Sample Of Low-income Women Research Articles

Racial Differences in Mental Health Service Utilization Among Low-Income Women

SUMMARY The authors present data on mental health outpatient services in non-specialty settings in a sample of low-income women by exploring service use in the general medical sector, specialty mental health/substance services, the human service sector, and self-help groups. Findings are reported from 668 African American and White women in the Mothers' Well-Being Study (MWS). The MWS measured a range of psychiatric and substance dependence disorders using the Composite International Diagnostic Interview, Version 2.1 (CIDI 2.1). The MWS also gathered data regarding outpatient mental health service utilization. In the year preceding the study, 43.9% of the White respondents and 39.0% of the African American respondents had at least one of the mental health disorders measured in the MWS. There were no significant differences in the frequency of any of the disorders by race. However, White respondents with disorders received more treatment than African American women in the general medical sector. In the year prior to the interview, nearly a quarter (22.4%) of White women with any diagnosis received care in the general medical sector compared to only 9.1% of African American women. The racial disparity in mental health treatment in the general medical sector may indicate that African American low-income women are not receiving the same level of care as White women. The authors discuss the implications of this disparity and suggest ways of expanding access to care for African American women in the general medical setting.

Body Image: A Study in a Tri-Ethnic Sample of Low Income Women

This study was designed to examine the evaluative, affective, and behavioral components of body image among 1,217 low-income European American, African American, and Latina women. Participants completed a multidimensional body image questionnaire while awaiting an outpatient clinic appointment. Body mass index (BMI) was determined by medical chart review. Nearly all normal weight and a number of overweight and obese African Americans characterized their weight as normal. In contrast, nearly all overweight and obese European Americans and Latinas regarded themselves as overweight as did over 30% of those of normal weight. European Americans and Latinas with higher BMIs reported more appearance shame than their lower BMI peers did; this pattern was not observed among African Americans. Among Latinas, body image was influenced by length of residency in the U.S.

Race and parity as risk factors for obesity among low-income women in Brazil

In recent years, several reports have indicated that obesity and associated chronic diseases presented a huge increase worldwide, especially in low-income women living in undeveloped countries. The aim of this study was to verify, in a cross-sectional way, the association among obesity, diet, lifestyle and socioeconomic factors among 116 low-income women (mean age, 42.6 ± 13.4 years) living in a deprived neighborhood in the metropolitan area of São Paulo, the main city in Brazil. The sample was categorized in 3 strata according to body mass index (≤25.0, 25-29.9, and ≥30.0 kg/m 2). Anthropometric measurements and cardiovascular risk factors, as well as diet, lifestyle, and sociodemographic characteristics, were compared. Frequency of obesity was 28.4%—higher than the frequency of obesity observed in other Brazilian population samples. After multivariate adjustment, compared with women with less than 3 childbirths, women with 3 childbirths or more were more overweight (odds ratio [OR], 3.4; 95% confidence interval [95% CI], 1.2-9.6) and more obese (OR, 5.3; 95% CI, 1.3-17.5). Compared to black women, white women were also more obese (OR, 9.9; 95% CI, 1.5-64.6). In this sample of low-income women, parity and race were the most important factors associated with obesity.

Patterns of care among breast cancer patients with financial need: Information from a Medicaid-claims and tumor registry linked database

6037 Background: There is little information describing patterns of health care in financially needy women with breast cancer in the United States. Methods: We previously created and validated a hybrid database linking Medicaid-claims and tumor registry data in a sample of patients with breast cancer in North Carolina. Here, we describe patterns of care among this sample of low income women. Logistic regression was used to determine predictors of type of surgery, radiation therapy use after breast conserving surgery, and chemotherapy use. Results: The sample consisted of 984 women. Ages ranged from 23–102, with 21% < 50, 28% 50–64, 20% 65–74, and 32% ≥ 75. Fifty-eight percent were Caucasian. Mean Charlson comorbidity score was 3.4 (SD 3.1). Twelve percent had tumors <1 cm, 30% 1–2 cm, 46% 2–5 cm, and 13% >5 cm. Nodes were negative in 47%. Hormone receptors were positive in 47%. Main results are tabulated below. 67% were managed with mastectomy, 41% received adjuvant chemotherapy, 60% of women who had breast conserving therapy received adjuvant radiation. BCS = breast conserving therapy 1reference category <50; 2reference category 0–1 cm; 3reference category 4+ nodes Conclusions: In this low income insured group of breast cancer patients, black women were more likely than white women to have breast conserving surgery and higher Charlson scores predicted greater mastectomy rate and higher likelihood of chemotherapy use. No significant financial relationships to disclose.

Neighborhood disorder, psychological distress, and heavy drinking

Studies show that residents of disadvantaged neighborhoods drink more heavily than residents of more affluent neighborhoods. However, explanations for this association are not well developed. Using data collected from a sample of low-income women with children from Boston, Chicago, and San Antonio, we explore the possibility that perceptions of neighborhood disorder encourage heavy drinking. Drawing on Conger's (Q. J. Stud. Alcohol 17 (1956) 296) tension reduction hypothesis, we propose that the stress of living in a neighborhood characterized by problems with drugs, crime, teen pregnancy, unemployment, idle youth, abandoned houses, and unresponsive police can be psychologically distressing and lead some people to consume alcohol as a means of palliative escape, to regulate feelings of anxiety and depression. In support of the tension reduction hypothesis, we find that the positive association between neighborhood disorder and heavy drinking is largely mediated by anxiety and depression.

