Is trade a blessing or a curse? A panel data analysis of the determinants of depressive disorders
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ORIGINAL ARTICLE
Is trade a blessing or a curse? A panel data analysis of the determinants of depressive disorders Yu-Chun Lin1 • Yu-Hung Chang2 • Huang-Ting Yan3 Received: 22 January 2020 / Revised: 7 June 2020 / Accepted: 9 June 2020 Swiss School of Public Health (SSPH+) 2020
Abstract Objectives Given the speculation of the market economy causing an epidemic of depression, this study aimed to examine the influence of international trade on the prevalence of depressive disorders. Methods We used panel data from 1993 to 2015 covering 170 countries (n = 3787) and applied fixed effects regression models. We modeled the prevalence of depressive disorders as a function of international trade, adjusting for economic development, economic growth, and population size. Regime types, media freedom, and capital–labor ratio were included as moderators. Results A 100% point increase in the value of international trade indicated a 0.09% point decrease in the prevalence of depressive disorders (- 0.09, confidence interval [CI] - 0.01 to - 0.18). However, this effect existed only for democratic countries (- 0.15, CI - 0.03 to - 0.28). The effect was more prevalent when the governments allowed the media more freedom (score of 100, - 0.31, CI - 0.17 to - 0.45) or when a country’s capital–labor ratio of endowments was high (50,000, - 0.22, CI - 0.08 to - 0.35). Conclusions Trade brings about positive mental health outcomes in democracies, countries having free media, or capitalabundant economies. Keywords Capital–labor ratio Democracy Depression Export Import Media Trade
Introduction
This article is part of the special issue ‘‘Market-driven forces and Public Health’’.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00038-020-01410-6) contains supplementary material, which is available to authorized users. & Huang-Ting Yan [email protected] Yu-Chun Lin [email protected] Yu-Hung Chang [email protected] 1
Department of Chinese Medicine, China Medical University Hospital, Taichung City, Taiwan
2
Department of Public Health, China Medical University, Taichung City, Taiwan
3
Department of Government, University of Essex, Colchester, UK
Depressive disorders are characterized by a depressed mood, loss of interest or pleasure, disturbed sleep or appetite, reduced physical movement, poor concentration, and recurrent suicidal ideation. Depression can lead to suicide, cardiovascular death, stroke, lowered income or unemployment, and the dissolution of a marriage (Le´pine and Briley 2011). The total estimated number of people living with depression increased by 18.4% between 2005 and 2015, and the World Health Organization predicts that by 2030, depression will be the leading cause of disease burden globally. The broader literature examines the economic determinants of mental health, such as an economic crisis (Economou et al. 2013; Gili et al. 2013; McInerney et al. 2013), income inequality (Patel et al. 2018; Ribeiro
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