ArticleBMC public health2026
The accumulation of adverse life events across the life course and their association with mental health and well-being: exploring gender heterogeneity.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMost individuals experience multiple adverse life events across their life course, accumulating into cumulative disadvantage with lasting consequences for mental health and well-being. Evidence suggests that women's mental health and well-being is more vulnerable to the negative consequences of single adverse life events, due to gender differences in event perception, available resources, and preferred coping strategies. Until now it's unclear whether these gendered patterns hold when looking at the accumulation of adverse events over a life course. The aim of this study is to examine if the accumulation of adverse life events is associated with depressive symptomatology, life satisfaction, and quality of life with a central focus on gender differences in these relationships.
methodsA secondary data analysis was conducted using Wave 3 of the English Longitudinal Study of Ageing (ELSA). Accumulation of adverse life events was operationalized as the number of different adverse events experienced during the life course, covering 22 life events. Three accumulation scores were calculated: a total score (TCALE) including all adverse events and two separate scores for self-oriented (SOCALE) and other-oriented (OOCALE) adverse events. Associations with depressive symptomatology, life satisfaction, and quality of life were analyzed using logistic and linear regression models. Interaction terms between accumulation scores and gender were included to examine gender differences in these associations.
resultsGreater accumulation of adverse life events is associated with higher likelihood of depressive symptomatology, lower life satisfaction, and reduced quality of life. Gender moderates the relationships for TCALE, with women being more vulnerable to the accumulation of adverse life events. Although no consistent gender interactions could be found for SOCALE and OOCALE, non-significant trends, for OOCALE, aligned with the patterns observed for the total accumulation score.
conclusionCumulative life course adversity is a significant risk factor for poorer mental health and well-being, with women showing heightened vulnerability.
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