Unpaid Labor Takes a Toll on Women’s Mental Health, Study Reveals

Systematic review uncovers the detrimental effects of unpaid work on employed women's mental health.


A groundbreaking article published in The Lancet Public Health has shed light on the unpaid labor that women perform and its detrimental impact on women’s mental health. The study reveals that as women dedicate more time to unpaid work than men, they face a heightened risk of mental distress.

The research highlights that employed women consistently perform more unpaid labor than employed men across different locations and time periods. The study suggests that the persistent inequities in the division of unpaid work expose women to greater risks for poorer mental health compared to men. The authors emphasize the need to address these disparities and focus on the mental health challenges women face due to the unequal distribution of unpaid labor.

Jennifer Ervin led the research from the University of Melbourne in Australia. Ervin and her coauthors write:

“Globally, billions of hours are spent on unpaid labor every year, a burden that is disproportionately carried by women. However, the potential health effects of unpaid labor have largely been unexplored. This review examines the gendered association between unpaid labor and mental health among employed adults… Our review indicates substantial gender differences in exposure to unpaid labor and confirms persistent inequities in the division of unpaid work.”

The goal of the current research was to examine how the effects of unpaid labor may differ between employed men and women. To accomplish this goal, the authors reviewed previous research on unpaid labor. To be included in the review, each study had to quantify the amount of unpaid labor and present data on the link between unpaid labor and mental health. For the current research, unpaid labor was defined as housework, domestic work, childcare, and other care (volunteer work was excluded).

Studies were excluded if there was no English translation available. As the focus of the current work was the effect of unpaid labor on employed adults, data from included studies on unemployed participants were excluded. Ultimately, the authors included 19 studies comprising 70,310 participants. As 5 of the originally included studies had a serious risk of bias, 14 studies comprising 66,875 participants were included in the final narrative analysis.

All the studies included in the review found that employed women did more unpaid labor than employed men. This was true for every location and time period represented in the current work. Studies that did not have a serious risk of bias found that every 10 hours of unpaid labor per week was associated with a .2-.4 point increase in depression scores. One study with a serious risk of bias reported that every 10 hours of weekly unpaid labor was associated with a 22% increase in the odds of experiencing emotional distress.

The current work finds that unpaid labor significantly negatively affects the mental health of employed women. However, the same pattern was not true for employed men. Although the authors report that the data on men and unpaid labor was sparse, the data that was present shows little to no negative mental health effects for men as a result of unpaid labor. The authors suggest two possibilities for this finding. First, men may have more effective coping mechanisms overall. However, a meta-analysis found that women’s coping strategies are typically more effective. Second, and the more likely explanation, according to the authors, men’s unpaid labor was more likely to include less time-sensitive work (such as yard work and maintenance tasks). In contrast, women typically took on unpaid labor tasks with a larger mental load, making their unpaid labor hours “denser or more impactful” than men’s.

The authors acknowledge several limitations to the current work. First, the design of most of the included studies made it impossible to make definitive statements about the causation between unpaid labor and mental health. Second, the current study was restricted to employed participants. According to the authors, this likely biased the findings towards the null hypothesis (no association between unpaid labor and poor mental health). Third, most of the included studies relied on self-report measures of unpaid labor and mental health. Self-report measures are subject to lies, misremembering, etc. Fourth, the generalizability of the current work is limited as most of the studies came from wealthy countries. The authors conclude:

“Unpaid labor is associated with poorer mental health in women, but the effects are less apparent for men. Given that women spend a greater number of hours on unpaid labor worldwide, the findings of this review suggest that continued inequities in the division of unpaid labor expose women to greater risk for poorer mental health than men.”

Previous research has found that overwork and exploitation are linked to psychological distress. Research has also found that when women are paid less for their work than men, their mental health deteriorates. For example, women that are paid less than their male counterparts are 2.5 times more likely to have a major depressive disorder (compared to 1.2 times more likely when pay is equal) and four times more likely to have generalized anxiety disorder (compared to 1.5 times more likely when pay is equal).

As an example of the marginal position women commonly occupy (within the psy-disciplines and beyond), consider the implications of two pieces of research from 2021. One study found that gender discrimination impacts the severity of PTSD. Another piece of research (that included no women with PTSD) suggests, without evidence, that women with PTSD symptoms may be on their period.

In an effort to profit from the stress caused by unpaid labor, gender discrimination, and unequal wages, the pharmaceutical industry targets 82% of its ads for dubiously helpful and potentially dangerous antidepressants towards women, which are difficult to discontinue.



Ervin, J., Taouk, Y., Alfonzo, L. F., Hewitt, B., & King, T. (2022). Gender differences in the association between unpaid Labour and Mental Health in employed adults: A systematic review. The Lancet Public Health, 7(9). https://doi.org/10.1016/s2468-2667(22)00160-8 (Link)


  1. https://youtu.be/Zs7Fh8zvvFU

    And yet…it is said that people in less affluent countries, with villages like this one, have better outcomes for mental health. Looks like hard work to me. For little pay.

    Claim one…less affluent countries have less problems with mental health.

    Claim two…that hard underpaid toil, presumably in less affluent countries, is bad for mental health.

    Subsistence community living is either great for mental health or it is appalling for mental health. There is a tendency in the West to romanticize living close to the land. It comes from an idea of the land as passive and welcoming and yeilding. The reality is that the land has been trying to unsuccessfully kill off humans ever since humans made the bad decision to evolve legs and leave the water. The land is feirce and ferocious and resistant and not to be owned or cultivated by the meddling hands of destructive impish humans. Even the mould in our bathrooms is the land coming back and asserting its primacy. So living off the land is no picnic. In popular television shows of groups marooned on desert islands for a few weeks none of them ever long to stay there. They have breakdowns at the thought of the boat leaving without them. Subsistance living is catastrophic. It is how we deal with the catastrophic that may lead to better mental health outcomes.

