Women who always ate last in the household had four times greater chance of having “probable depression,” study finds. Credit: Shutterstock.
By Marty Logan
KATHMANDU, Feb 12 2024 – Studies have long shown that some women’s lower status in Nepali households could mean that they eat last and less and as a result lack nutrition. Experts are now looking into how this could affect their mental health, and if the growing impacts of climate change might amplify the process.
“When women eat last (as a mark of respect or due to low status in the household), they often get the last bits of food left over, and they may be compromising the amount of food, which could also be adversely impacting their mental health,” says researcher Lakshmi Gopalakrishnan, in an online interview.
Gopalakrishnan’s research is based on interviews with about 200 newly married women, ages 18-25, in Nawalparasi District in Nepal’s southern Madhesh region, bordering northern India. As is customary, the women moved into their new husband’s homes, living with in-laws in an extended family. They also ate after everyone else had finished their meals, another custom.
The study, titled The relationship between the gendered norm of eating last and mental health of newly married women in Nepal, found that women who always ate last in the household had four times greater chance of having “probable depression.” The reason? Eating last is symbolic of women’s ranking in the household, explains Gopalakrishnan. In the newly married context, women “don’t have the autonomy to make their own decisions; they don’t have the freedom to move outside the house,” she adds.
Food insecurity is key
More recent research concluded that household food insecurity is the main factor in determining women’s eating patterns. Although changes such as a woman becoming pregnant or getting a paying job could improve her household status, and therefore her order of eating — at least temporarily — there would be no changes if the household remained food insecure.
Climate change is already destroying croplands, causing farmers to seek seasonal work and migration to escape food insecurity. This leaves their wives victimized in the community, leading to stress and mental illness in these women
“Across the board, women in food insecure households are more likely to eat last always or most of the time,” says the 2022 article, Do changes in women’s household status in Nepal improve access to food and nutrition? published in the journal Maternal & Child Nutrition.
It adds, “a recent analysis of data from India found that women who eat last have worse mental health, suggesting that there could be additional health impacts of this practice.”
Gopalakrishnan did not find the same link between diminishing household food insecurity and eating less. Her study suggests that’s because “women are treated as lower-status individuals regardless of food security levels in the households.”
The researcher is quick to point out that her work did not find that the women had four times as many episodes of depression, but that they were four times more likely to have “probable depression”. She also suggests, but did not measure, that as women are eating last they might not be eating enough or getting adequate nutrition, creating a “biological pathway” to depression.
Chanda Gurung, a consultant in gender equality and social inclusion, agrees that a possible biological link needs further inquiry. “Sometimes there is food, but what kind of food?” she asks in an online interview. “We really need health professionals (who can say) what kind of food is required to affect mental health, such as stress levels, or what women think? The physical impacts we know.”
Gurung formerly worked as a senior gender expert with the International Centre for Integrated Mountain Development, which focuses on eight countries in the Hindu Kush Himalaya mountain region. She is confident that climate change is affecting food security, but adds that there are many more factors that take a toll on rural women’s lives.
“With more men migrating… women’s workload has grown to the point that they shoulder most of the activities now —whether it’s on the farm, meeting government officials, going to health centres; women are doing all that,” Goodyear says.
Mental and physical health affected
“In some ways it has made women more empowered, more confident because now they can interact more easily. In a way that’s a blessing… but the work burden is extremely high, which takes a toll on both their physical and mental health.”
The heavier workload, added to societal demands — “She’s alone. Is she getting harassed in the family? Facing a lack of income?” — puts more stresses on women, she adds.
A 2021 assessment found that “mental health issues are likely to increase in Nepal due to climate change… For example, climate change is already destroying croplands, causing farmers to seek seasonal work and migration to escape food insecurity. This leaves their wives victimized in the community, leading to stress and mental illness in these women.”
“Poor, rural, female-headed families will face higher vulnerabilities as the climate continues to change,” concluded the report, by the International Federation of Red Cross and Red Crescent Societies.
Gopalakrishnan says studies have shown that there are ways to influence the gender norms that translate into how women are treated in their households.
For example, in one “interventional study”, girls and boys at school were taught about gender equality for two years. “And that actually led to increased support for women and girls opportunities and changed their attitudes towards gender. So these are some examples where we see that yes, it’s possible to change people’s gender attitudes.”