title: Postpartum Depression among African-American and Latina Mothers Living in Small Cities, Towns, and Rural Communities.
abstract: BACKGROUND
  The presence of postpartum depression can lead to poor maternal-child attachment, failure to thrive, and even infant death. Postpartum depression affects 13-19 % of parturients. However, among racial and ethnic minority parturients, postpartum depression rates have been shown to reach up to 35-67 % (as reported by O'Hara and McCabe, Annu Rev Clin Psychol 9:379-407, 2013; Boury et al., Women Health. 39(3):19-34, 2004; Ramos-Marcuse et al.. J Affect Disord. 122(1-2):68-75, 2010; Lucero et al., J Am Acad Nurse Pract. 24(12):726-34, 2012). This is more concerning when considering the fact that these mothers are also hardest to reach because they are usually marginalized and displaced within mainstream US society. The current study assesses potential risk factors that contribute to postpartum depression among African-American and Latina mothers.
  
  
  METHODS
  We analyze data from 3317 Healthy Start participants living in small cities, towns, and rural areas in Pennsylvania using a logistic regression analysis controlling for known contributing risk factors, including maternal health, family life, social support, socioeconomic and demographic characteristics, and community of residence. We use a multiple imputation multivariate analysis to account for the potential effects of missing data.
  
  
  RESULTS
  The results show that the odds of a risk of postpartum depression is nearly 80 and 40 % greater for African-American (OR = 1.80, p < .001) and Latina mothers (OR = 1.41, p < .01), respectively, as compared to white mothers. While the higher risks of postpartum depression for Latinas is explained in part by socioeconomic status, community of residence, and immigrant status, the significantly higher risk among African-American mothers cannot be completely ameliorated by the controlled variables. Our study highlights the need for further research into the impact of social and environmental stressors on postpartum depression among racial and ethnic minority populations living in small cities, towns, and rural areas.
authors.affiliation: Department of Anthropology and Sociology, West Chester University of Pennsylvania, 102 Old Library Building, West Chester, PA, 19380, USA. mceballos@wcupa.edu.
authors.forename: Miguel
authors.identifier: http://orcid.org/0000-0001-7685-0878
authors.initials: M
authors.lastname: Ceballos
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Wallace
authors.affiliation: , Sacramento, CA, 95825, USA.
authors.forename: Glenda
authors.initials: G
authors.lastname: Goodwin
keywords: African-American; Health disparities; Latino; Maternal health; Mental health; Postpartum depression; Race and ethnicity