Gender-Specific Pathways Linking Unemployment and Depression: A Cross-National Panel Study, 2010-2023
Abstract
Objective To examine whether population-level associations between national unemployment and depression burden differ for women and men across 18 major global economies from January 1, 2010 to December 31, 2023. Patients and Methods This cross-national longitudinal panel study analyzed gender-disaggregated, country-level annual data across predefined valid observation years (2010, 2013, and from January 1, 2015 to December 31, 2023) from 18 Group of twenty nations. Age-standardized depression disability-adjusted life year rates (Global Burden of Disease 2021) served as the primary outcome; international labor organization standardized 25-64-year gender-specific unemployment rates were the exposure. Linear mixed-effects models with random country and year intercepts were specified as the primary analytic framework, adjusted for log-transformed per capita gross domestic product, Gini coefficient, and annual health expenditure (% gross domestic product). Country-level Pearson correlations and multi-dimensional sensitivity analyses were conducted to assess cross-national heterogeneity and result robustness. Results The final analytic dataset contained 282 valid country-year-gender complete observations. Each 1 percentage-point national unemployment rise corresponded to a statistically significant 16.04 (95% CI, 8.89-23.19) disability-adjusted life year per 100,000 increases in female depression burden (P<.001). No meaningful association was detected among males (β=−2.52; 95% CI, −10.67 to 5.63; P=.54). The unemployment × male gender interaction coefficient was strongly significant (β=−18.56; 95% CI, −25.22 to −11.90; P<.001). Substantial cross-country heterogeneity existed, with within-nation unemployment-depression correlation coefficients ranging from −0.87 to 0.85; gendered effects were amplified in high-income countries. All sensitivity analyses confirmed the robustness of the primary findings. Conclusion Macroeconomic unemployment growth generates disproportionately larger population-level depression burden among women across major global economies. Public health surveillance, labor stabilization policies, and clinical mental health intervention frameworks must integrate gender-sensitive design to mitigate female mental health risks during economic downturns.