scholarly journals Postpartum mood among universally screened high and low socioeconomic status patients during COVID-19 social restrictions in New York City

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Michael E. Silverman ◽  
Laudy Burgos ◽  
Zoe I. Rodriguez ◽  
Omara Afzal ◽  
Alyssa Kalishman ◽  
...  

AbstractThe mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus Disease 2019 (COVID-19) pandemic on postpartum women are of increasing concern among mental health practitioners. To date, only a handful of studies have explored the emotional impact of the pandemic surrounding pregnancy and none have investigated the consequence of pandemic-related social restrictions on the postpartum mood of those living among different socioeconomic status (SES). All postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient’s socioeconomic status (high/low) was determined by their location of clinical service. A total of 516 postpartum patients were screened. While no differences in EPDS scores were observed by SES prior to social restrictions (U = 7956.0, z = − 1.05, p = .293), a significant change in mood symptomatology was observed following COVID-19 restrictions (U = 4895.0, z = − 3.48, p < .001), with patients living in lower SES reporting significantly less depression symptomatology (U = 9209.0, z = − 4.56, p < .001). There was no change in symptomatology among patients of higher SES (U = 4045.5, z = − 1.06, p = .288). Postpartum depression, the most common complication of childbearing, is a prevalent, cross-cultural disorder with significant morbidity. The observed differences in postpartum mood between patients of different SES in the context of temporarily imposed COVID-19-related social restrictions present a unique opportunity to better understand the specific health and social support needs of postpartum patients living in urban economic poverty. Given that maternal mental illness has negative long-term developmental implications for the offspring and that poor mental health reinforces the poverty cycle, future health policy specifically directed towards supporting postpartum women living in low SES by ameliorating some of the early maternal burdens associated with balancing employment-family-childcare demands may assist in interrupting this cycle while simultaneously improving the long-term outcomes of their offspring.

2020 ◽  
Author(s):  
Michael E. Silverman ◽  
Laudy Burgos ◽  
Zoe I. Rodriguez ◽  
Omara Afzal ◽  
Alyssa Kalishman ◽  
...  

Abstract Introduction: The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus disease 2019 (COVID-19) pandemic on postpartum women is of increasing concern among mental health practitioners. To date only a handful of studies have explored the impact of the pandemic during pregnancy and none have attempted explore the impact of pandemic related social restrictions on postpartum mood.Methods: Postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient’s socioeconomic status (SES; high/low) was determined by their location of clinical service.Results: 516 postpartum patients were screened. While no differences in EPDS scores were observed by SES prior to social restrictions (t(262)=0.23, p=.82), a significant change in mood symptomatology was observed following COVID-19 restrictions (t(288)=2.32, p<.02), with patients living in lower SES reporting significantly less depression symptomatology (t(321)=4.07, p<.01). There was no change in symptomatology among patients of higher SES (t(191)=0.59, p=0.56).Discussion: Postpartum depression, the most common complication of childbearing, is a prevalent, cross-cultural disorder with significant morbidity. The observed differences in postpartum mood between patients of different SES in the context of temporarily imposed COVID-19 related social restrictions present a unique opportunity to better understand the specific health and social support needs of postpartum patients living in urban poverty. Given that maternal mental illness has negative long-term developmental implications for the offspring, and that poor mental health reinforces the poverty cycle, future policy specifically directed towards supporting urban postpartum women living in low-SES by ameliorating some of the early maternal mental health burdens associated with balancing employment-family-childcare demands may assist in interrupting this cycle while simultaneously improving the long-term outcomes of their offspring.


