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Heshmati A, Dunlavy A, Mussino E, Fritzell S, Juárez SP. Health before pregnancy and eligibility for parental leave benefits: a Swedish total population cohort study. BMC Public Health 2025; 25:1045. [PMID: 40102758 PMCID: PMC11917127 DOI: 10.1186/s12889-025-22248-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/07/2025] [Indexed: 03/20/2025] Open
Abstract
BACKGROUND Parental leave generosity is protective for mothers' mental health in the postpartum period and beyond. Strong work requirements exist for parents in Sweden to receive more generous benefits which might penalise individuals who, due to poor health, have a weak labour market attachment. The aim of the study was to examine whether mothers with poor health prior to pregnancy are less likely to be eligible for more generous benefits in Sweden. METHODS We used total population registers to study first-time mothers, aged 25-45 years, who were resident in Sweden and gave birth between 1 January 2009 and 30 September 2013 (n = 151,452). We used logistic regression to examine the association between health one and two consecutive years prior to pregnancy (to assess chronicity) and eligibility for earnings-related parental leave benefits. RESULTS Mothers who were admitted to hospital or received specialist outpatient care for any health condition in the year prior to pregnancy were less likely to be eligible for earnings-related benefits (OR 0·79, 95%CI 0·76-0·83) compared to healthy mothers, particularly those with chronic health issues (OR 0·64, 95%CI 0·62-0·68). Findings were driven by mothers with mental disorders (OR 0·22, 95%CI 0·20-0·23 for the year before pregnancy), and associations were stronger for those with chronic health issues and for Swedish-born mothers. CONCLUSION Mothers with prior health conditions, particularly mental disorders, are less likely to benefit from the protective health effect of parental leave as they may not meet the eligibility requirements for more generous remunerations. This study highlights how the strong work requirement for accessing generous parental leave benefits could unintentionally exacerbate socioeconomic inequalities between mothers with and without poor mental health. Easing work requirements for eligibility to more generous parental leave remuneration could help reduce these inequalities and thus promote better mental health for all, particularly among more disadvantaged groups. As such, our findings empirically support the need for adopting the Health in All Policies framework when designing parental leave policies in order to minimise health inequalities.
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Affiliation(s)
- Amy Heshmati
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
- Department of Public Health Sciences, Stockholm University, Albanovägen 12, Stockholm, 10 691, Sweden.
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Andrea Dunlavy
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Albanovägen 12, Stockholm, 10 691, Sweden
| | | | - Sara Fritzell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Sol P Juárez
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Albanovägen 12, Stockholm, 10 691, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Chen H, Zhang Y, Cao K. Housing debt and depressive symptoms: evidence from the China family panel studies. BMC Psychol 2024; 12:186. [PMID: 38581029 PMCID: PMC10996272 DOI: 10.1186/s40359-024-01667-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/16/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND There is limited evidence on the association between housing debt and depressive symptoms in China. This study aimed to examine the impact of housing debt on depressive symptoms and explore the heterogeneous impacts arising from two sources of housing debt and two types of housing demands. METHODS Using data from the 2016 and 2018 China Family Panel Studies (CFPS), this study included 25,232 Chinese individuals. Depressive symptoms were assessed using the eight-item Center for Epidemiological Studies Depression Scale (CES-D8). Housing debt was measured by dummy variables, indicating whether an individual had housing debt, and continuous variables, which were the logarithm of the total amount of housing debt. The two-way fixed effects model was used to examine the relationship. RESULTS Housing debt had a significant positive impact on depressive symptoms in China. Individuals with housing debt had a 0.176-point higher depressive symptom score than those without housing debt. A 10% increase in the total amount of housing debt led to a 0.16-point increase in depressive symptoms. Non-bank housing loans significantly increased the level of depressive symptoms with a larger coefficient (coef = 0.289), while the impact of bank housing loans was small and not statistically significant. In terms of the types of housing demands, a positive impact was observed only among individuals who had only one property meeting their housing consumption demands. CONCLUSIONS This study found a significant positive impact of housing debt on depressive symptoms, primarily driven by non-bank housing loans. Furthermore, housing debt increased the depressive symptoms among individuals with consumption demands, while those with investment demands did not show a significant impact. Government interventions should prioritize easing formal financial constraints and providing support for individuals with housing consumption demands.
