Racial Disparities in Perinatal Depression in an Underserved Los Angeles County Population [3OP

Abstract

INTRODUCTION: Perinatal depression affects one in seven women, and is associated with significant morbidity. Limited data suggest depression rates to be twice as high among low-income, minority women. This study aimed to identify associations between race/ethnicity and perinatal depression in a medically and psychosocially at-risk population. METHODS: Study data were collected from interviews conducted from December 2013 through August 2016 by Community Health Workers as part of the initial obstetric assessment. Depression was scored on the Center for Epidemiologic Studies Depression (CES-D) Scale, with depression defined as a score of greater than 16 for clinical symptoms. Race and ethnicity were self-reported. Chi-square analyses were performed. RESULTS: A total of 3,214 women were included in the study. Analyses revealed that a larger proportion of African American women (26.2%) met criteria for depression than their White (20.1%), Asian (5.2%) and Mixed Race counterparts (2.6%; chi-square less than .01, P greater than .001). Analyses involving ethnicity revealed that women who identified as Hispanic/Latina (27.1%) were less likely than non-Hispanic women (38.5%) to meet CES-D depression criteria (chi-square=44, P less than .001). CONCLUSION: Race and ethnicity were significantly associated with perinatal depression. A higher proportion was seen among African American women, while a lower proportion seen among Hispanic/Latinas. Implications for practice include increasing mental health support and a referral network to access during pregnancy and postpartum. Future research might include examination of protective factors for depressive symptoms in pregnant women of different ethnic/racial backgrounds. Screening tools for other mental health conditions may account for other ethnic/racial differences.