Stress and the Social Determinants of Maternal Health among Puerto Rican Women: A CBPR Approach

Abstract

This qualitative research project explores how poverty, the built environment, education, working conditions, health care access, food insecurity and perceived discrimination are experienced by Puerto Rican Latinas through the course of their lives. Five focus groups were conducted with the primary objective of documenting community experiences and perspectives regarding: 1) stress, including perceived discrimination based on race/ethnicity (racism); 2) the impact of stress on Puerto Rican women of reproductive age, their families, and/or their community; and 3) stressors that affect maternal health. Focus groups were conducted in English and Spanish in the two cities with the highest rates of premature birth and low infant birthweight in the state of Connecticut. Focus group findings indicate that participants perceived poverty, food insecurity, lack of access to quality education, and unsafe environments as significant life stressors affecting maternal and child health.

Aging in Puerto Rico: A Comparison of Health Status Among Island Puerto Rican and Mainland U.S. Older Adults

“…In addition, women on the island may be living in more adverse conditions than men. Research has shown that island Puerto Rican women perceive poverty, food insecurity, lack of access to quality education, and unsafe neighborhood environments as significant life stressors (Bermúdez-Millan et al, 2011), and these stressors may get “under the skin” and increase Puerto Rican women’s risk for poor health. In addition, obesity is a risk factor for the health indicators on which Puerto Rican women were more disadvantaged, and thus gender differences on these health outcomes may reflect women’s higher rates of overweight and obesity (Pérez et al, 2013).…”

A Comparison of Birth Outcomes Among Black, Hispanic, and Black Hispanic Women

“…In terms of discrimination and racism, Black women are unlike women of most other racial backgrounds in that they tend to have higher levels of lifelong perceived discrimination and exposure to experiences of racism [41]. Research suggests that while US-born Hispanics may experience similar levels of discrimination as Blacks, they may not identify it as a major stressor leading to PTB or LBW [42, 43]. Although skin color is not recorded in the birth certificate data, it is possible that Hispanic women who self-identify as Black may share some of the phenotypic features of Black women, including skin color, that is associated with discrimination and racism [31, 33, 34].…”

Social Capital Accumulation among Puerto Rican Mothers in Urban Neighborhoods

“…This supported Small's argument that institutions (not only or nor primarily people's own independent efforts) determine the extent and nature of social capital that people develop. A mother's engagement with her child's activities suggested that she benefitted from an array of institutional actions, arrangements, and activities regardless of her individual characteristics [12]. When mothers attended events for their children, these institutions provided access to opportunities.…”

“…By social networks, we mean a set of interdependent relations among family, friends, or neighbors who exchange some form of support on a regular basis that influence social behavior [12]. We use the concept of resources when referring to supportive behaviors that demonstrate solidarity, trust, and other resilience-enhancing support; provide tangible aid and services to meet an immediate personal need for instrumental support; and/or share knowledge and information needed to facilitate problem-solving [18].…”