Demographic, Psychological, and Relationship Factors in Domestic Violence During Pregnancy in a Sample of Low-Income Women of Color

Research suggests that a significant number of women first experience domestic violence during pregnancy. The current study examines correlates of violence during pregnancy, first by comparing women who did and did not report violence, and second examining three subgroups of women who reported violence (violence initiated, violence persisted, violence ceased). Results indicated that controlling for demographics, more frequent violence was associated with less support and satisfaction with support from the baby's father, more negative interactions with the baby's father, and more verbal aggression in their relationships than those who did not report violence. Differences among subgroups of women reporting violence emerged only for the relationship variables. Implications for detecting violence in clinical settings are discussed.

Weight and Behavioral and Psychosocial Factors Among Ethnically Diverse, Low-Income Women After Childbirth: I. Methods and Context

ABSTRACT Objective: In this paper, we present the background, hypotheses, methods, and descriptive findings from the Austin New Mothers Study, a longitudinal series measuring weight and contextual variables across the first postpartum year. Among the distinguishing features of this study are its tri-ethnic sample of low-income women and its serial measurement of the behavioral and psychosocial context of postpartum weight changes post-delivery and at 6 weeks, and 3, 6, and 12 months postpartum. Method: A prospective longitudinal design was used to assess body mass index (BMI), energy intake, fat intake, physical activity, health-related lifestyle, depressive symptoms, body image, and weight-related distress at each observation. Sample: The analytic sample consisted of 382 White, African American, and Hispanic women. Findings: For BMI, effects for ethnicity (p < .001), time (p < .001), and their interaction (p = .005) were significant. All ethnic groups had significant declines in BMI from delivery to 6 weeks postpartum. Thereafter, BMIs of White women declined during the second 6 months, whereas those of Hispanic and African American women either displayed small gains or plateaus between adjacent observations. Time-related effects were significant for behavioral and psychosocial variables except for body image and weight-related distress, whereas effects for ethnicity were significant on fat intake, depressive symptoms, and body image. Despite declines in depressive symptoms, women remained at risk of depression across the first postpartum year. Conclusions: Low-income ethnic minority women have a higher vulnerability to postpartum weight gains or plateaus. High depressive symptoms occurred in all ethnic groups examined.

Low-income women's use of substance abuse and mental health services.

This paper examines the utilization of mental health, alcohol, and drug treatment in a sample of low-income women. We analyze data from the Women's Employments Study, a study examining the barriers to employment for welfare recipients, and compare prevalence rates of mental health disorders and service utilization with the National Comorbidity Survey. Fewer than one in five of the respondents with a current mental health and/or substance dependence problem in the Women's Employment Study (WES) received treatment in the past 12 months. A logistic regression model of the association among demographic variables, risk factors, and service utilization in the WES found that having a co-occurring substance dependence and mental health disorder was significantly associated with receiving treatment. Those respondents with an increased number of barriers were significantly less likely to receive treatment. The authors argue that the success of welfare reform may hinge on low-income women's access to and utilization of appropriate services.

Factor Structure of the Center for Epidemiologic Studies Depression Scale in Low- Income Women Attending Primary Care Clinics

Given the high rates of major depressive disorder in primary care settings, routine use of screening measures to assist in identifying depressed individuals is warranted. The Center for Epidemiologic Studies Depression Scale (CES-D) ( Radloff, 1977 ) is a self-rated measure of distress commonly used to screen for depression in primary care settings. The present study was undertaken to confirm the original four-factor model in a sample of low-income women attending primary care clinics (N = 179). Although the original four-factor structure has been replicated in a variety of population groups, internal validity of the measure has not been previously examined in this population sample. A series of confirmatory factor analytic procedures failed to replicate the original four-factor structure or a second-order model. An exploratory analysis, using principal components and a VARIMAX rotation yielded three factors: Depressed Affect/Somatic Symptoms, Positive Affect, and Interpersonal Difficulties. Results of this study add support to previous research documenting an increased somatic presentation of depression in low-income samples. Implications for the use of the CES-D as a screening tool to identify depression in similar primary care samples are discussed.

Predicting Parenting Behaviors From Antisocial Practices Content Scale Scores of the MMPI-2 Administered During Pregnancy

This article examines the relation between scores on the Antisocial Practices (ASP) content scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and parenting behaviors in a sample of low-income women. During pregnancy, 141 women were administered the MMPI-2 and then placed into 1 of 3 groups: an antisocial, nonclinical, or clinical control group. When their children were 13 and 24 months old, antisocial mothers were observed to be less understanding and more hostile and harsh in their parenting styles than mothers in the other groups. The nonclinical and clinical control groups did not differ on any measures. Other MMPI-2 measures of antisocial behavior were not predictive of harsh parenting styles. These findings support the predictive and construct validity of the ASP content scale of the MMPI-2.

Life stress, social support, and anxiety in mid- and late-pregnancy among low income women.

The stability and multivariate effects of life stress, social support, and anxiety from mid to late pregnancy in a sample of low-income women were examined. The sample of 190 was approximately equally divided among black, Hispanic, and white groups. Scores from the two time periods were highly consistent. The multivariate effects of life stress and social support on anxiety were similar at the two time periods, explaining 30% to 34% of the variance in anxiety, over and above the effects of ethnicity or marital status. The prospective test (Time 1 variables predicting Time 2 anxiety), however, explained only 22% of the variance in anxiety. Significant stress-buffering effects from social support were found for both the Time 1 regression and the prospective test. The combination of high life stress and low partner support was associated with the highest anxiety. The findings confirmed that mid-pregnancy measures of these psychosocial variables were valid indicators of their level over the course of the remainder of the pregnancy, allowing for early assessment and intervention to improve perinatal well-being.