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Affiliation(s)
- Huan Chen
- School of Public Affairs, Zhejiang University, 310058, Hangzhou, China
| | - Yuehua Zhang
- School of Public Affairs, Zhejiang University, 310058, Hangzhou, China
- Innovation Center of Yangtze River Delta, Zhejiang University, 314100, Jiaxing, China
| | - Kang Cao
- Department of Regional and Urban Planning, Zhejiang University, 310058, Hangzhou, China.
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O'Donnell O. Health and health system effects on poverty: A narrative review of global evidence. Health Policy 2024; 142:105018. [PMID: 38382426 DOI: 10.1016/j.healthpol.2024.105018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024]
Abstract
Ill-health causes poverty. The effect runs through multiple mechanisms that span lifetimes and cross generations. Health systems can reduce poverty by improving health and weakening links from ill-health to poverty. This paper maps routes through which ill-health can cause poverty and identifies those that are potentially amenable to health policy. The review confirms that ill-health is an important contributor to poverty and it finds that the effect through health-related loss of earnings is often larger than that through medical expenses. Both effects are smaller in countries that are closer to universal health coverage and have higher social safety nets. The paper also reviews evidence from low- and middle-income countries (LMICs) and the United States (US) on the poverty-reduction effectiveness of public health insurance (PubHI) for low-income households. This reveals that PubHI does not always deliver financial protection to its targeted population in LMICs. Countries that have succeeded in achieving this goal often combine extension of coverage with supply-side interventions to build capacity and avoid perverse provider incentives in response to insurance. In the US, PubHI is effective in reducing poverty by shielding low-income households with children from healthcare costs and, consequently, generating long-run improvements in health that increase lifetime earnings. Poverty reduction is a potentially important co-benefit of health systems.
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Affiliation(s)
- Owen O'Donnell
- Erasmus University Rotterdam, P.O. Box 1738, Rotterdam 3000 DR, the Netherlands.
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Liu J, Zhang Y. Indebtedness and mental health in China: the moderating roles of income and social support. Front Public Health 2024; 11:1279683. [PMID: 38239797 PMCID: PMC10794583 DOI: 10.3389/fpubh.2023.1279683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/13/2023] [Indexed: 01/22/2024] Open
Abstract
Objective To explore the effect of indebtedness on mental health and the moderating effects of two types of coping resources (i.e., income and social support) in the Chinese context. Methods 41,274 adults from four waves of China Family Panel Studies conducted in 2012, 2016, 2018, and 2020. Center for Epidemiologic Studies Depression Scale was used for investigation. Pooled ordinary least squares regressions were used to examine the effect of indebtedness on mental health and the moderating effects of income and social support. Stata 16.0 was used to conduct data analysis. Results The results showed that indebtedness had an adverse effect on mental health among Chinese adults. Furthermore, debtors with higher incomes showed fewer mental disorders than those with lower incomes. In terms of social support, monetary support from relatives was able to moderate the negative effects of indebtedness; however, the moderating effects of emotional support were negligible. Conclusion The results of this study indicated the adverse mental health outcomes of indebtedness in emerging economies and highlighted that economic resources played protective roles against debtors' mental disorders.
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Affiliation(s)
- Jiankun Liu
- School of Humanities and Social Sciences, Harbin Engineering University, Harbin, China
| | - Yueyun Zhang
- School of Social Sciences, Harbin Institute of Technology, Harbin, China
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Stickley A, Shirama A, Sumiyoshi T. Financial debt, worry about debt and mental health in Japan. BMC Psychiatry 2023; 23:761. [PMID: 37848860 PMCID: PMC10580597 DOI: 10.1186/s12888-023-05235-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/29/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Financial debt has been linked to poorer mental health. However, most research has been undertaken in western countries. This study examined the association between financial debt, worry about debt, and mental health in Japan, where there has been little specific focus on debt and its effects on mental health. METHODS Data were analyzed from 3717 respondents collected in an online survey in 2023. Information on financial debt and worry about debt was collected with single-item questions. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scale were used to respectively collect information on depression and anxiety symptoms, while a single-item measure was used to obtain information on a recent history of suicidal ideation. Logistic regression was used to assess associations. RESULTS Both financial debt (17.7%) and worry about debt (14.8%) were prevalent in the study sample. In fully adjusted analyses, compared to those with no debt and worry about debt, individuals who were worried about debt but had no debt, or who had debts and were worried about debt had significantly higher odds for suicidal ideation and depressive symptoms. In contrast, having debt but not being worried about debt was not associated with any of the mental health outcomes. CONCLUSION The results of this study suggest that worrying about debt is strongly associated with poorer mental health among Japanese adults. Interventions to address debt and its associated worries may be important for improving public mental health in Japan.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo, 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo, 187-8553, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo, 187-8553, Japan
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Rivera R, Capers T, Chandler M, Matthews E, Rzewinski J, Rees J, Israel S, Lushin V. Socioeconomic Stability Buffers Racial Discrimination Effect on Depression in a Marginalized Community. J Racial Ethn Health Disparities 2023; 10:130-140. [PMID: 35040107 DOI: 10.1007/s40615-021-01203-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/03/2023]
Abstract
Depression disproportionately burdens poverty-affected minority communities. Racism and racial discrimination are well-known determinants of depression among members of marginalized minority communities. Less is known about potential buffers of the discrimination effects on depression, particularly those that could serve as targets for efficient community-based policies and interventions. Our secondary analysis of data from a community needs assessment survey (N = 677) in an urban minority neighborhood of low socio-economic status revealed that high school completion and current employment significantly weakened the association between discrimination and depression. Our findings frame community-level efforts to foster high school completion and employment as potential strategies to reduce the footprint of racism on the mental health of marginalized community members. Implications for future research and policy are discussed.
