Mental Health Disadvantage Research Articles

The rural side of the rainbow: Mental health and the intersections of geography, sexuality, and partnership.

Lesbian, gay, and bisexual (LGB) persons tend to be geographically concentrated in larger metropolitan areas and research persistently observes LGB persons as a disadvantaged population for mental health outcomes when compared to their heterosexual counterparts. Conflicting evidence suggests that mental health risk exposures are greater for LGB people in rural spaces while other research posits that urban residency is more detrimental for LGB mental health. One positively contributing factor to the mental well-being of LGB persons is their partnership status. To date, no study estimates how partnership may ameliorate unfavourable mental health outcomes for LGB populations in urban and rural areas. Using 10 years of pooled data from the nationally representative Canadian Community Health Survey (CCHS), this study examines mental health and the intersection of sexuality, geographic residency, and partnership. Logistic regression models estimate the intersections of sexuality, geography, and partnership status on mental health, stratified by respondents' gender. Findings show partnered gay men in rural areas experiencing better mental health than their partnered heterosexual counterparts in the largest urban cities. Although not significant, the same pattern is observed for partnered lesbian women who do not experience a significant mental health disadvantage at any geographic level. Regardless of partnership and geographic space, bisexual men, and especially bisexual women, exhibit worse mental health outcomes compared to their heterosexual counterparts.

Southern California Asian Americans and the Obesity Epidemic: A Qualitative Study to Improve Understanding and Cultural Competence

ABSTRACT Background Obesity continues to be a public health concern in the United States, yet limited research exists on the impact of obesity and weight gain among Asian Americans. Purpose The purpose of this study was to illuminate the lived realities and physical, mental, and social impacts of obesity on overweight and obese Asian Americans in Southern California. Methods A basic qualitative exploratory approach was used. Twenty-five participants were interviewed, leveraging a protocol derived from the health belief model (HBM). Results Six themes highlight obesity’s impact among Asian Americans in Southern California: physical and mental health disadvantages, motivation and consistency, taboo nature of being overweight or obese, model minority misnomer, cultural incongruence, and perception of BMI as an outdated measure. Discussion Findings reveal obesity’s impact among Asian Americans to be complex, linked to both internal and external factors, and suggest that this population is as important as others when discussing obesity prevention. Translation to Health Education Practice Health Educators and health professions need to improve their understanding of the complexities and impact obesity has among Asian Americans and increase cultural competence to develop more responsive obesity and weight interventions and Health Education content. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Gig work and mental health during the Covid-19 pandemic: A gendered examination of comparisons with regular employment and unemployment

The rise of the platform economy during the Covid-19 pandemic has stimulated extensive discussions about whether gig workers can obtain equivalent mental health benefits of regular paid employment. Drawing on nationally representative data in the UK, this study aims to examine (1) whether transitioning from no paid work to gig work during Covid-19 is associated with better or worse mental health compared with those who remained not employed and those who became employed in regular jobs; (2) what mechanisms can explain the mental health differences; (3) how the patterns may differ by gender. The results show that transition into gig work is associated with better mental health compared with those who remained not employed, but this pattern is only for male (rather than female) gig workers and can be largely explained by their better financial situation and lower level of loneliness. For both men and women, the transition into gig work is associated with worse mental health compared with the transition into regular employment, but the mechanisms vary across genders. For male gig workers, both higher levels of financial precarity and loneliness in gig work can explain their mental health disadvantages compared with regular workers, but for female gig workers, none of them is at work. These findings facilitate a better understanding of the health consequences of the gig economy, revealing important gender-differentiated socio-psychological mechanisms through which gig work shapes mental health.

