a social determinant of depressive symptoms: Results from the Northern Swedish cohort

Background: The importance of social and avoidable determinants of depressive symptoms has been increasingly recognized in public health research. However, when it comes to determinant of gender differences in depressive symptoms the focus is predominantly on biological unavoidable determinants. Thus, there is a need for more focus on gendered social determinants of health. The aim of this study was to analyse the importance of gender relations for depressive symptoms after taking socioeconomic factors and earlier depressive symptoms into account in the Northern Swedish cohort. Methods: A 26-year follow-up study of a cohort of all school leavers in a middle-sized industrial town in Northern Sweden was performed from age 16 until age 42. Of those still alive of the original cohort, 94% participated during the whole period and answered extensive questionnaires. Exposure was measured as socioeconomic status, financial strain, perceived gender inequity in the couple relationship and division of responsibility for domestic work. The outcome was depressive symptoms at age 42, while depressive symptoms were controlled at age 30. Results: In multivariate logistic regression analyses significant relations between financial strain and, among women only, also perceived gender equity in the couple relationship and depressive symptoms after adjustment for earlier health status, as well as for all other exposure measures. Conclusions: Financial strain, and among women, also gender inequity in the couple relationship was related to depressive mood. There is a need to pay more attention to gender relations in future research on social determinants of depressive mood.