2019 ◽  
Vol 22 (5) ◽  
pp. 312-320 ◽  
Author(s):  
Janine R. Lam ◽  
Jessica Tyler ◽  
Katrina J. Scurrah ◽  
Nicola J. Reavley ◽  
Gillian S. Dite

AbstractLow socioeconomic status (SES) has been established as a risk factor for poor mental health; however, the relationship between SES and mental health problems can be confounded by genetic and environmental factors in standard regression analyses and observational studies of unrelated individuals. In this study, we used a within-pair twin design to control for unmeasured genetic and environmental confounders in investigating the association between SES and psychological distress. We also employed within–between pair regression analysis to assess whether the association was consistent with causality. SES was measured using the Index of Relative Socio-economic Disadvantage (IRSD), income and the Australian Socioeconomic Index 2006 (AUSEI06); psychological distress was measured using the Kessler 6 Psychological Distress Scale (K6). Data were obtained from Twins Research Australia’s Health and Lifestyle Questionnaire (2014–2017), providing a maximum sample size of 1395 pairs. Twins with higher AUSEI06 scores had significantly lower K6 scores than their co-twins after controlling for shared genetic and environmental traits (βW [within-pair regression coefficient] = −0.012 units, p = .006). Twins with higher income had significantly lower K6 scores than their co-twins after controlling for familial confounders (βW = −0.182 units, p = .002). There was no evidence of an association between the IRSD and K6 scores within pairs (βW, p = .6). Using a twin design to eliminate the effect of potential confounders, these findings further support the association between low SES and poor mental health, reinforcing the need to address social determinants of poor mental health, in addition to interventions targeted to individuals.


2019 ◽  
Author(s):  
Emma Frankham

WORKING PAPER Is socioeconomic status a predictor of mental health-related 911 calls independent of mental health? Answering this question is important because knowing which factors are associated with mental health-related calls could influence effective resource allocation. I analyze census tract- level data across three cities and find that a lack of financial resources is positively associated with mental health-related calls, independent of poor mental health. I argue that individuals of low socioeconomic status rely on this public safety net more so than affluent individuals, and that this is an under-recognized mechanism by which individuals of low socioeconomic status with mental illness come into contact with police.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044463
Author(s):  
Danielle Borg ◽  
Kym Rae ◽  
Corrine Fiveash ◽  
Johanna Schagen ◽  
Janelle James-McAlpine ◽  
...  

IntroductionThe perinatal–postnatal family environment is associated with childhood outcomes including impacts on physical and mental health and educational attainment. Family longitudinal cohort studies collect in-depth data that can capture the influence of an era on family lifestyle, mental health, chronic disease, education and financial stability to enable identification of gaps in society and provide the evidence for changes in government in policy and practice.Methods and analysisThe Queensland Family Cohort (QFC) is a prospective, observational, longitudinal study that will recruit 12 500 pregnant families across the state of Queensland (QLD), Australia and intends to follow-up families and children for three decades. To identify the immediate and future health requirements of the QLD population; pregnant participants and their partners will be enrolled by 24 weeks of gestation and followed up at 24, 28 and 36 weeks of gestation, during delivery, on-ward, 6 weeks postpartum and then every 12 months where questionnaires, biological samples and physical measures will be collected from parents and children. To examine the impact of environmental exposures on families, data related to environmental pollution, household pollution and employment exposures will be linked to pregnancy and health outcomes. Where feasible, data linkage of state and federal government databases will be used to follow the participants long term. Biological samples will be stored long term for future discoveries of biomarkers of health and disease.Ethics and disseminationEthical approval has been obtained from the Mater Research Ethics (HREC/16/MHS/113). Findings will be reported to (1) QFC participating families; (2) funding bodies, institutes and hospitals supporting the QFC; (3) federal, state and local governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.


Author(s):  
Stephanie L. Orstad ◽  
Kristin Szuhany ◽  
Kosuke Tamura ◽  
Lorna E. Thorpe ◽  
Melanie Jay

Increasing global urbanization limits interaction between people and natural environments, which may negatively impact population health and wellbeing. Urban residents who live near parks report better mental health. Physical activity (PA) reduces depression and improves quality of life. Despite PA’s protective effects on mental health, the added benefit of urban park use for PA is unclear. Thus, we examined whether park-based PA mediated associations between park proximity and mental distress among 3652 New York City residents (61.4% 45 + years, 58.9% female, 56.3% non-white) who completed the 2010–2011 Physical Activity and Transit (PAT) random-digit-dial survey. Measures included number of poor mental health days in the previous month (outcome), self-reported time to walk to the nearest park from home (exposure), and frequency of park use for sports, exercise or PA (mediator). We used multiple regression with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation by park-based PA and moderation by gender, dog ownership, PA with others, and perceived park crime. Park proximity was indirectly associated with fewer days of poor mental health via park-based PA, but only among those not concerned about park crime (index of moderated mediation = 0.04; SE = 0.02; 95% BC CI = 0.01, 0.10). Investment in park safety and park-based PA promotion in urban neighborhoods may help to maximize the mental health benefits of nearby parks.