Health Care Utilization Following Interventions to Improve Social Well-Being

It has been suggested that interventions that aim to improve social well-being may contribute to decreased health care use; however, such evidence has not been fully systematically synthesized. To systematically review and meta-analyze available evidence on the associations between psychosocial interventions and health care utilization. Medline, Embase, PsycInfo, Cumulated Index to Nursing and Allied Health Literature, Cochrane, Scopus, Google Scholar, and reference lists of systematic reviews were searched from inception until November 31, 2022. Included studies were randomized clinical trials reporting on both health care utilization and social well-being outcomes. The reporting of the systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Full-text and quality assessments were conducted by 2 reviewers independently. Multilevel random-effects meta-analyses were used to synthesize the data. Subgroup analyses were conducted to examine the characteristics associated with decreased health care use. The outcome of interest was health care utilization, including primary, emergency, inpatient, and outpatient care services. Social well-being was measured as social support, social participation, social relationships, community support, social integration, or loneliness. A total of 41 studies were retrieved from 18 969 citations; 37 studies were eligible for meta-analysis. Data were analyzed for 7842 participants, including 2745 older adults, 1579 young women considered to be at risk of social and mental health disadvantages, 1118 people with chronic illnesses, 1597 people with mental illnesses, and 803 caregivers. The odds ratio (OR) random-effects model showed an overall reduction in health care use (OR, 0.75; 95% CI, 0.59 to 0.97), but the standardized mean difference (SMD) random effect model showed no association. An improvement in health care utilization was observed in association with social support interventions (SMD, 0.25; 95% CI, 0.04 to 0.45) but not in loneliness interventions. Subgroup analysis indicated a reduced length of inpatient visits (SMD, -0.35; 95% CI, -0.61 to -0.09) and number of emergency care visits (OR, 0.64; 95% CI, 0.43 to 0.96) following the intervention. However, an increase in outpatient care associated with psychosocial interventions was observed (SMD, 0.34; 95% CI, 0.05 to 0.62). The largest reductions in health care use were associated with interventions among caregivers (OR, 0.23; 95% CI, 0.07 to 0.71) and individuals with mental illnesses (OR, 0.31; 95% CI, 0.13 to 0.74). These findings suggest that psychosocial interventions were associated with most measures of health care utilization. As the association differed by participant and intervention delivery characteristics, these characteristics should be considered in the design of future interventions.

The Disproportionate Mental Health Burden Among Incarcerated Transgender and Gender Diverse People.

This article examines the distribution of self-reported mental health conditions and clinical contact among incarcerated transgender and gender diverse (TGD) individuals compared to cisgender women and men. Data are derived from the 2016 Survey of Prison Inmates. Results indicate that TGD respondents report more mental health symptoms, conditions, and clinical contact than their cisgender counterparts. The findings have important implications for the mental health disadvantages experienced by TGD people currently in prison.

"Si Mis Papas Estuvieran Aquí": Unaccompanied Youth Workers' Emergent Frame of Reference and Health in the United States.

Relying on in-depth interviews and ethnographic data in Los Angeles, California, this study examines the health experiences of unaccompanied, undocumented Latin American-origin immigrant youth as they come of age as low-wage workers. Findings demonstrate that unaccompanied, undocumented youth undergo cumulative physical and mental health disadvantages in the United States's secondary labor market and during critical developmental life stages while lacking the parental monitoring and guidance to navigate them. Developing comparisons between their past and present living conditions and between themselves and other youth in Los Angeles-what I refer to as an emergent frame of reference-youth workers come to perceive family disruptions, and especially separation from their parents, as the most salient factor affecting their health. While some youth ultimately resign themselves to short-term attempts to assuage illness, injury, or distress through activities like substance abuse, others pursue community connections and support groups that can sustain them long term.

The impact of son or daughter care on Chinese older adults' mental health

RationaleThe traditional cultural norm in China is that eldercare should be offered by a son and his family. However, several decades of family planning policies and rapid economic growth have led to low fertility rates, urbanisation, and cultural change, resulting in both reduced household size and the availability of sons. The traditional eldercare system is thus being challenged, especially in urban areas, with an increasing number of daughters supporting their parents, enabled by rising female empowerment, formal economic employment and improved financial capacities. Existing studies examine and compare the amount and types of support provided by sons and daughters, but very little is known about the differential health outcomes of parents experiencing eldercare offered by sons and by daughters. ObjectiveThis study investigates the difference in mental health outcomes of parents who receive eldercare from their sons and from their daughters. MethodWe analyse waves 2013, 2015, and 2018 of the China Health and Retirement Longitudinal Study, with mental health measured by a 10-item Center for Epidemiological Studies-Depression (CES-D-10) score. We compare the CES-D-10 score between parents with different sources of care — son's family, daughter's family or other — with multivariate statistical analysis. ResultsReceiving regular care from a son (or a daughter-in-law) is associated with a lower CES-D score than from a daughter (or a son-in-law). The difference mainly exists amongst those with a stronger son preference and those who are heavily deponent on their children, in particular rural parents, mothers, and those with less wealth. ConclusionOur study explores the evidence on mental health inequalities among parents with different sources of care, highlighting that lack of son care creates an apparent mental health disadvantage. Lowering older adults’ dependency on their children may alleviate this inequality by improving their financial independence. We also suggest the development of a long-term care system and greater facilitation of older adults to take-up supplementary services for family care.

