Exploring the link between women’s empowerment, depression, and anxiety in Bangladesh: evidence from a nationally representative cross-sectional study

Background: Women's mental health remains critically under-researched in Bangladesh, despite its close links with gender inequality. In this study, we examined how three domains of women's empowerment - attitudes to violence, social independence, and decision-making - are associated with mental health outcomes among currently married women in Bangladesh. Methods: Using nationally representative data from the 2022 Bangladesh Demographic and Health Survey, we analysed 18 900 currently married women. We assessed women's empowerment using the survey-based women's empowerment index, which was categorised as low, medium, or high. Depression and anxiety were measured using the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder-7, respectively. We applied multivariable logistic regression models, adjusting for key sociodemographic covariates. Results: Overall, 4.6% women reported depression, and 4.0% reported anxiety. Women with low empowerment in attitude to violence domain had higher odds of depression (adjusted odds ratio (aOR) = 1.48; 95% confidence interval (CI) = 1.17-1.86) and anxiety (aOR = 1.41; 95% CI = 1.09-1.82), compared to women with high empowerment. In the social independence domain, low empowerment was significantly associated with anxiety (aOR = 1.28; 95% CI = 1.02-1.60) but not with depression. Low empowerment in the decision-making domain was not associated with depressive or anxiety symptoms; however, it was associated with lower odds of severe depressive (aOR = 0.48; 95% CI = 0.33-0.70) and anxiety symptoms (aOR = 0.44; 95% CI = 0.28-0.71) when the outcome was disaggregated by severity. Conclusions: Women's empowerment is associated with mental health in Bangladesh. Structural interventions must integrate gender-transformative approaches that challenge discriminatory norms and promote women's social standing, reinforcing the interconnection between Sustainable Development Goal three (good health and well-being) and five (gender equality).