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Affiliation(s)
- Rebecca Rivera
- Long Island University Brooklyn Campus, Brooklyn, NY, USA
| | - Tracey Capers
- Bedford Stuyvesant Restoration Corporation, Brooklyn, NY, USA
| | | | | | | | - Jo Rees
- School of Health Professions, Long Island University Brooklyn Campus, Brooklyn, NY, USA
| | - Shimonah Israel
- Bedford Stuyvesant Restoration Corporation, Brooklyn, NY, USA
| | - Victor Lushin
- Long Island University Brooklyn Campus, Brooklyn, NY, USA.
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McGovern ME, Rokicki S, Reichman NE. Maternal depression and economic well-being: A quasi-experimental approach. Soc Sci Med 2022; 305:115017. [PMID: 35605471 DOI: 10.1016/j.socscimed.2022.115017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/17/2022] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
Abstract
Maternal depression is associated with adverse impacts on the health of women and their children. However, further evidence is needed on the extent to which maternal depression influences women's economic well-being and how unmeasured confounders affect estimates of this relationship. In this study, we aimed to measure the association between maternal depression and economic outcomes (income, employment, and material hardship) over a 15-year time horizon. We conducted longitudinal analyses using the Fragile Families and Child Wellbeing Study, an urban birth cohort study in the United States. We assessed the potential contribution of time-invariant unmeasured confounders using a quasi-experimental approach and also investigated the role of persistent versus transient depressive symptoms on economic outcomes up to 15 years after childbirth. In models that adjusted for time-invariant unmeasured confounders, maternal depression was associated with not being employed (an adjusted risk difference of 3 percentage points (95% CI 0.01 to 0.05)) and experiencing any material hardship (an adjusted risk difference of 14 percentage points (95% CI 0.12 to 0.16)), as well as with reductions in the ratio of household income to poverty by 0.10 units (95% CI -0.16 to -0.04) and annual household income by $2114 (95% CI -$3379 to -$850). Impacts at year 15 were strongest for those who experienced persistent depression. Results of our study strengthen the case for viewing mental health support services as interventions that may also foster economic well-being, and highlight the importance of including economic impacts in assessments of the cost-effectiveness of mental health interventions.
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Affiliation(s)
- Mark E McGovern
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA
| | - Slawa Rokicki
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA; Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.
| | - Nancy E Reichman
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Princeton University, Princeton, NJ, USA
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Capistrano CG, Grande LA, McRae K, Phan KL, Kim P. Maternal socioeconomic disadvantage, neural function during volitional emotion regulation, and parenting. Soc Neurosci 2022; 17:276-292. [PMID: 35620995 PMCID: PMC10829500 DOI: 10.1080/17470919.2022.2082521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/27/2022] [Indexed: 10/18/2022]
Abstract
The transition to becoming a mother involves numerous emotional challenges, and the ability to effectively keep negative emotions in check is critical for parenting. Evidence suggests that experiencing socioeconomic disadvantage interferes with parenting adaptations and alters neural processes related to emotion regulation. The present study examined whether socioeconomic disadvantage is associated with diminished neural activation while mothers engaged in volitional (i.e., purposeful) emotion regulation. 59 mothers, at an average of 4 months postpartum, underwent fMRI scanning and completed the Emotion Regulation Task (ERT). When asked to regulate emotions using reappraisal (i.e., Reappraise condition; reframing stimuli in order to decrease negative emotion), mothers with lower income-to-needs ratio exhibited dampened neural activation in the dorsolateral and ventrolateral PFC, middle frontal and middle temporal gyrus, and caudate. Without explicit instructions to down-regulate (i.e., Maintain condition), mothers experiencing lower income also exhibited dampened response in regulatory areas, including the middle frontal and middle temporal gyrus and caudate. Blunted middle frontal gyrus activation across both Reappraise and Maintain conditions was associated with reduced maternal sensitivity during a mother-child interaction task. Results of the present study demonstrate the influence of socioeconomic disadvantage on prefrontal engagement during emotion regulation, which may have downstream consequences for maternal behaviors.