Influence of Prolonged Visual Display Terminal Use on Physical and Mental Conditions among Health Care Workers at Tertiary Hospitals, Taiwan.

This study aimed to examine the effects of prolonged VDT working time on physical and mental health disadvantages among health care workers (HCWs) in tertiary hospitals based on their work characteristics, age, and sex. Included in the study were 945 and 1868 participants in the non-doctor/nurse and doctor/nurse groups, respectively. The questionnaire included VDT usage-related information, the Nordic Musculoskeletal Questionnaire (NMQ), computer vision syndrome (CVS), perceived occupational stress, burnout, the Brief Symptom Rating Scale-5 (BSRS-5), and self-rated health (SRH). After adjustment, multiple logistical regression analysis revealed that the two groups showed that the longer the VDT working time, the higher the risk of muscle pain, severe headaches, severe job stress, and self-assessed bad sleep quality. This showed that the condition of the doctor/nurse group was more severe than that of the non-doctor/nurse group. According to the stratified analysis by sex and age, in the group of women under the age of 30, the adjusted odds ratio value of physical and mental conditions increased with longer VDT working time and was statistically significant. The result show that it is important to reduce daily VDT exposure for doctor, nurses, and women under 30.

Are Women in Hypogamous Unions More Depressed? A Cross-National Comparison among the Highly Educated

AbstractOwing to educational expansion, women are now increasingly over-represented in higher education. Faced with diminished opportunities to homogamously match, a rising number of women opt for lower educated partners (female hypogamy). Up to now, patterns of women’s mental health across educational sorting configurations have remained largely undocumented. Compared to those in homogamous couples, hypogamous women may be more vulnerable to stress and poor mental health given a presumably stronger double burden, lower partnership quality, or greater financial strain. In this study, we explore whether hypogamy is linked to greater levels of depression among highly educated women. We also examine contextual variation by looking at the effect of three dimensions of gender regimes: women’s educational advantage, family-related social spending, and gender pay gap. The study investigates women’s depression in 69 country-period clusters across 27 countries (N = 9,659) via a series of multilevel linear regression models drawing on data from three rounds of the European Social Survey (2006, 2012, and 2014). Results confirmed that women in hypogamous unions were more depressed than those in homogamous couples, largely due to greater economic insecurity. We also found that the mental health disadvantage of hypogamous women, especially when married, faded in contexts that institutionally and economically promoted gender equality and female empowerment.

Psychological distress in middle eastern immigrants to the United States: A challenge to the healthy migrant model?

Research has documented a robust mental health advantage among Asian and Latino immigrants to the United States relative to the native-born. The current investigation extended this line of research, asking whether Middle Eastern immigrants to the United States enjoy a similar mental health advantage. Drawing on pooled cross-sections from the 2007-2018 National Health Interview Surveys, we used OLS regression to examine psychological distress in Middle Eastern immigrants relative to both native-born Whites and immigrants from other global regions. We used statistical interactions to assess whether gender and period differences are contingent on region of birth. Findings reveal that the average level of psychological distress is higher among Middle Eastern immigrants than among both U.S.-born Whites and immigrants from other regions. Despite changing circumstances of migration for Middle Easterners and implementation in the United States of anti-immigrant policies, we see no evidence that distress increased more among immigrants compared to native-born Whites. Results point to greater psychological distress among Middle Eastern women than their native-born White counterparts and women from other immigrant groups, as well as Middle Eastern men. In contrast, psychological distress levels for Middle Eastern and native-born White men were indistinguishable, suggesting that the Middle Eastern mental health disadvantage in the United States is borne solely by women. Results show that the mental health advantage enjoyed by some immigrant groups does not extend to Middle Eastern women, contradicting the healthy migrant model and challenging the assumption of a uniform mental health advantage across immigrant groups.

