Mental health, family roles and employment status inside and outside the household in Spain.

OBJECTIVE: To document the prevalence of poor mental health by gender and social class, and to analyze if poor mental health is associated with the family roles or the employment status inside and outside the household.

METHOD: A cross-sectional study based on a representative sample of the Spanish population was carried out (n = 14,247). Mental health was evaluated using GHQ-12. Employment status, marital status, family roles (main breadwinner and the person who mainly carries out the household work) and educational level were considered as explanatory variables. Multiple logistic regression models stratified by gender and social class were fitted and adjusted odds ratios (aOR) were obtained.

RESULTS: Gender and social class differences in the prevalence of poor mental health were observed. Unemployment was associated with higher prevalence. Among men the main breadwinner role was related to poor mental health mainly in those that belong to manual classes (aOR = 1.2). Among women, mainly among nonmanual classes, these problems were associated to marital status: widowed, separated or divorced (aOR = 1.9) and to dealing with the household work by themselves (aOR = 1.9).

CONCLUSIONS: In Spain, gender and social class differences in mental health still exist. In addition, family roles and working situation, both inside and outside the household, could constitute a source of inequalities in mental health.