Post-partum Depression in Minority Populations
SCREENING TOOLS
BARRIERS TO CARE
CAUSES
STIGMA
Low income is associated with an increased risk of PPD, but she says that racial and ethnic disparities persist after controlling for maternal educational attainment, income, marital status, and other measures of SES
probability of experiencing toxic stressor landscapes declines with income, but also many of these stressors emerge from structural factors, including segregation, lack of access to employment with insurance coverage for behavior health or supply of behavioral health providers
potential explanation is stigma related to seeking behavioral health services
providers may also misinterpret symptoms based on a lack of knowledge of cultural differences, particularly among immigrants
interpersonal racism: evidence links the experience of interpersonal racism to depression among people of color to depression among people of color. the link between racism and depression can actually be stronger among more educated people.
greater stigma associated with mental health in communities of color, including nativity, english proficiency, challenges with getting to care in the first place, and lack of patient-provider racial/ethnic concordance
problem: continuous insurance coverage. black women are disproportionately likely to have their pregnancy and deliveries covered by Medicaid, but lower income mothers on medicaid are removed from the rolls 60 days postpartum in they don't meet the income criteria for regular medicaid= disruption in continuity of care
black women choose to struggle on their own rather than seek care and risk having their families torn apart by child welfare services
studies have found that child welfare workers deem black mothers unfit at a higher rate than they do white mothers, even with controlling factors like education and poverty
the tools were developed based on mostly white research participants, often those screening tools are less relevant for women of color
different cultures talk about mental illness in different ways. African Americans are less likely to use the term depression, but they may say they don’t feel like themselves,
more common for people in minority communities to experience mental illness as physical symptoms. Depression can show up as headaches, for example, or anxiety as gastrointestinal issues