{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:42Z","timestamp":1788419802803,"version":"build-2803163510"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Economic inequalities are established determinants of mental conditions, yet the role of gender remains insufficiently examined. In this article, we suggest that women experience a \u201cdouble risk\u201d in contexts of economic inequality: higher exposure to economic disadvantage and greater vulnerability to its mental health effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a two-step synthesis. First, we analyzed sex differences in relative poverty across high-income OECD countries. Mean differences were assessed using Welch t-tests, with sensitivity analyses across COVID-19 periods. Second, we performed a systematic review and multivariate random-effects meta-analysis following PRISMA guidelines. We included 21 studies reporting gender-disaggregated associations between income rank and income inequality and ICD-\/DSM-based mental conditions. Effect sizes were transformed to log odds ratios and analyzed using multilevel models accounting for within-study dependencies. Gender was examined as a moderator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women exhibited higher relative poverty rates than men (20.5% vs. 18.3%; mean difference: 2.2 percentage points; p &amp;lt; 0.001). The meta-analysis (46 effect sizes) showed a significant association between lower income and poorer mental health (log(OR)=0.55, 95% CI 0.26\u20130.85), with substantial heterogeneity. Gender did not moderate effects across all outcomes. However, in depression-specific analyses (k=17), gender significantly moderated the association (p=0.016), with stronger effects in women. Income inequality (Gini index) showed no overall association with mental health, but gender still emerged as a significant moderator, with effects concentrated among women in adjusted models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gender shapes both exposure to economic disadvantage and vulnerability to its mental health consequences. While income-related mental health inequalities affect both sexes, women appear disproportionately impacted, particularly regarding depression. These findings highlight the importance of integrating gender-sensitive approaches into research and policy addressing socioeconomic determinants of mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251123692<\/jats:ext-link>\n                      , identifier CRD420251123692.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1835495","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:44:24Z","timestamp":1788417864000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gender differences in the effects of economic inequality on mental conditions: a multivariate meta-analysis of Gini index and relative income position in high-income OECD countries"],"prefix":"10.3389","volume":"17","author":[{"given":"Olivia","family":"Kalinowski","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Neurosciences, Psychiatric University Clinic of Charit\u00e9 at St. Hedwig Hospital","place":["Berlin, Germany"]},{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford","place":["Oxford, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wulf","family":"R\u00f6ssler","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurosciences, Psychiatric University Clinic of Charit\u00e9 at St. Hedwig Hospital","place":["Berlin, Germany"]},{"name":"Department of Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich","place":["Zurich, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/s2215-0366(17)30159-1","article-title":"Income inequality and mental illness-related morbidity and resilience: a systematic review and meta-analysis","volume":"4","author":"Ribeiro","year":"2017","journal-title":"Lancet Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9781615371501.lr06","article-title":"The social determinants of mental health","volume":"13","author":"Compton","year":"2015","journal-title":"Focus"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.894370","article-title":"Social vulnerability and mental health inequalities in the \u201csyndemic\u201d: call for action","volume":"13","author":"Mezzina","year":"2022","journal-title":"Front Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.socscimed.2013.04.026","article-title":"Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review","volume":"90","author":"Reiss","year":"2013","journal-title":"Soc Sci Med"},{"key":"B5","article-title":"Social determinants of mental health: a review of the evidence","volume":"30","author":"Silva","year":"2016","journal-title":"Eur J Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","first-page":"579","DOI":"10.3238\/arztebl.m2025.0144","article-title":"Relative poverty and mental illness in adults, children, and adolescents in industrialized countries","volume":"122","author":"Kalinowski","year":"2025","journal-title":"Deutsches \u00c4rzteblatt Int"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/esr\/jcu057","article-title":"Who feels inferior? 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