Department of Health Policy and Management, UC Berkeley, Berkeley, California, USA.
Institute of Global Health Sciences and Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
Matern Child Nutr. 2023 Jul;19(3):e13508. doi: 10.1111/mcn.13508. Epub 2023 Mar 30.
Eating last is a gendered cultural norm in which the youngest daughters-in-law are expected to eat last after serving others in the household, including men and in-laws. Using women's eating last as an indicator of women's status, we studied the association between eating last and women's mental health. Using four rounds of prospective cohort data of 18-25-year-old newly married women (n = 200) cohabiting with mothers-in-law between 2018 and 2020 in the Nawalparasi district of Nepal, we examined the association between women eating last and depressive symptom severity (measured using 15-item Hopkins Symptom Checklist for Depression; HSCL-D). Twenty-five percent of women reported eating last always. The prevalence of probable depression using the established cutoff was 5.5%, consistent with the prevalence of depression in the general population. Using a hierarchical mixed-effects linear regression model, we found that women who always ate last had an expected depressive symptom severity (0-3 on HSCL-D) 0.24 points (95% confidence interval [CI]: 0.13-0.36) greater compared to women who did not eat last when adjusted for demographic variables, household food insecurity, and secular trends. Sensitivity analysis using logistic regression also suggested that women who eat last have greater odds of having probable depression (adjusted odds ratio [AOR] = 4.05; 95% CI: 1.32-12.44). We explored if the association between eating last and depressive symptom severity was moderated by household food insecurity and did not observe evidence of moderation, underscoring the significance of eating last as a woman's status indicator. Our study findings highlight that newly young married women in Nepal are a vulnerable group.
最后进食是一种性别化的文化规范，即年轻的媳妇在为家中的其他人（包括男性和姻亲）服务后应该最后进食。我们以女性最后进食作为女性地位的指标，研究了最后进食与女性心理健康之间的关联。本研究使用了尼泊尔纳瓦尔帕拉西地区 2018 年至 2020 年期间 18-25 岁与婆婆同住的新婚女性（n=200）的四轮前瞻性队列数据，研究了女性最后进食与抑郁症状严重程度（使用 15 项 Hopkins 症状清单抑郁量表[HSCL-D]测量）之间的关联。25%的女性报告总是最后进食。使用既定切点，可能患有抑郁症的患病率为 5.5%，与一般人群中的抑郁症患病率一致。使用分层混合效应线性回归模型，我们发现，与从不最后进食的女性相比，总是最后进食的女性预期的抑郁症状严重程度（HSCL-D 得分为 0-3）高 0.24 分（95%置信区间[CI]：0.13-0.36），在调整人口统计学变量、家庭食物不安全和世俗趋势后。使用逻辑回归的敏感性分析也表明，最后进食的女性更有可能患有可能的抑郁症（调整后的优势比[AOR]=4.05；95%CI：1.32-12.44）。我们探索了最后进食与抑郁症状严重程度之间的关联是否受家庭食物不安全的影响，但未观察到调节作用的证据，突出了最后进食作为女性地位指标的重要性。我们的研究结果表明，尼泊尔的新婚年轻女性是一个脆弱群体。
