Gender differences in life expectancy free of depressive symptoms in Chile between 2003 and 2016

Abstract

The aim of the study was to analyze gender differences in life expectancy free of depressive symptoms among the adult population in Chile between 2003 and 2016. The Sullivan method was used to estimate the total and marginal life expectancy, based on prevalence data from the National Health Survey (2003, 2010 and 2016), and abridged life tables for the Chilean population. There was a compression of morbidity among middle-aged men during the first period and among younger and older women during the last one. Men at all ages could expect to live a higher proportion of their lives without depressive symptoms during the whole period. The gender gap in the proportion of life expectancy free of depressive symptoms reached 10 percent points or more, considering almost all ages and periods. Unemployment and lower education increased the probability of depressive symptoms, and these effects were more marked among women. Public policies should have a gender-sensitive approach to address the gap in depression and the disadvantage experienced by women in life expectancy free of depressive symptoms, considering those dimensions that intersect with gender, such as access to education, employment or income. Impact statementDepression is the most frequent mental health problem. The international literature consistently reports a gender gap in depression. Also, an association between this gap and gender inequalities is supported by previous evidence. This study adds to the previous knowledge by examining if the advantage in life expectancy experienced by women compensates the higher prevalence of depressive symptoms across the life span through the assessment of gender differences in life expectancy free of depressive symptoms in 2003, 2010 and 2016 in Chile. Our findings showed a persistent gender gap, with women expecting to live 10 percent points or more of their remaining life with depressive symptoms, compared to men, at all ages and years considered. We analyzed the interaction of gender with other social dimensions that could exacerbate gender differences, and we observed that lower level of education and unemployment increased the probability of depressive symptoms among men and women, but the effect was larger and more persistent among women. The results of our research support the importance of including a gender approach in public policies aimed at reducing inequalities among the population in Chile, considering the intersection of gender and other social dimensions that amplify disadvantages among certain groups of the population. With respect to mental health care, efforts have been made in Chile to improve access, quality, opportunity and financial protection to health-care users via the Regime of Explicit Health Guarantees (GES program), which included depression in 2006. The guidelines of this program should be updated, considering gender perspective and tailored interventions, to improve not only the access of certain groups but also the relevance and effectiveness of treatments.