Relationships of Race and Socioeconomic Status to Postpartum Depressive Symptoms in Rural African American and Non-Hispanic White Women

Abstract

This study examines the potential racial disparity in postpartum depression (PPD) symptoms among a cohort of non-Hispanic white and African American women after taking into consideration the influence of socioeconomic status (SES). Participants (N = 299) were recruited from maternity clinics serving rural counties, with over-sampling of low SES and African Americans. The Edinburgh Postnatal Depression Scale (EPDS) was administered 1 and 6 months postpartum, and subjective SES scale at 6 months postpartum. Demographic information was collected during enrollment and 1 month postpartum, with updates at 6 months postpartum. Separate logistic regressions were conducted for 1 and 6 month time points for minor-major PPD (EPDS ≥ 10) and major PPD (EPDS > 12); with marital status, poverty, education, subjective SES, and race predictors entered in block sequence. After including all other predictors, race was not a significant predictor of minor-major or major PPD at 1 or 6 months postpartum. Subjective SES was the most consistent predictor of PPD, being significantly associated with minor-major PPD and major PPD at 6 months postpartum, with higher subjective SES indicating lower odds of PPD, even after accounting for all other predictors. This study shows that significant racial disparities were not observed for minor-major or major PPD criteria at 1 or 6 months postpartum. The most consistent and significant predictor of PPD was subjective SES. Implications of these findings for future research, as well as PPD screening and intervention are discussed.

Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions

“…In the specific cultural groups of the U.S, the reported prevalence vary within 4.6-10.7 % in Asian-American [106,107], 6.4-16.7 % in Hispanic [107,108], 3.7-20.7 % in African-American and 2.6-14.8 % in Caucasian [107][108][109].…”

“…Caucasian women, compared with other cultural groups, have the lowest risk for PPD [107][108][109] and a greater chance for their disease to be diagnosed by professionals of mental health [107].…”

“…Additional common predisposing factors according to bibliography are low income and financial difficulties [21,23,98,116,144], free marital status [24,70,93,109,134,140,144,145], prenatal mood disorders [21,90,93,105,108], unwanted or unplanned pregnancy [21][22][23][24]89], poor marital and intrafamilial relationships [21,23,26,56,84,86,89,146,147], premature birth and infant's health problems [21-23, 84, 141, 147], low self-esteem [21,26,108,148], poor conditions of living [21,93,149], unemployment [8,21,23,26,8688], stressful life events [8,21,25,…”

Postpartum Depression and the Affordable Care Act: Recommendations for Social Work Educators

“…While some researchers have found the rates of postpartum depression to be higher in rural areas (Villegas, McKay, Dennis, & Ross, 2011), others have reported the prevalence to be higher in urban areas (Clare & Yeh, 2012). Likewise, various researchers have found differences among racial and ethnic groups (Gress-Smith, Luecken, Lemery-Chalfant, & Howe, 2012; Savitz, Stein, Ye, Kellerman, & Silverman, ADVANCES IN SOCIAL WORK, Fall 2015, 16 (2) 204 2011) and the likelihood that the rates for low-income mothers and for mothers of color are higher than estimated (CDC, 2008;Dolbier, et al, 2013;Gress-Smith et al, 2012;Lara et al, 2015).…”

“…While some researchers have found the rates of postpartum depression to be higher in rural areas (Villegas, McKay, Dennis, & Ross, 2011), others have reported the prevalence to be higher in urban areas (Clare & Yeh, 2012). Likewise, various researchers have found differences among racial and ethnic groups (Gress-Smith, Luecken, Lemery-Chalfant, & Howe, 2012; Savitz, Stein, Ye, Kellerman, & Silverman, ADVANCES IN SOCIAL WORK, Fall 2015, 16 (2) 204 2011) and the likelihood that the rates for low-income mothers and for mothers of color are higher than estimated (CDC, 2008;Dolbier, et al, 2013;Gress-Smith et al, 2012;Lara et al, 2015).Some researchers have suggested that mothers of color face more elevated rates of postpartum depression than White mothers because of greater life stressors, including economic factors known to affect postpartum depression. To date, research has concluded that compared to White mothers and mothers from privileged backgrounds, mothers of color have lower incomes (Dagher, McGovern, Dowd, & Gjerdingen, 2012;Feder et al, 2009;Kozinsky et al, 2012;Lara et al, 2015), lower levels of education (Dagher et al, 2012;Lanes, Kuk, & Tamim, 2011), higher rates of unemployment (Boyce & Hickey, 2005;Dagher et al, 2012;Janssen, Heaman, Urquia, O'Campo, & Thiessen, 2012), greater likelihood of single parenting (Boyce & Hickey, 2005;Lewin, Mitchell, & Ronzio, 2013), and worse housing conditions (Cutrona et al, 2005;Jacobs, 2011;Redshaw & Henderson, 2013).…”