title: Polygamy and poor mental health among Arab Bedouin women: do socioeconomic position and social support matter?
abstract: OBJECTIVE
  Polygamy is a complex phenomenon and a product of power relations, with deep cultural, social, economic, and political roots. Despite being banned in many countries, the practice persists and has been associated with women's marginalization and mental health sequelae. In this study, we sought to improve understanding of this ongoing, complex phenomenon by examining the contribution of socioeconomic position (SEP) and social support to the excess of depressive symptoms (DS) and poor self-rated health (SRH) among women in polygamous marriages compared to women in monogamous marriages. Measuring the contribution of these factors could facilitate policies and interventions aimed at protecting women's mental health.
  
  
  METHODS
  The study was conducted among a sample of Arab Bedouin women living in a marginalized community in southern Israel (N=464, age 18-50). The women were personally interviewed in 2008-2009. We then used logistic regression models to calculate the contribution of SEP (as defined by the women's education, family SEP, and household characteristics) and social support to excess of depressive symptoms and poor SRH among participants in polygamous versus monogamous marriages.
  
  
  RESULTS
  About 23% of the participants were in polygamous marriages. These women reported almost twice the odds of depressive symptoms (OR=1.91, 95%CI=1.22, 2.99) and poorer SRH (OR=1.73, 95%CI=1.10, 2.72) than those in monogamous marriages. Women's education changed these associations slightly, but family SEP and household characteristics resulted in virtually no further change. Social support reduced the odds for poor SRH and DS by about 23% and 28%, respectively.
  
  
  CONCLUSIONS
  Polygamy is associated with higher risk for poor mental health of women regardless of their SEP and education. Social support seems to have some protective effect.
authors.affiliation: a Department of Epidemiology and Health Systems Evaluation, Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer- Sheva , Israel.
authors.forename: Nihaya
authors.initials: N
authors.lastname: Daoud
authors.forename: Ilana
authors.initials: I
authors.lastname: Shoham-Vardi
authors.forename: Marcelo Louis
authors.initials: ML
authors.lastname: Urquia
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Campo
mesh_terms: D000293:Adolescent; D000328:Adult; D018912:Arabs / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D007557:Israel / Q000453:epidemiology; D008393:Marriage / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Arab Bedouin minority; depressive symptoms; marriage; polygamy; self-rated health; social determinants; women's mental health