Abstract
Background
Depression and anxiety are common in women between 15 and 49 years of age. This study aims to quantify sociodemographic variation in the global burden of depression and anxiety under different regional policy contexts.
Methods
We evaluated the 30-year trends of depression and anxiety in terms of age-adjusted prevalence by the Socio-Demographic Index (SDI) using the Global Burden of Disease Study data (1990-2021) in women of reproductive age. We assessed the slope index of inequality (SII) across SDI categories with respect to 13 policy domains using the Regional Organizations Competencies (ROCO) database across 76 regional organizations from 1945 to 2015. Relative correlation coefficients were computed to assess the strength of association between policy domains and the mental health burden.
Results
During the past 30 years, the global age-standardized prevalence of depressive and anxiety disorders rose from 56 to 63 per 1,000 women of reproductive age, with the steepest increase in high SDI regions. Similar increasing pattern from 59 to 71 per 1,000 women of reproductive age was observed for anxiety. Although sociodemographic disparities persisted over the study period, the SII for depressive disorders increased from -1.70 (95%UI: -3.07, -0.32) in 1990 to 0.26 (-1.34, 1.86) in 2021, while anxiety-related SII dropped from 4.19 (3.18, 5.20) to 2.72 (1.85, 3.59). Around the world, regional Migration and Finance policies showed the strongest positive correlations with the increasing burden of depressive disorders in women of reproductive age (relative correlation coefficient: 0.40 and 0.32, respectively), whereas regional Environment and Development Cooperation policies indicated a protective impact on mental health inequalities in women of reproductive age.
Conclusions
The observed rising burden of depression and anxiety calls for continuing investment on integration of social support and mental health services into routine care for women of reproductive age.
Key messages
• Policy competencies are linked to mental health inequality in women of reproductive age.
• Strengthening equity-focused policy domains can reduce global mental health disparities.