Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
School of Psychology, Universidad de las Américas, Providencia, Chile.
Ann Work Expo Health. 2019 Mar 29;63(3):359-370. doi: 10.1093/annweh/wxy107.
It is widely known that women have a higher prevalence of depression than men. These differences may be explained by social differences between women and men due to gender roles. In Chile, as elsewhere, women have greater household responsibilities, lower job incomes, and especially low labor market participation. However, the incidence of these gender differences on the higher prevalence of depression in women requires further study in the Chilean context.
To identify main social differences between women and men associated with gender differences in the prevalence of depression in middle-aged Chilean men and women.
Data comes from the second Chilean National Health Survey (2009-2010), a cross-sectional, nationally representative sample (n = 2771) composed of 1103 men and 1668 women (39.8 and 60.2%, respectively), whose age range goes from 25 to 55 years old. This study was approved by the Ethics Committee of Pontificia Universidad Católica de Chile.
Prevalence ratios were calculated through Poisson regression models to estimate associations between the prevalence of past episodes of depression and social stressful life events variables for men and women separately. Gender prevalence ratios of depression (Gender PR) adjusted for age and subsequently adjusted by the social and stressful life events variables. The analyses considered factors such as age, educational level, per-capita household income, work status, role as the head of household, marital status, events of violence, family problems, personal health problems or accidents, and self-reported financial stress.
This study finds that doing housework, reporting a serious family problem and having high financial stress were associated with a higher prevalence of depression in both genders. Whereas, health problems were only associated with prevalence in men. The age-adjusted gender PR was 2.84 [confidence interval (CI): 2.0-4.1], and when all selected variables were included attenuated to a PR of 1.86 (CI 1.3-2.7). The variable most strongly associated with depression in the fully-adjusted model was housework (PR: 5.3; CI: 1.3-21.0).
In conclusion, this study finds that depression in in Chile is associated with social factors such as participation in housework, family problems, and financial stress, all of which are more common in women. To make further progress in the study of this public health problem in Chile, it is essential to incorporate more detailed characterization of gender roles in surveys and other studies. Likewise, social policies and interventions that contribute to reduce gender social inequalities in the exposure to adverse life circumstances can contribute to reduce unnecessary and avoidable gender disparities in health.
众所周知，女性患抑郁症的比例高于男性。这些差异可能可以用男女之间的社会差异来解释，这是由于性别角色造成的。在智利，和其他地方一样，女性承担着更多的家务，收入较低，尤其是劳动力市场参与度较低。然而，在智利背景下，这些性别差异对女性中更高的抑郁症发病率的影响仍需要进一步研究。
确定女性和男性之间的主要社会差异，这些差异与中年智利男女中性别差异导致的抑郁症发病率有关。
数据来自于智利第二次国家健康调查（2009-2010 年），这是一个横截面、全国代表性样本（n=2771），由 1103 名男性和 1668 名女性组成（分别为 39.8%和 60.2%），年龄范围在 25 至 55 岁之间。这项研究得到了智利天主教大学伦理委员会的批准。
通过泊松回归模型计算患病率比，以估计过去抑郁发作的患病率与男性和女性社会压力生活事件变量之间的关联。根据年龄调整了抑郁的性别患病率比（Gender PR），随后根据社会和压力生活事件变量进行了调整。分析考虑了年龄、教育程度、家庭人均收入、工作状况、家庭户主角色、婚姻状况、暴力事件、家庭问题、个人健康问题或事故以及自我报告的财务压力等因素。
本研究发现，做家务、报告严重家庭问题和高财务压力与两性的更高抑郁症患病率有关。而健康问题仅与男性的患病率有关。年龄调整后的性别 PR 为 2.84（置信区间[CI]：2.0-4.1），当纳入所有选定变量时，PR 减弱至 1.86（CI 1.3-2.7）。在完全调整模型中，与抑郁关系最密切的变量是家务（PR：5.3；CI：1.3-21.0）。
总之，本研究发现，智利的抑郁症与社会因素有关，如参与家务、家庭问题和财务压力，这些因素在女性中更为常见。为了在智利研究这一公共卫生问题方面取得进一步进展，必须在调查和其他研究中更详细地描述性别角色。同样，有助于减少性别在面临不利生活环境方面的社会不平等的社会政策和干预措施，有助于减少健康方面不必要和可避免的性别差异。
