Association between school dropouts, early marriages, childbearing, and mental health in early adulthood of women: Evidence from a cohort study in Bihar, India

Document Type

Article (peer-reviewed)

Publication Date



School dropouts, early marriages, and low age at childbearing are issues still prevalent in Indian states like Bihar, which may be responsible for poor mental health among young adults. The present study examined the effect of life-course events such as school dropouts, early marriages, and early childbearing on mental health status at later ages (23–28 years). Using data from the Understanding the Lives of Adolescents and Young Adults consisting of a 2360 adolescent (ages 15 – 19) girl cohort interviewed in 2007 and re-interviewed at ages 23 – 28 in 2016 from the state of Bihar, India, we applied ordinal logistic regression models in analyzing factors associated with mental health status. Women who never attended school, or dropped out from school, and who got married before age 19 showed a poorer mental health status in their young adulthood (22 – 28 years) compared to their respective counterparts who attended a school and who got married at age 19 or older. As compared to women who had a child before age 19, those who did not have any child, or who had children after 20 years of age were more likely to have poor mental health. Working women, high self-efficacy of women, and women who have decision-making power showed better mental health outcomes as compared to their respective counterparts. To enhance psychological well-being of young women, the study recommends continue education and delaying marriage as the programmatic keys with attention to improving young women’s autonomy and gender role attitudes and reducing societal pressure for bearing first child soon after marriage.