Unmet healthcare needs, gender, and depressive Symptoms: Evidence from asymmetric fixed effects models

초록

Objectives: Although unmet healthcare needs have been recognized as an important risk factor for adverse health outcomes, empirical evidence on the potential differential effects of transitioning into and out of unmet healthcare needs remains limited. This study examines potential asymmetries in the relationship between unmet healthcare needs and depressive symptoms among young adulthood, with particular attention to gender differences in these effects. Study design: We analyzed data from Waves III and IV of the National Longitudinal Study of Adolescent to Adult Health, a large-scale, nationally representative longitudinal dataset. Methods: To separately estimate the associations of transitions into and out of unmet healthcare needs while accounting for unobserved individual-level heterogeneity, we employed novel asymmetric fixed effects models. Results: Conventional fixed effects models indicate that unmet healthcare needs are positively associated with depressive symptoms. The preferred asymmetric fixed effects models provide unique evidence on gendered asymmetric patterns in these associations: for women, the positive association between transitioning into unmet healthcare needs and depressive symptoms (b = 1.225, p < 0.001) was larger in magnitude than the negative association for transitioning out of unmet needs (b = -0.649, p < 0.001), whereas no such asymmetry was observed for men. Moreover, the association of transitioning into unmet healthcare needs was significantly greater for women than for men (b = 0.451, p < 0.05). Conclusions: These findings likely reflect distinct underlying gender differences in health-related attitudes and behavioral responses. Understanding these gendered dynamics can inform more targeted and equitable strategies for addressing unmet healthcare needs and promoting mental health.

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