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Affiliation(s)
| | - Leah A Grande
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Kateri McRae
- Department of Psychology, University of Denver, Denver, CO, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, CO, USA
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Richardson T, Enrique A, Earley C, Adegoke A, Hiscock D, Richards D. The Acceptability and Initial Effectiveness of “Space From Money Worries”: An Online Cognitive Behavioral Therapy Intervention to Tackle the Link Between Financial Difficulties and Poor Mental Health. Front Public Health 2022; 10:739381. [PMID: 35493363 PMCID: PMC9046654 DOI: 10.3389/fpubh.2022.739381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 03/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background Previous research has shown a strong relationship between financial difficulties and mental health problems. Psychological factors such as hope and worry about finances appear to be an important factor in this relationship. Objective To develop an online based psychological intervention (Space from Money Worries) to tackle the psychological mechanisms underlying the relationship between poor mental health and financial difficulties, and to conduct an initial evaluation of the acceptability and preliminary efficacy of the intervention. Materials and Methods 30 participants accessing Increasing Access to Psychological Therapies (IAPT) services completed GAD-7 to measure anxiety and PHQ-9 to measure depression upon signing up to the online intervention and again 4 to 8 weeks after this. Participants also completed a measure of perceived financial distress/wellbeing and a “Money and Mental Health Scale” constructed for the evaluation. Results Overall, 77% (n = 23) completed the intervention and follow-up assessments. Intent to Treat Analysis showed that there were statistically significant improvements in symptoms of depression, anxiety, improved perceived financial wellbeing and reduced scores on the money and mental health scale. The vast majority of participants rated each module positively. Conclusions Space from Money Worries appears to be acceptable and may lead to improvements in mental health, perceived financial wellbeing and a reduced relationship between financial difficulties and poor mental health. However, future research with a larger sample and a control group are needed to confirm that these changes are due to the intervention.
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Affiliation(s)
- Thomas Richardson
- Richardson Psychological Consultation Limited, The Psychotherapy Practice, Southampton, United Kingdom
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
- *Correspondence: Thomas Richardson
| | - Angel Enrique
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
- E-Mental Health Research Group, School of Psychology, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - Caroline Earley
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Adedeji Adegoke
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Douglas Hiscock
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Derek Richards
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
- E-Mental Health Research Group, School of Psychology, University of Dublin, Trinity College Dublin, Dublin, Ireland
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Guan N, Guariglia A, Moore P, Xu F, Al-Janabi H. Financial stress and depression in adults: A systematic review. PLoS One 2022; 17:e0264041. [PMID: 35192652 PMCID: PMC8863240 DOI: 10.1371/journal.pone.0264041] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/31/2022] [Indexed: 12/27/2022] Open
Abstract
Financial stress has been proposed as an economic determinant of depression. However, there is little systematic analysis of different dimensions of financial stress and their association with depression. This paper reports a systematic review of 40 observational studies quantifying the relationship between various measures of financial stress and depression outcomes in adults. Most of the reviewed studies show that financial stress is positively associated with depression. A positive association between financial stress and depression is found in both high-income and low-and middle-income countries, but is generally stronger among populations with low income or wealth. In addition to the "social causation" pathway, other pathways such as "psychological stress" and "social selection" can also explain the effects of financial stress on depression. More longitudinal research would be useful to investigate the causal relationship and mechanisms linking different dimensions of financial stress and depression. Furthermore, exploration of effects in subgroups could help target interventions to break the cycle of financial stress and depression.
