Using Community-Based Participatory Research to Explore Social Determinants of Women's Mental Health and Barriers to Help-Seeking in Three Urban, Ethnically Diverse, Impoverished, and Underserved Communities

doi:10.1016/j.apnu.2013.09.001

Archives of Psychiatric Nursing

Volume 27, Issue 6, December 2013, Pages 278-284

https://doi.org/10.1016/j.apnu.2013.09.001 Get rights and content

Abstract

Depression and anxiety are significant mental health issues that affect urban, ethnically diverse, impoverished women disproportionately. This study sought to identify social determinants of mental health and barriers to help-seeking for this population. Using community based participatory research and focus groups, sixty-one Black, Hispanic, and White women identified economic, family, cultural, and neighborhood issues as perceived determinants of their depression/anxiety. They identified practical, psychosocial, and cultural barriers to their help-seeking behavior. These results can promote women's health by fostering an understanding of social factors as perceived determinants of depression/anxiety and shaping practice and policy initiatives that foster positive aggregate outcomes.

Section snippets

Definitions of Social Determinants of Health

The Centers for Disease Control and Prevention assert that biological, socioeconomic, psychosocial, behavioral, and social influences determine the health of a population (Centers for Disease Control and Prevention (CDC), 2012). Of those, the social determinants of health have been least explored. Social determinants of health:

…are the conditions in which people are born, grow, live, work, and age, including the health system. These circumstances are shaped by the distribution of money, power,

Design

The ideological perspective of community based participatory research (CBPR) was used to explore the following research questions: (1) What contributes to the experience of depression and anxiety of urban, ethnically diverse, impoverished women? and (2) What barriers prevent urban, ethnically diverse, impoverished women from using existing mental health resources? The designation of urban, ethnically diverse, and impoverished women included city dwelling women who are Black, Hispanic, or White

Results

These results are part of a larger study on women's mental health. Themes, derived from six focus groups, and subthemes, from at least four of the six groups, are presented in Table 3. Quotations support the results and include the designation “P” to indicate the contributions of participants.

Discussion

The economic, cultural, neighborhood and family contributing factors as well as the practical, psychosocial, and cultural barriers to help-seeking identified by the study participants clearly constitute social determinants of health. The themes encompass the social environment, the physical environment, and health services (Centers for Disease Control and Prevention (CDC), 2012) as well as comprising the “conditions in which people are born, grow, live, work, and age, including the health

Acknowledgment

The authors gratefully acknowledge the support of the Calvin College Sabbatical Leave Program, the Marian Petersen Nursing Research Fund, and the Perrigo Company Charitable Foundation for providing financial support for the research activities of the primary investigator, stipends for the participants, and wages for the research assistants.

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Using Community-Based Participatory Research to Explore Social Determinants of Women's Mental Health and Barriers to Help-Seeking in Three Urban, Ethnically Diverse, Impoverished, and Underserved Communities

Abstract

Section snippets

Definitions of Social Determinants of Health

Design

Results

Discussion

Acknowledgment

Women’s Health Issues

Journal of Professional Nursing

Women’s Mental Health Issues

Perceived everyday discrimination and psychological distress: Does social support matter?

Ethnicity & Health

Economic hardships in adulthood and mental health in Sweden: The Swedish National Public Health Survey

BMC Public Health

Acculturation, discrimination, and depressive symptoms among Korean immigrants in New York City

Community Mental Health Journal

Predictors of mental health service utilization by people using resources for homeless people in Canada

Psychiatric Services

The social determinants of health: Coming of age

Annual Review of Public Health

Health, United States, 2011

Social determinants of health – Definitions

Discrimination, family relationships, and major depression among Asian Americans

Journal of Immigrant Minority Health

Doing qualitative research

Listening to rural Hispanic immigrants in the midwest: A community-based participatory assessment of major barriers to health care access and use

Qualitative Health Research

Social stressors associated with antepartum depressive symptoms in low-income African-American women

Public Health Nursing

Does perceived financial strain predict depression among young women? Longitudinal findings from the Southampton women’s survey

Mental Health in Family Medicine

Comparison of users and non-users of mental health services among depressed women: A national study

Women’s Health

Economic stress, social support, and maternal depression: Is social support deterioration occurring?

Social Work Research

Competing paradigms in qualitative research

Listening to community voices: Community- based research, a first step in partnership and outreach

Journal of Higher Education Outreach and Engagement

The importance of addressing social determinants of health at the local level: The case for social capital

Health and Social Care in the Community

Food insecurity: Special considerations for women

American Journal of Clinical Nutrition

Achieving organizational change: Findings from case studies of 20 California healthy cities and communities coalitions

Health Promotion International

Focus groups: A practical guide for applied research

Naturalistic inquiry

Risk factors for major antenatal depression among low-income African-American women

Journal of Women’s Health