Does Alleviating Poverty Affect Mothers' Depression?: A Quasi-Experimental Investigation of Mexico's Oportunidades Program

Background: Depression is a major cause of disability worldwide, particularly among women, and is often caused by poverty. Beyond its direct effects, maternal depression can harm children's health and development. This study aimed to assess the effect of a large-scale anti-poverty program in Mexico (Oportunidades, formerly Progresa) on maternal depressive symptoms.

Methods: In 2003, 5,050 women living in rural communities that had participated in Oportunidades since its inception were assessed and compared to a group of 1,293 women from matched communities, whose families had received no exposure to Oportunidades at the time of assessment but who later enrolled. Self-reported depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Ordinary least squares regressions were used to evaluate the treatment effect of program participation on depression while adjusting for covariates and clustering at the community level.

Results: Women in the treatment group had lower depressive symptoms than those in the comparison group (CES-D scores: 16.9±9.8 versus 18.6±10.2). In multi-variate analyses, program participation was significantly associated with lower depression while controlling for maternal age, education, and household demographic, ethnicity, and socio-economic variables.

Conclusion: Although Oportunidades did not target maternal mental health directly, we found modest but potentially clinically meaningful effects on depression. Our rigorous quasi-experimental design permits stronger causal inference than observational studies that have linked poverty and depressive symptoms. There are several implications of these findings in the context of other economic and clinically-based approaches that aim to improve mental health among women living in poverty.