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Affiliation(s)
- Naijie Guan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- * E-mail:
| | - Alessandra Guariglia
- Department of Economics, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Patrick Moore
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Fangzhou Xu
- Department of Economics, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Hareth Al-Janabi
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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Family Structure and Maternal Depressive Symptoms: A Cross-National Comparison of Australia, the United Kingdom, and the United States. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11020078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to understand the relationship between family structure and maternal depressive symptoms (MDS) in Australia, the United Kingdom, and the United States. Family structures that involve transitions across life’s course, such as divorce, can alter access to resources and introduce new stressors into family systems. Using the stress process model, we examine the links between family structure, stress, resources, and MDS. Using nationally representative data from Australia, the United Kingdom, and the United States and cross-sectional models for each country, we find that family structure may influence MDS differently in the UK than it does in Australia or, especially, the US. Specifically, mothers in the UK who either enter or leave a marriage after the birth of their child experience increased levels of MDS compared with mothers who do not experience a similar transition. These findings demonstrate that the effects of family structure transitions across life’s course may vary according to the country context as well as to the mother’s access to resources and exposure to stress. Considering that the effects of family structure transitions are not universal, this indicates that greater attention should be paid to the country contexts families exist in and the effects that public policies and social safety nets can have on MDS.
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12
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Gao J, Hu H, He H. Household indebtedness and depressive symptoms among older adults in China: The moderating role of social network and anticipated support. J Affect Disord 2022; 298:173-181. [PMID: 34737018 DOI: 10.1016/j.jad.2021.10.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Examine the association of household financial indebtedness with depressive symptoms in old age, and investigate whether social network and support anticipation moderate the association. METHODS Data were obtained from Sample Survey on Vulnerable Populations from Poor Families in Urban/Rural China (2018), with a sample of 5 934 older adults included. Center for Epidemiologic Studies Depression Scales was applied to measure depressive symptoms. Household indebtedness was measured in several ways, including whether the household was indebted, the amount of debts, and types of debts. We used the 6-item Lubben Social Network Scale to measure individual's social network. Socio-demographic, socioeconomic status and physical health variables were included as covariates. RESULTS Household indebtedness, in form of being indebted and increased amount of debts, was associated with greater depressive symptoms in the Chinese elderly. The association of indebtedness and depressive symptoms may be driven by consumption and emergency debts. The moderating roles of social network and anticipation of support in the association of household indebtedness and depressive symptoms were found. Among those with household debts, older adults with larger size of social network and/or higher anticipation of being supported in the future reported with less symptoms of depressed. LIMITATIONS Due to a lack of information on the duration and debtor of household debt, we were not able to present a precise estimate for the exact impact of household indebtedness on mental health of elderly. CONCLUSION Familial financial strain was associated with aging mental well-being, increased social networks and social protections benefit aging health.
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Affiliation(s)
- Jiamin Gao
- School of Social Development and Public Policy, Beijing Normal University, No. 19 Xinjiekouwai St. Haidian District, Beijing 100875, PR China
| | - Hongwei Hu
- School of Public Administration and Policy, Renmin University of China, No. 59, Zhongguancun Street, Haidian District, Beijing 100872, PR China.
| | - Haotian He
- School of Public Administration and Policy, Renmin University of China, No. 59, Zhongguancun Street, Haidian District, Beijing 100872, PR China
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The implementation of basic income: A mental health approach. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2021. [DOI: 10.1017/iop.2021.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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14
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Connelly JP, O'Connell M. Gender differences in vulnerability to maternal depression during early adolescence: Girls appear more susceptible than boys. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J. P. Connelly
- School of Psychology University College Dublin Dublin Ireland
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15
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Bialowolski P, Weziak-Bialowolska D, Lee MT, Chen Y, VanderWeele TJ, McNeely E. The role of financial conditions for physical and mental health. Evidence from a longitudinal survey and insurance claims data. Soc Sci Med 2021; 281:114041. [PMID: 34087548 DOI: 10.1016/j.socscimed.2021.114041] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Both theory and empirical evidence suggest that financial conditions are influential for mental health and might contribute to physical health outcomes. METHODS Using longitudinal survey data and health insurance claims data from 1209 employees in a large U.S. health insurance company, we examined temporal associations between measures of financial safety, financial capability, financial distress, their summary index (financial security) and six subsequently measured mental and physical health outcomes. RESULTS We found that financial safety and financial capability were positively associated, while financial distress was negatively associated, with subsequent self-reported measures of physical and mental health, even after controlling for these health measures at baseline and other confounders. Additionally, financial conditions were associated with reduced risk of depression based on health insurance claims data. Financial safety was also associated with anxiety. CONCLUSIONS Policy-makers might consider the introduction of more effective measures for ensuring favorable financial conditions as an important contributor to better population health. Furthermore, policy could encourage teaching adequate financial management techniques and the importance of understanding of long-term consequences of financial decisions, as those might be pivotal for health outcomes.
