Gender and Mental Health in a Neighborhood of Managua, Nicaragua

Purpose: The Global Burden of Disease Unit (GDB) estimates that by the year 2020, mental and neurological disorders will cause almost 15% of the disabilities among the people of the world. In addition, numerous multi-national studies demonstrate that women are twice as likely as men to experience major depression, and have a higher prevalence of other common mental disorders (CMD) (World Health Organization [WHO], 2006). The WHO (2000) strongly urges that gender be incorporated into country specific mental health research because of its socially contextualized nature. Due to the high correlation between CMD and poverty, it is predicted that there are higher rates of CMD in developing nations (Chant, 2003). Yet, there is a paucity of research examining mental health in third world countries. As part of social work's mission to promote the general welfare of society on a global level (NASW, 1996), and as a response to the social consequences of a growing global economy, research investigating the well being of people in third world countries is warranted and necessary. Guided by feminist theory, which calls for a gendered analysis of the interconnection between macro political, social and economic realities and their impact on people's everyday lives, this study investigates gender roles, self-esteem, and social support as predictors of CMD among residents of Barrio 3-80 of Managua, Nicaragua.

Method: With the approval of the Nicaraguan government, a cross-sectional design was used and each household in Barrio 3-80 was approached. Data were collected from 227 adult men and women residents of the neighborhood. In face to face individual interviews, participants were asked demographic questions and questions using the validated and reliable Spanish versions of the following standardized surveys: Rosenberg Self Esteem Scale, BEM Sex Role Inventory, Multidimensional Scale of Perceived Social Support, and the General Health Questionnaire. Data were analyzed using hierarchical multiple regression analysis, correlations, and descriptive statistics. In an effort to corroborate quantitative findings, six participants answered a set of qualitative questions regarding gender roles and mental health. Thematic content analysis was conducted with the transcripts.

Results: A high level of CMD was discovered among all respondents, but women were found to have significantly higher CMD scores (t = -2.570, p = .011). Self-esteem was negatively correlated to CMD and was the only significant predictor of CMD in the overall regression model (beta = -1.209, p = .001). Self-esteem scores for both men and women were high. Poverty was not related to self-esteem or CMD. Qualitative interviews revealed three themes: (a) mental distress as a way of life; (b) an understanding of the external forces involved in poverty; (c) a societal resistance toward changing traditional gender roles.

Implications: The data provide information on a largely understudied population. The findings highlight the complexity of the relationship between poverty and CMD and the importance of culturally and contextually appropriate measurement and use of theory in research with diverse populations. The substantive agency of “oppressed” women regardless of a lack of formal power within a traditional power structure is also discussed.