Sex differences in mental health among older adults: investigating time trends and possible risk groups with regard to age, educational level and ethnicity

Objectives Older women report lower mental health compared to men, yet little is known about the nature of this sex difference. Therefore, this study investigates time trends and possible risk groups. Method Data from the Doetinchem Cohort Study (DCS) and the Longitudinal Aging Study Amsterdam (LASA) were used. General mental health was assessed every 5 years, from 1995 to 1998 onwards (DCS, n = 1412, 20-year follow-up, baseline age 55–64 years). Depressive and anxiety symptoms were assessed for two birth cohorts, from 1992/1993 onwards (LASA cohort 1, n = 967, 24-year follow-up, age 55-65 years,) and 2002/2003 onwards (LASA cohort 2, n = 1002, 12-year follow-up, age 55–65 years) with follow-up measurements every 3–4 years. Results Mixed model analyses showed that older women had a worse general mental health (−6.95; −8.36 to 5.53; range 0–100, ∼10% lower), more depressive symptoms (2.09; 1.53–2.63; range 0-60, ∼30% more) and more anxiety symptoms (0.86; 0.54–1.18; range 0–11, ∼30% more) compared to men. These sex differences remained stable until the age of 75 years, where after they decreased due to an accelerated decline in mental health for men compared to women. Sex differences and their course by age were consistent over successive birth cohorts, educational levels and ethnic groups (Caucasian vs. Turkish/Moroccan). Conclusion There is a consistent female disadvantage in mental health across different sociodemographic groups and over decennia (1992 vs. 2002) with no specific risk groups.

Combining jobs and motherhood: is it worse when growing children alone?

Abstract Background Women combining paid job and motherhood may experience a poorer health status than those childless. This risk is expectedly higher among lone mothers due to their greater emotional, social, and economic vulnerability. This study aims to assess the impact of employment characteristics on the health of working mothers and to understand differences between lone and coupled mothers. Methods We used data from the 5th Portuguese National Health Survey from employed women (N = 1,649) aged 25-55 living with a child (<16). We modelled depression (assessed by the Personal Health Questionnaire-8) and less-than-good self-reported health as a function of employment variables (part-time job; self-employment; instable job situation; skill level and sector of activity) using logistic regressions, adjusting for age, family variables, socioeconomic status, and social support. Interaction terms assessed differences between lone and coupled mothers. Results Women in part-time (OR = 3.04, 95%CI=2.97-3.11), high-skilled jobs (OR = 3.57, 95%CI=1.30-1.38), and self-employed (OR = 1.34, 95%CI=1.30-1.38) had higher odds for depression, compared to those working in low-skilled, full time and not self-employed jobs. Less-than-good health was also more likely among those working part-time (OR = 1.34, 95%CI=1.31-1.36) and self-employed (OR = 1.34, 95%CI=1.31-1.37). Mothers' mental health disadvantage was amplified when alone regarding self-employment and part-time jobs. Conclusions Employed mothers' physical and mental health may be harmed by part-time jobs, self-employment, and working in more differentiated jobs. Employed lone mothers may experience greater risks than coupled mothers. Key messages Part-time, high-differentiated jobs or self-employment may harm the physical and mental health of working mothers. Lone mothers are disproportionately impacted by these employment characteristics.

A latent class analysis of acculturation and depressive symptoms among Latino immigrants: Examining the role of social support

Drawing upon Berry’s (1980) bi-dimensional model of acculturation and using data from a community-based sample of adults in Miami-Dade, Florida, the current investigation compared various immigrant acculturation profiles in their levels of depressive symptoms and assessed the mediating role of social support in explaining mental health differences across these acculturation profiles. Latent class analysis specified separated, partial separated, bicultural and marginal profiles of acculturation among Latino immigrants. Notably, our findings identified a small, albeit significant, marginal class among Latino immigrants, and both bivariate and multivariate findings demonstrated that those in marginal class reported the poorest mental health. Our findings further revealed that the observed mental health disadvantage among the marginal class relative to other immigrants was due to their disadvantage in family support . Overall, this investigation further underscores the importance of family support as an element of immigrant acculturation experience and mental health. From a policy perspective, social support, specifically family support, is critical for immigrant mental health, and a lack of family support may increase the risk for developing a marginal experience and mental health problems among a growing population of Latino immigrants in the United States.