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Affiliation(s)
- Piotr Bialowolski
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA; Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.
| | - Dorota Weziak-Bialowolska
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA; Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA
| | - Matthew T Lee
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA
| | - Ying Chen
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Eileen McNeely
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
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16
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The relationship between the prevalence of postpartum depression and anxiety, and depression levels in the mothers of premature, and term newborns admitted to a pediatric emergency department. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.892101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cao H, Zhou N, Li X, Serido J, Shim S. Temporal dynamics of the association between financial stress and depressive symptoms throughout the emerging adulthood. J Affect Disord 2021; 282:211-218. [PMID: 33418369 DOI: 10.1016/j.jad.2020.12.166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emerging adulthood is a life stage with elevated risk for both mental disorders and financial distress. Although a positive link between financial stress and depressive symptoms has been identified, there is a lack of delineation on the temporal dynamics of this link spanning the entire stage of emerging adulthood (roughly ages 18 to 29). METHODS Using a statistical approach that partitions between-person from within-person variation and based on four waves of data from a college cohort (N = 2,098) throughout emerging adulthood, this study addresses this gap. RESULTS Latent growth curve model analyses indicate that the trajectory of financial stress throughout emerging adulthood followed an inverted "U" shape, whereas that of depressive symptoms displayed a linear, decreasing trend. The positive correlations of both intercepts and slopes between financial stress and depressive symptoms indicated a co-development pattern. Classical, cross-lagged panel model analyses (i.e., a model aggregating between-person and within-person variation) demonstrated a reciprocal positive association between financial stress and depressive symptoms across waves. Random intercept, cross-lagged panel model analyses (i.e., a model disaggregating between-person and within-person effects) indicated a unidirectional positive within-person effect from depressive symptoms to financial stress across waves, controlling for between-person effects. LIMITATIONS Shared-method and shared-informant variance may inflate the identified associations, and the correlational data precludes casual inferences. CONCLUSION Improving young adults' mental well-being, specifically intervening depressive symptoms, could be an avenue for reducing their financial stress. Future research is pressing to examine mechanisms via which depression symptoms manifest as financial stress during transition to adulthood.
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Affiliation(s)
- Hongjian Cao
- Institute of Early Childhood Education, Faculty of Education, Beijing Normal University. 512 Ying Dong Building, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing 100875, China.
| | - Nan Zhou
- Department of Educational Psychology and School Counseling, Faculty of Education, Beijing Normal University. 528 Ying Dong Building, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing 100875, China.
| | - Xiaomin Li
- Department of Family Studies and Human Development, University of Arizona, 650 N. Park Avenue PO Box 210078, Tucson, AZ, 85721-0078, USA.
| | - Joyce Serido
- Department of Family Social Science, University of Minnesota-Twin Cities, 299b McNeal Hall, 1985 Buford Ave, Saint Paul, MN, 55108, USA.
| | - Soyeon Shim
- School of Human Ecology, University of Wisconsin-Madison, Office 2135, Nancy Nicholas Hall, 1300 Linden Drive, Madison, WI, 53706, USA.
