Racial Disparities in Perinatal Depression in an Underserved Los Angeles County Population [3OP]

Celaya, Anna K.; Batra, Priya; Jackson, Ashaki; Robinson, Nuriya; Dossett, Emily C.; Reina, Astrid

doi:10.1097/01.aog.0000513932.83081.9a

Cited by 3 publications

(5 citation statements)

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“…Among Black individuals, the risk of PPD increased in a dose-response manner from 39.0% to 60.0% as NDI increased (NDI Q2 ARR, 1.39 [95% CI, 1. 13 a Values from χ 2 test of the association.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…These study findings provide new information relating to Black individuals and specifically to neighborhood disadvantage; Black individuals from neighborhoods with greater deprivation have poorer health outcomes, including mental health. 13 , 14 The association between higher neighborhood disadvantage with higher rates of PPD among Black individuals is likely multifactorial and complex. Systemic factors and discriminatory practices, such as redlining and housing discrimination, inequitable access to education, employment discrimination, disproportionate rates of incarceration, and health disparities, add a tremendous burden to the normal stressors of life.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The compounded stress from limited resources in areas of high disadvantage may be associated with the heightened rates of PPD observed among patients in racial minority groups. 13 , 14 It has been posited that the stressors associated with living in a disadvantaged neighborhood are compounded for members of stigmatized minority groups. 15 , 16 Black and Hispanic populations are disproportionately affected, as those individuals who develop negative health behaviors in disadvantaged areas experience worse long-term outcomes compared with their White counterparts exhibiting the same behaviors.…”

Section: Introductionmentioning

confidence: 99%

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Neighborhood Disadvantage, Race and Ethnicity, and Postpartum Depression

Onyewuenyi,

Peterman,

Zaritsky

et al. 2023

JAMA Netw Open

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ImportancePostpartum depression (PPD) is a debilitating condition with higher rates among Black individuals. Increasingly, neighborhood disadvantage is being recognized as a contributor to poor health and may be associated with adverse postpartum mental health; however, associations between neighborhood disadvantage, race and ethnicity, and PPD have not been examined.ObjectiveTo investigate the association between neighborhood disadvantage and PPD and evaluate the extent to which these associations may differ by race and ethnicity.Design, Setting, and ParticipantsThis population-based cross-sectional study included 122 995 postpartum Kaiser Permanente Northern California members 15 years or older with a live birth between October 7, 2012, and May 31, 2017, and an address in the electronic health record. Analyses were conducted from June 1, 2022, through June 30, 2023.ExposuresNeighborhood disadvantage defined using quartiles of the Neighborhood Deprivation Index (NDI), a validated census-based socioeconomic status measure; self-reported race and ethnicity ascertained from Kaiser Permanente Northern California electronic health records.Main Outcomes and MeasuresMultivariable Poisson regression was conducted to assess associations between neighborhood disadvantage, race and ethnicity, and a diagnosis of PPD.ResultsOf 122 995 included postpartum individuals, 17 554 (14.3%) were younger than 25 years, 29 933 (24.3%) were Asian, 8125 (6.6%) were Black, 31 968 (26.0%) were Hispanic, 47 527 (38.6%) were White, 5442 (4.4%) were of other race and ethnicity, and 15 436 (12.6%) had PPD. Higher neighborhood disadvantage and race and ethnicity were associated with PPD after covariate adjustment. Compared with White individuals, Black individuals were more likely to have PPD (adjusted relative risk [ARR], 1.30; 95% CI, 1.24-1.37), whereas Asian (ARR, 0.48; 95% CI, 0.46-0.50), and Hispanic (ARR, 0.92; 95% CI, 0.89-0.96) individuals and those identified as having other race and ethnicity (ARR, 95% CI, 0.90; 0.85-0.98) were less likely to have PPD. Associations between NDI and PPD differed by race and ethnicity (likelihood ratio test for interaction, χ212 = 41.36; P &lt; .001). Among Black individuals, the risk of PPD was the greatest overall and increased with neighborhood disadvantage in a dose-response manner (quartile [Q] 2 ARR, 1.39 [95% CI, 1.13-1.71]; Q3 ARR, 1.50 [95% CI, 1.23-1.83]; Q4 ARR, 1.60 [95% CI, 1.32-1.93]; Cochrane-Armitage test for trend, P &lt; .001). Neighborhood disadvantage was associated with PPD among Asian (Q2 ARR, 1.17 [95% CI, 1.04-1.31]; Q3 ARR, 1.20 [95% CI, 1.06-1.35]) and White (Q3 ARR, 1.14 [95% CI, 1.07-1.21]; Q4 ARR, 1.17 [95% CI, 1.09-1.26]) individuals and those of other race and ethnicity (Q3 ARR, 1.34 [95% CI, 1.09-1.63]; Q4 ARR, 1.28 [95% CI, 1.03-1.58]), but the magnitude of risk was lower. Neighborhood disadvantage was not associated with PPD among Hispanic individuals (eg, Q2 ARR, 1.04 [95% CI, 0.94-1.14]; Q3 ARR, 1.00 [95% CI, 0.91-1.10]; Q4 ARR, 0.98 [95% CI, 0.90-1.08]).Conclusions and RelevanceIn this cross-sectional study of postpartum individuals, residing in more disadvantaged neighborhoods was associated with PPD, except among Hispanic individuals. Neighborhood disadvantage may be associated with racial and ethnic differences in postpartum mental health. Geographic targeting of mental health interventions may decrease postpartum mental health inequities.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%