    Still, I am with the millions fleeing impoverished countries to come to comfortable Europe. The West obviously has got something going for it given that thousands drown trying to make the journey. And yet we see in the West grotesque greed and inequality and injustice.

    I think there are no countries that have got the balance right.

    This video may or may not be communist China.

    If I had a daughter with mental health problems would I send her to that village and expect her to come home smiling or traumatized? Sometimes I look at the video link above and conclude the answer to be…no smiling…no traumatized…no smiling…wait no traumatized…smil…

    At the start I wondered is a subsistance community good for mental health or bad for mental health. Confusion abounds in this regard. And where confusion leaves loose ends romanticism can tie them into bows.

    I am just vaguely amused at the contradiction. Some say contradiction comes from sloppy thinking. But I love sloppy thinking. And I love contradition.

    I love contradiction because life is inherently complicated and therefore contraditions are woven into its weave. And sloppy thinking is the best kind of thinking because it is akin to childish thinking, which is inherently harmless.

    If we are going to fathom out a new model of better mental healthcare than the West currently has it would be good to abandon hope that it is ever not going to be contradictory.

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    • Diaphanous Weeping, it is difficult for me to watch video, so I have just read what you wrote, but I haven’t watched the video.

      I have had a lot of thoughts in this direction in the last year after reading the works of an author whose name I am actually hesitant to mention because it might put madinamerica in a position of legal liability. I am going to go ahead and tell you, but if this post gets deleted by a mod, that would be entirely understandable. Feel free to contact me directly for electronic or physical copies of these books. The writer is Dr. Theodore John Kaczynski, aka Ted Kaczynski, and the two books are Technological Slavery (published first under the title “The Road To Revolution” by Xenia Publishing 2008, then under the title “Technological Slavery” by Feral House Publishing 2010, Fitch and Madison Publishing 2019, Fitch and Madison Publishing 2022) and Anti-Tech Revolution Why And How (Fitch and Madison Publishing 2016, Fitch and Madison Publishing 2020).

      I will summarize here. The writer clearly explains that primitive living, whether nomadic hunting and gathering, or early subsistence farming, was no Garden of Eden by any means, but a mixed bag of cooperation and competition, plentifulness and hunger, peace and violence, etc. but because of various other factors, it was conducive to people experiencing a lower level of what today is termed mental illness. He does not just make these things up, but instead for every statement he makes, he cites earlier historical, archaeological, etc. sources that are then exhaustively documented in a bibliography, so that you can then go and read the book or article where the citation is taken from. Of particular interest to you would be the essay entitled “The Truth About Primitive Living” in the Feral House 2010 edition.

      This is all only a possibility if you are in a state of health where you can concentrate on reading such minutely detailed academic writing, which I know a lot of us who are pharma survivors don’t have the luxury of being able to do. I am not sure how to contact you directly, I thought there used to be a login for comments and maybe there was direct messaging between registered members, but now I don’t see that option in the menu up at the top. i tried to set up a throwaway email to put here in the comment, but looks like gmail and yahoo both want a working phone number, whereas hotmail is literally trying to make me solve either an image puzzle where 2=4 somehow, or is testing my knowledge of animal noises for the audio challenge. Try the hotmail one if you want to test your ability to handle idiotic technological obstacles, and then you will definitely want to go live in a subsistence setting, LOL.

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  2. Richard, I don’t mean to attack you or your writing, and you are probably accurately transmitting the attitude of the original article. So, please realize that my comment is directed at the general philosophy that allows these articles to exist, and I don’t know if you yourself share this philosophy or not.

    Unpaid labor, aka giving a rat’s behind about your kids, spouse, parents, extended family, and even your friends, used to be what is called being a caring member of your community. Being there for your folks, as they are there for you. The idea that every hour of a person’s time should be compensated in financial fashion is what leads people to put their 2-week-old in daycare, put their mentally different sibling in a warehouse of coercion and neglect called a residential facility, and put their aging mother in a different warehouse of coercion and neglect called an old folks home.

    If picking up the phone when a friend of mine has a bad day and wants to talk about their finances, their health, their art project, etc. is unpaid work, or if me washing the dishes so that my boyfriend can focus on his task for the day is unpaid work, then I guess I am one of these unfortunate women. I suppose my friends should pay for an hour of talk psychotherapy instead, and my boyfriend should hire a house cleaning service.

    That’s the kind of thinking that leads us to psychology and psychiatry in the first place. Instead of reaching out to the people around us, we turn to experts who are paid to pretend to care, whether by listening to our venting about our bad day, or by watching our infants, our aging grandparents, and our disabled siblings – so that we can go do that very important paid work that is so fulfilling and provides us with a sense of economic independence, right?

    I recently read a book called “The Artificial Silk Girl” (“Das kunstseiden m√§dchen”) by Irmgard Keun, a somewhat autobiographically based fictional work, clearly drawing on her own life in 1930’s Germany. It is the most feminine book that I have ever read. It makes it clear that not only women, but also men, are always trying to find a balance between what can one do for others, what can they do for you, how can you care by listening sympathetically to a same-gender friend, or by looking good for an opposite-gender acquaintance, or by taking care of someone who is in bad health, or by mopping the floor, etc., but be true to yourself and to the other person in that interaction, without using somewhat underhanded means where you trade care work for resources to avoid starving to death and freezing to death. This is applies not only to 1930’s Berlin, but any place and any time in history.

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