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18
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Santos IS, Munhoz TN, Blumenberg C, Barcelos R, Bortolotto CC, Matijasevich A, Júnior HGS, Marques Dos Santos L, Correia LL, de Souza MR, Lira PIC, Altafim E, Marino E, Macana EC, da Silva RS, Ohana EF, Fontes MTA, Victora CG. Post-partum depression: a cross-sectional study of women enrolled in a conditional cash transfer program in 30 Brazilian cities. J Affect Disord 2021; 281:510-516. [PMID: 33388462 DOI: 10.1016/j.jad.2020.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Investigate factors associated with symptoms of postpartum depression in mothers from families in social vulnerability. METHODS Information was used from the baseline of a randomized trial to assess a child development program that enrolled 3,242 children < 12 months of age from beneficiary families of the Bolsa Família Program residing in 30 municipalities (counties) in six states of Brazil. The Edinburgh Postnatal Depression Scale (EPDS) was applied to the mothers, and depression was defined as score ≥10. Information on the mother (schooling, age, parity, marital status, skin color, smoking, number of prenatal appointments, and planning of the pregnancy), family (paternal schooling, household crowding, support from the child's father and the family during the pregnancy, and number of children under 7 years living in the household), and infant (sex, gestational age, birthweight, Apgar score, and child's age at the time of the interview) was collected. Prevalence rates for depressive symptoms were calculated with crude and adjusted odds ratios (OR) and 95% confidence intervals (95%CI), using hierarchical logistic regression, in a multilevel model. RESULTS The analysis included 3,174 mothers with information on EPDS. The interviews were conducted on average 7.9 months (standard deviation= 2.9) after childbirth. Overall prevalence of depressive symptoms was 26.5% (25.0-28.1%). In the adjusted analysis, higher parity was associated with higher odds of postpartum depression (p <0.001). Women with ≥3 previous deliveries showed an odds 84% higher of presenting depressive symptoms (OR= 1.84; 1.43-2.35) than primiparae. Higher maternal and paternal schooling, presence of husband or partner, and having received support from the child's father and the family during the pregnancy were protective factors against postpartum depression. CONCLUSION The study showed high prevalence of postpartum depressive symptoms. Promotion of parental education, alongside with the promotion of support to the woman during pregnancy by the child's father and by the family, as well as family planning leading to birth spacing are measures that may help to prevent postpartum depressive symptoms.
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Affiliation(s)
- Ina S Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas; Pelotas, RS, Brasil.
| | - Tiago N Munhoz
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas; Pelotas, RS, Brasil; Curso de Psicologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Cauane Blumenberg
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas; Pelotas, RS, Brasil
| | - Raquel Barcelos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas; Pelotas, RS, Brasil
| | - Caroline C Bortolotto
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas; Pelotas, RS, Brasil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo; São Paulo, SP, Brasil
| | | | - Letícia Marques Dos Santos
- Instituto de Humanidades Artes de Ciências da Universidade Federal da Bahia (UFBA); Salvador, Bahia, Brasil
| | - Luciano L Correia
- Departamento de Saúde Comunitária, Universidade Federal do Ceará; Fortaleza, CE, Brasil
| | | | - Pedro I C Lira
- Departamento de Nutrição do Centro de Ciências da Saúde, Universidade Federal de Pernambuco; Recife, PB, Brasil
| | - Elisa Altafim
- Fundação Maria Cecília Souto Vidigal; São Paulo, SP, Brasil
| | - Eduardo Marino
- Fundação Maria Cecília Souto Vidigal; São Paulo, SP, Brasil
| | | | | | | | | | - Cesar G Victora
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas; Pelotas, RS, Brasil
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19
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Piotrowski MC, Lunsford J, Gaynes BN. Lifestyle psychiatry for depression and anxiety: Beyond diet and exercise. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Madison C. Piotrowski
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Julia Lunsford
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Bradley N. Gaynes
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina
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20
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Ibrahim F, McHugh N, Biosca O, Baker R, Laxton T, Donaldson C. Microcredit as a public health initiative? Exploring mechanisms and pathways to health and wellbeing. Soc Sci Med 2021; 270:113633. [PMID: 33395609 DOI: 10.1016/j.socscimed.2020.113633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
Abstract
The widening health gap between the best and worst-off in the UK requires innovative solutions that act upon the social, economic and environmental causes of ill-health. Initiatives such as microcredit have been conceptualised as having the potential to act on the social determinants of health. However, pathways that lead to this impact have yet to be empirically explored. People living on low incomes, who are financially-excluded, require access to credit to cope with everyday financial needs. While research shows the connections between debt and health, this link is often focused on over-indebtedness and negative health outcomes. In this paper, we investigate the impact of responsibly-delivered credit on the health and wellbeing of borrowers. In 2016-17, in-depth, semi-structured interviews were undertaken with fourteen borrowers from two microcredit providers offering personal and business microloans, operating in Glasgow, United Kingdom. Findings are presented, using social determinants of health as an analytic lens, and illustrated in a conceptual model explaining the loan mechanisms and pathways connecting microcredit to health and wellbeing. Microcredit, and the mechanisms through which it is delivered, were perceived by participants as positively impacting on their health and wellbeing. Access to flexible, responsibly-delivered, microloans enabled participants to plan and feel secure when faced with (un)expected financial events, reducing the associated stress, sustaining social relationships and empowering borrowers to take greater control over their lives. For some, receiving microcredit was stressful, as it is still a debt that needs to be repaid. Such stress can also be exacerbated by particular aspects of the lending model; for example, group lending. Our results contribute to growing evidence on the impact of financial inclusion approaches on health and wellbeing, highlighting the potential role of microcredit as a public health initiative and the need to support 'alternative' economic spaces in the UK to serve the financially-excluded.