Unrealized Educational Expectations and Mental Health: Evidence from a Low-Income Country.

The rapid expansion of schooling across low-income countries, combined with intensive governmental and nongovernmental efforts to promote education, has encouraged youth in these contexts to form exceptionally high educational expectations, despite immense structural barriers to achieving them. Consequently, many young people's educational expectations go unmet, driving concerns over the possible unintended consequences, including their elevated risk of mental health problems. At the same time, role transitions (e.g., marriage, parenthood) remain important elements of the transition to adulthood in many low-income countries, and may be a source of resilience-allowing youth to shift their identity away from education towards a new role. In this study, we explore the mental health implications of young women's unmet educational expectations, and the possible buffering impact of motherhood, in a low-income community in Malawi, in southeast Africa. Analyses of six years of longitudinal data show that young women's unmet expectations to continue school are associated with multiple indicators of mental health disadvantage across two points in time. In the short term, however, this is only true of young women who did not enter motherhood in the midst of their educational plans going unrealized: young women who became mothers-and thus achieved a key element of the transition to adulthood in this setting-experience fewer mental health disadvantages. The findings demonstrate the potential mental health consequences of young adults' expectations exceeding their outcomes while also highlighting a source of resilience.

PTSD and timing of trauma exposure in shaping the HPA-axis profile in depression

Drawing upon Berry’s (1980) bi-dimensional model of acculturation and using data from a community-based sample of adults in Miami-Dade, Florida, the current investigation compared various immigrant acculturation profiles in their levels of depressive symptoms and assessed the mediating role of social support in explaining mental health differences across these acculturation profiles. Latent class analysis specified separated, partial separated, bicultural and marginal profiles of acculturation among Latino immigrants. Notably, our findings identified a small, albeit significant, marginal class among Latino immigrants, and both bivariate and multivariate findings demonstrated that those in marginal class reported the poorest mental health. Our findings further revealed that the observed mental health disadvantage among the marginal class relative to other immigrants was due to their disadvantage in family support . Overall, this investigation further underscores the importance of family support as an element of immigrant acculturation experience and mental health. From a policy perspective, social support, specifically family support, is critical for immigrant mental health, and a lack of family support may increase the risk for developing a marginal experience and mental health problems among a growing population of Latino immigrants in the United States.

2317 - The Health Impact of Rural Transport Deprivation and Social Exclusion in the Older Population: A Systematic Literature Review

This paper examines the literature on rural transport and social exclusion in regard to the potential health impact in the older population (defined as those aged 60 and over).A lack of access to affordable transport and rurality have been identified as contributing significantly to social exclusion. People are living longer, predictions indicate that by 2024 more than one in four UK residents will be over 60. The ageing process has implications for mobility, this is particularly associated with wellbeing for older people. While previous literature reviews have examined transport related social exclusion, none have addressed it's associated health impact. By acknowledging that social exclusion is a multi-disciplinary concept this review extends existing research to include the health impact of transport related social exclusion Database searches identified 751 studies. Of these 32 were identified as pertinent. Search criteria comprised of transport related social exclusion, older populations and rural communities in developed countries. Qualitative and quantitative articles from peer reviewed journals between 2000 to 2017 were reviewed. Findings were analysed using themes of social exclusion, wellbeing, rurality, older age, accessibility and public transport. Results of the literature review found that older people in general, make fewer, shorter journeys than other age groups. In rural areas, where public transport is unavailable and for those older people who do not have a car, there appears to be a tendency to utilise car-pooling and social networks to access essential services such as doctor's surgeries, hospitals and shopping. Additionally, results highlighted the unmet needs of older people in rural communities. Difficulty accessing public transport presents a barrier for older people's independence and freedom to make leisure trips such as visiting friends and relatives. This presents a physical and mental health disadvantage, particularly for those older people who live alone. In conclusion, the prevalence of older people relying on social networks and car-pooling for their essential transport needs appears to indicate a disconnect with public transport providers and healthcare services. There are obvious synergies here presenting opportunities to forge links and overcome barriers faced by older people in accessing transport particularly for leisure. Future research should explore these synergies and the potential for community led, demand responsive transport with multi stakeholder engagement. This review highlights that access to public transport in rural communities is an important factor in mitigating social exclusion for older people, their physical and mental wellbeing and maintaining an active lifestyle.

