Multiple forms of discrimination and postpartum depression among indigenous Palestinian-Arab, Jewish immigrants and non-immigrant Jewish mothers

Abstract

BackgroundWhile discrimination takes multiple forms, racial or ethnic discrimination is a root cause of this health-damaging social phenomenon. We drew on intersectionality theory, which offers an account of discrimination’s multiple effects, to consider associations between women’s experiences of discrimination and postpartum depression (PPD) using four measures: single forms of discrimination (SFD); multiple forms of discrimination (MFD); ethnic discrimination combined with MFD (E-MFD); and a composite MFD that interacted with women’s identity (C-MFD).MethodsWe interviewed a stratified sample of 1128 mothers face to face in 2014–2015 during mothers’ visits to maternal and child health clinics. The mothers belonged to three groups in Israel: Palestinian-Arab minority, Jewish immigrant, and non-immigrant Jewish. We conducted unadjusted and adjusted logistic regressions for PPD, measured on the Edinburgh Postnatal Depression Scale, in associations with SFD (experiencing discrimination based on any of the following: age, sex, class, ethno-national identity, religiosity level and skin color); MFD (experiencing 0,1, 2 or ≥ 3 of SFD); E-MFD (ethnic discrimination combined with other MFD); and finally, C-MFD (interaction between MFD and women’s identity).ResultsPalestinian-Arab mothers had higher PPD and reported higher SFD (based on ethnicity, religiosity level, and socioeconomic status), as well as higher MFD and E-MFD. This was followed by Jewish immigrant mothers, and lastly by non-immigrant Jewish mothers. However, both MFD and E-MFD had a strong association with PPD among non-immigrant Jewish mothers reporting 2MFD and ≥ 3MFD, and Palestinian-Arab mothers reporting ≥3MFD, but no significant association among immigrant Jewish mothers. When we used C-MFD, we found a dose-response association in which Palestinian-Arab mothers experiencing more MFD (2MFD and ≥ 3MFD) were more likely to experience PPD. This was followed by immigrant Jewish mothers (reporting 2MFD and ≥ 3MFD), and lastly by non-immigrant Jewish mothers.ConclusionsMFD should be considered in relation to women’s identity (being part of a minority, immigrant, or non-immigrant majority group) in maternal mental health research and practice. Otherwise, we risk underestimating the effects of MFD on PPD, especially in minority and immigrant mothers, who are more likely to face interlocking forms of discrimination.

Residential segregation, neighborhood violence and disorder, and inequalities in anxiety among Jewish and Palestinian-Arab perinatal women in Israel

“…Aggregate discrimination in a neighborhood was associated with almost 2.4-fold more anxiety in Palestinian-Arab women in the final fully adjusted model adjusted. This confirms, in part, our second hypothesis, with Palestinian-Arab women reporting higher ethno-national discrimination compared to Jewish women [19]. In the current study, high neighborhood aggregate discrimination was around 70% among Palestinian-Arab women, 35% in Jewish women.…”

“…Thus, we put forward the following hypotheses: Compared to Jewish women, Palestinian-Arab women will report higher neighborhood violence and disorder and higher anxiety, as they live in neighborhoods that suffer from prolonged residential segregation, and based on three aspects of neighborhood disadvantage: low SES [ 37 , 66 ], high levels of neighborhood aggregate discrimination [ 17 ] and low neighborhood social factors (low collective efficacy (social cohesion and informal social control) and low social capital, [ 15 ]. Neighborhood crime and disorder will be associated with higher anxiety in all women, but this association will be stronger among Palestinian-Arab women compared to Jewish women, as Palestinian-Arab women will present increased levels of chronic stress and low social support resulting from more neighborhood disadvantaged including lower levels of collective efficacy (social cohesion and informal control), lower social capital, higher neighborhood economic deprivation [ 18 ], as well as higher neighborhood aggregate discrimination) [ 19 ]. …”

“…Neighborhood crime and disorder will be associated with higher anxiety in all women, but this association will be stronger among Palestinian-Arab women compared to Jewish women, as Palestinian-Arab women will present increased levels of chronic stress and low social support resulting from more neighborhood disadvantaged including lower levels of collective efficacy (social cohesion and informal control), lower social capital, higher neighborhood economic deprivation [ 18 ], as well as higher neighborhood aggregate discrimination) [ 19 ].…”

Feminism, gender medicine and beyond: a feminist analysis of "gender medicine"

“…GM publications recognize the effect of poverty and racial discrimination on cardiovascular risk [12,28], however a call to improve and study minority women's health is lacking. Minority women in the US, Canada, Israel, Europe, and Australia report discrimination within healthcare systems and discriminatory institutional policies and stigmas, with negative effects on their health [91,92]. Gender discrimination in healthcare is suggested by the findings described in several of the studies we reviewed [16, 18-20, 23, 27].…”

Health-Related Quality of Life and Risk Factors among Chinese Women in Japan Following the COVID-19 Outbreak

“…Due to the COVID-19 outbreak, the general female population in Japan experienced poor mental health, with a significantly increased suicide rate [13]. Immigrant women, as a minority group, experienced more mental health problems than native women [14]. A qualitative study on the immigrant community in the United States (U.S.) reported that the COVID-19 pandemic affects immigrants' mental health and interpersonal relationships [15].…”