title: Racial/Ethnic Differences in the Correlates of Mental Health Services Use among Pregnant Women with Depressive Symptoms.
abstract: Objectives To examine correlates of lifetime mental health services (MHS) use among pregnant women reporting prenatal depressive symptoms by race/ethnicity. Methods This cross-sectional population-based study included 81,910 pregnant women with prenatal depressive symptoms using data from the Florida Healthy Start prenatal screening program (2008-2012). Multivariable logistic regression was conducted to ascertain adjusted odds ratios and corresponding 95 % confidence intervals for racial/ethnic differences in the correlates of lifetime MHS use. Results Findings of this study revealed racial/ethnic differences in MHS use among women with prenatal depressive symptoms, the highest rates being among non-Hispanic Whites and the lowest rates among Mexicans and other Hispanics. Most need for care factors, including illness, tobacco use, and physical or emotional abuse, consistently predicted MHS use across racial/ethnic groups after adjusting for covariates. Adjusted associations between predisposing and enabling/restricting factors and MHS use were different for different racial/ethnic groups. Conclusions Racial/ethnic differences in MHS use were found, with pregnant Hispanic women reporting prenatal depressive symptoms being the least likely to use MHS. Our study findings have significant public health implications for targeted intervention for pregnant women with prenatal depressive symptoms.
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Ave., Suite 300, St. Louis, MO, 63104, USA. jjchang@slu.edu.
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Ave., Suite 300, St. Louis, MO, 63104, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Tabet
authors.affiliation: Department of Health Management and Policy, Saint Louis University College for Public Health and Social Justice, St. Louis, MO, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Elder
authors.affiliation: Nursing and Allied Health Center, Lindenwood University, St. Charles, MO, USA.
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Kiel
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Ave., Suite 300, St. Louis, MO, 63104, USA.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Flick
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology* / Q000523:psychology; D005260:Female; D005431:Florida / Q000453:epidemiology; D019538:Health Care Surveys; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008423:Maternal Age; D008605:Mental Health Services / Q000706:statistics & numerical data*; D011247:Pregnancy; D037841:Pregnant People / Q000208:ethnology / Q000523:psychology*; D011295:Prenatal Care; D015995:Prevalence; D012959:Socioeconomic Factors; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Maternal depression; Mental health utilization; Pregnant women; Racial disparity