2017 ◽  
Vol 40 ◽  
Author(s):  
Nisheeth Srivastava ◽  
Narayanan Srinivasan

AbstractWe suggest that steep intertemporal discounting in individuals of low socioeconomic status (SES) may arise as a rational metacognitive adaptation to experiencing planning and control failures in long-term plans. Low SES individuals' plans fail more frequently because they operate close to budgetary boundaries, in turn because they consistently operate with limited budgets of money, status, trust, or other forms of social utility.


2004 ◽  
Vol 2 (2) ◽  
pp. 125-138 ◽  
Author(s):  
DANIEL KARUS ◽  
VICTORIA H. RAVEIS ◽  
KATHERINE MARCONI ◽  
PETER SELWYN ◽  
CARLA ALEXANDER ◽  
...  

Objective:To describe mental health status and its correlates among clients of three palliative care programs targeting underserved populations.Methods:Mental Health Inventory (MHI-5) scores of clients from programs in Alabama (n= 39), Baltimore (n= 57), and New York City (n= 84) were compared.Results:Mean MHI-5 scores did not differ among sites and were indicative of poor mental health. Significant differences were noted among sites with regard to client sociodemographics, physical functioning, and perceptions of interpersonal relations. Results of multivariate regression models estimated for each site suggest variation in the relative importance of potential predictors among sites. Whereas poorer mental health was primarily associated with history of drug dependence at Baltimore and more physical symptomatology at New York, better mental health was most strongly correlated with more positive perceptions of interpersonal relationships at Baltimore and increasing age and more positive perceptions of meaning and purpose in life at New York.Significance of results:The data presented suggest the importance of assessing clients' history of and current need for mental health services. Evidence of a relationship between positive perceptions of meaning and purpose and better psychological function underscores the importance of existential issues for the overall well-being of those who are seriously ill.


2011 ◽  
Vol 42 (6) ◽  
pp. 1273-1282 ◽  
Author(s):  
J. Leung ◽  
C. Gartner ◽  
W. Hall ◽  
J. Lucke ◽  
A. Dobson

BackgroundTobacco smoking and poor mental health are both prevalent and detrimental health problems in young women. The temporal relationship between the two variables is unclear. We investigated the prospective bi-directional relationship between smoking and mental health over 13 years.MethodParticipants were a randomly selected community sample of 10 012 young women with no experience of pregnancy, aged 18–23 years at baseline (1996) from the Australian Longitudinal Study on Women's Health. Follow-up surveys over 13 years were completed in 2000, 2003, 2006 and 2009, allowing for five waves of data. Measures included self-reported smoking and mental health measured by the Mental Health Index from the 36-item short-form health questionnaire and the 10-item Center for Epidemiologic Studies Depression Scale. Sociodemographic control variables included marital status, education level and employment status.ResultsA strong cross-sectional dose–response relationship between smoking and poor mental health was found at each wave [odds ratio (OR) 1.41, 95% confidence intervals (CI) 1.17–1.70 to OR 2.27, 95% CI 1.82–2.81]. Longitudinal results showed that women who smoked had 1.21 (95% CI 1.06–1.39) to 1.62 (95% CI 1.24–2.11) times higher odds of having poor mental health at subsequent waves. Women with poor mental health had 1.12 (95% CI 1.17–1.20) to 2.11 (95% CI 1.68–2.65) times higher odds of smoking at subsequent waves. These results held after adjusting for mental health history and smoking history and sociodemographic factors. Correlation analysis and structural equation modelling results were consistent in showing that both directions of the relationship were statistically significant.ConclusionsThe association between poor mental health and smoking in young women appeared to be bi-directional.


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