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

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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 oversampling 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.

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Acknowledgment

The Community Child Health Network (CCHN) is a community-based participatory research network supported through cooperative agreements with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (U HD44207, U HD44219, U HD44226, U HD44245, U HD44253, U HD54791, U HD54019, U HD44226-05S1, U HD44245-06S1, R03 HD59584) and the National Institute for Nursing Research (U NR008929). CCHN reflects joint endeavors of five local sites: (1) Baltimore: Baltimore City Healthy Start and Johns Hopkins University (Community PI Maxine Vance, Academic PI Cynthia S. Minkovitz, Project Coordinator Nikia Sankofa, Co-Is Patricia O’Campo, Peter Schafer); (2) Lake County, Illinois: Lake County Health Department and Community Health Center and the Northshore University Health System (Community PI Kim Wagenaar, Academic PI Madeleine Shalowitz, Project Coordinator Beth Clark-Kauffman, Co-Is Emma Adam, Greg Duncan*, Chelsea McKinney, Rachel O’Connell, Alisu Schoua-Glusberg); (3) Los Angeles: Healthy African American Families, Cedars-Sinai Medical Center, and University of California, Los Angeles (Community PI Loretta Jones, Academic PI Calvin J.Hobel, Co-PIs Christine Dunkel Schetter, Michael C. Lu; Project Coordinators Mayra Lizzette Yñiguez, Dawnesha Beaver, Felica Jones); (4) East Carolina University, NC Division of Public Health, NC Eastern Baby Love Plus Consortium, and University of North Carolina, Chapel Hill (Community PIs Sharon Evans, Scharina Oliver*, Richard Woolard, Academic PI John Thorp, Project Coordinators Suzanne Kelly, Latoya S. Sahadeo, Kathryn Salisbury, Co-Is Julia DeClerque, Christyn Dolbier, Mary Glascoff*, Vijaya Hogan*, Carol Lorenz, Edward Newton, Belinda Pettiford, Research Partners Shelia Bunch, Sarah Maddox, Judy Ruffin); and (5) Washington, DC: Georgetown Center on Health and Education, Washington Hospital Center, and Developing Families Center (Community PI Loral Patchen, Academic PI Sharon L. Ramey, Academic Co-PI Robin Lanzi, Project Coordinator Nedaa Timraz, Co-Is Lorraine V. Klerman, Menachem Miodovnik, Craig T. Ramey, Linda Randolph, Community Coordinator Rosalind German). The following individuals also made critical contributions to CCHN: the Data Coordination and Analysis Center at the Pennsylvania State University (PI Vernon M. Chinchilli, Project Coordinator Gail Snyder, Co-Is Rhonda Belue, Georgia Brown Faulkner*, Marianne Hillemeier, Erik Lehman, Ian Paul, Jim Schmidt, Michele L. Shaffer, Christy Stetter), Steering Committee Chairs Mark Phillippe and Elena Fuentes-Afflick*, and NIH Program Scientists (V. Jeffrey Evans, Tonse Raju) and Program Officers (Yvonne Bryan*, Michael Spittel, Linda Weglicki, Marian Willinger). We thank the hospitals and other facilities sponsoring participant recruitment and the local community advisory boards at each site. For a detailed overview of CCHN please see the CCHN public website at http://www.communitychildhealthnetwork.com. *Indicates those who participated in the planning phase of the CCHN.

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Authors and Affiliations

  1. East Carolina University, Greenville, NC, USA

    Christyn L. Dolbier & Taylor E. Rush

  2. University of North Carolina, Chapel Hill, Chapel Hill, NC, USA

    Latoya S. Sahadeo & John Thorp

  3. Penn State Hershey College of Medicine, Hershey, PA, USA

    Michele L. Shaffer

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  1. Christyn L. Dolbier
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  2. Taylor E. Rush
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  4. Michele L. Shaffer
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  5. John Thorp
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The Community Child Health Network Investigators

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Correspondence to Christyn L. Dolbier.

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Dolbier, C.L., Rush, T.E., Sahadeo, L.S. et al. Relationships of Race and Socioeconomic Status to Postpartum Depressive Symptoms in Rural African American and Non-Hispanic White Women. Matern Child Health J 17, 1277–1287 (2013). https://doi.org/10.1007/s10995-012-1123-7

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