Sex-Based Variations in the Impact of Economic Disparities on Mental Health: A Comprehensive Meta-Analysis of Gini Coefficient and Relative Income Status in Affluent OECD Nations

By
Olivia Kalinowski
Wulf Rössler
September 3, 2026

Frontiers In Psychiatry

Objective:

To examine the role of gender in the relationship between economic inequalities and mental health conditions, particularly focusing on the differential impact on women.

Approach:

Evaluation of Relative Poverty: Assessed sex disparities in relative poverty across high-income OECD countries using Welch t-tests and sensitivity analyses for COVID-19 periods.
Systematic Review and Meta-Analysis: Conducted a PRISMA-guided systematic review and multivariate random-effects meta-analysis of 21 studies providing gender-disaggregated associations of income rank and income inequality with mental health conditions.

Key Findings:

Relative poverty was more prevalent among women (20.5%) than men (18.3%), with a significant mean difference of 2.2 percentage points (p < 0.001).
The meta-analysis revealed a significant relationship between lower income and poorer mental health (log(OR)=0.55, 95% CI 0.26–0.85).
Gender did not moderate effects across all outcomes, but in depression-focused analyses, significant moderation by gender was found (p=0.016), indicating larger effects among women.
The Gini index was not associated with mental health, but gender remained a significant moderator, with effects concentrated in women.

Interpretation:

Gender influences both exposure to economic disadvantage and susceptibility to its mental health effects, with women disproportionately affected, especially regarding depression.

Limitations:

The study primarily focuses on high-income OECD countries, which may limit generalizability.
Cross-sectional studies dominate the existing literature, hindering causal conclusions.