Risk of Major Depressive Episodes After Separation: The Gender-Specific Contribution of the Income and Support Lost Through Union Dissolution.

Marital status and union dissolution are strongly associated with health. Separated men and women have a mental health disadvantage compared to partnered individuals. The lower financial and social resources of separated individuals partly explained their poorer health. However, it is unclear whether this association is due to the loss in income and support precisely experienced through the separation. Due to the frequent asymmetry in partners' individual resources within couples, these losses are gender-specific, giving rise to a debate currently in France. As part of this debate, we explored to what extent gender-specific losses contribute to the separation/mental health association. We used the two-wave survey "Health and Occupational Trajectories," looking at 7321 individuals aged 25-74 in couple in 2006. We analyzed their depressive symptoms self-reported at second wave (2010) and their association with separation between the two waves; we took into account the concomitant social and income changes, as well as the socioeconomic and health situation in 2006. Separation between 2006 and 2010 is significantly associated with depressive symptoms in 2010, independently of the situation in 2006; it is associated with a loss of income, mainly in women, and a loss of support, slightly more pronounced in men. Nested logistic models indicate that the loss of support explained 5.5% of the separation/mental health association in men; the loss of income explained 19.2% of it in women. In France, an economic penalty of separation still primarily affects women and substantially contributes to the mental health vulnerability of newly separated women.

Predictors of positive mental health among refugees: Results from Canada's General Social Survey.

Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.

Religious Identity and Health Inequalities in Canada.

In the past few decades, most new immigrants to Canada have originated from non-Christian countries. During the same period, the unaffiliation rates have sharply increased in Canada. This paper investigates whether there are any health inequalities associated with religious identity, including also the individuals who do not identify with organized religion in the analysis. The study uses the Canadian General Social Survey of 2012 (N = 23,093), focused on Caregiving and Care-receiving. Employing multivariate regression analysis and controlling for a large set of characteristics inclusive of the degree of religious commitment, individuals who identify as Protestant are found at a physical and mental health advantage, compared with Roman Catholics and most other groups. On the other hand, individuals who identify as Jehovah's Witnesses are found at a considerable physical health disadvantage. Among the unaffiliated individuals, those who have retained some ties with organized religion without formally identifying with it are found at a mental health disadvantage compared with all religious groups, as well as the secular individuals who are strictly committed to their nonreligious views. Possible causes and various implications are discussed.

Gender career divide and women's disadvantage in depressive symptoms and physical limitations in France

This study investigated the relationship between women's disadvantage in mental health and physical functioning and gender differences in career backgrounds. Sexual division of labor persists and key career characteristics are overrepresented in women: low-skilled first job, downward occupational trajectory, interruptions. These interrelated characteristics are usually linked to poor health. Their overrepresentation in women may be related to the female-male health gap; however, it may not if overrepresentation transposed into substantially weaker associations with poor health outcomes. To address this question, we used the French population survey “Health and Occupational Trajectories” (2006) and focused on 45–74 year-old individuals who ever worked (n=7537). Past career characteristics were qualified by retrospective information. Logistic regressions identified past characteristics related to current depressive symptoms and physical limitations. Non-linear decomposition showed whether these characteristics contributed to the gender health gap, through their different distribution and/or association with health. The overrepresentation of unskilled first jobs, current and past inactivity and unemployment in women contributed to their excess depressive symptoms. These contributions were only slightly reduced by the weaker mental health-relatedness of current inactivity in women and increased by the stronger relatedness of low-skilled and self-employed first jobs. Overrepresentation of current inactivity, past interruptions and downward trajectories also contributed positively to women's excess physical limitations. Gender-specific career backgrounds were significantly linked to women's disadvantage in mental health and physical functioning. We need to further explore whether equalization of opportunities, especially at the early stages and in terms of career continuity, could help to reduce women’s mental and physical health disadvantage.