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Affiliation(s)
- Fatma Ibrahim
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, UK.
| | - Neil McHugh
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, UK
| | - Olga Biosca
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, UK
| | - Rachel Baker
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, UK
| | - Tim Laxton
- School of Health and Life Sciences at Glasgow Caledonian University, UK
| | - Cam Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, UK
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Dackehag M, Ellegård LM, Gerdtham UG, Nilsson T. Debt and mental health: new insights about the relationship and the importance of the measure of mental health. Eur J Public Health 2020; 29:488-493. [PMID: 30715315 PMCID: PMC6533593 DOI: 10.1093/eurpub/ckz002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Empirical research suggests that household debt and payment difficulties are detrimental to mental health. Despite well-known measurement problems that may contaminate analyses using subjective self-reported health measures, our knowledge is very limited concerning the effect of payment difficulties on 'objective' measures of mental health. Moreover, few studies use longitudinal data to examine the relationship. This study combines rich survey data and longitudinal data from administrative registers on a representative sample of the Swedish population to examine the relationship between payment difficulties and subjective and objective measures of mental health. METHODS We use data from a large survey of Swedish inhabitants (The Swedish Living Conditions Surveys) combined with data from administrative registers. We investigate both directions of the relationship between mental ill health and payment difficulties, controlling for previous mental health status and previous experiences of payment difficulties. We compare the association between payment difficulties and a self-reported measure of anxiety with the associations between payment difficulties and objective measures of mental ill health from a register of psychopharmaceutical drug consumption. RESULTS Payment difficulties associate with subjectively reported mental ill health, but less to psychopharmaca use. For objective measures, we find stronger evidence of a link running from mental ill health to later payment difficulties. CONCLUSIONS Self-reported and objective measures of mental problems may convey different messages regarding the impact of payment difficulties on mental health. Policy measures depend on whether the primary target group is individuals with severe mental problems or individuals with mild anxiety.
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Affiliation(s)
| | | | - Ulf-G Gerdtham
- Department of Economics, Lund University, Lund, Sweden.,Department of Clinical Sciences (Malmö), Lund University, Lund, Sweden
| | - Therese Nilsson
- Department of Economics, Lund University, Lund, Sweden.,Research Institute of Industrial Economics (IFN), Stockholm, Sweden
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22
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Jacques N, Mesenburg MA, Matijasevich A, Domingues MR, Bertoldi AD, Stein A, Silveira MF. Trajectories of maternal depressive symptoms from the antenatal period to 24-months postnatal follow-up: findings from the 2015 Pelotas birth cohort. BMC Psychiatry 2020; 20:233. [PMID: 32408866 PMCID: PMC7222527 DOI: 10.1186/s12888-020-02533-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 03/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal depression may be chronic and recurrent, with negative effects both on the health of mothers and children. Many studies have shown trajectories of postnatal depressive symptoms but few studies in low- and middle-income countries have evaluated the trajectories of depressive symptoms starting during pregnancy. This study aims to identify the different trajectories of depressive symptoms among mothers in the Pelotas 2015 birth cohort, from pregnancy to the second year of the child's life. METHODS This study used data from the 2015 Pelotas Birth Cohort, a longitudinal study of all live births occurred in 2015 in Pelotas, Brazil. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers who completed the EPDS on at least three follow-up visits beginning to the antenatal follow-up visit were included in the analyses. The trajectory of maternal depressive symptoms was estimated through group-based trajectory modeling. RESULTS A total of 3040 women were included in the present analysis. We identified five groups of maternal depressive symptoms trajectories, with 23.4% of the mothers presenting persistent depressive symptoms and 3.9% showing chronic high depressive symptoms throughout the study period. The probability of having persistent depressive symptoms increased among mothers with greater socioeconomic vulnerability. CONCLUSIONS This study shown the persistence of maternal depressive symptoms since pregnancy until 2 years postnatal. Additionally, alongside the known risk factors, pre-gestational depression and antenatal depressive symptoms are important risk factors for the persistence and severity of depressive symptoms. These findings support the need to provide mental health evaluation and care for women from pregnancy to the late postnatal period.
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Affiliation(s)
- Nadège Jacques
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, nº 1160 3º andar, Pelotas, CEP 96020-220, Rio Grande Do Sul, Brazil.
| | - Marilia Arndt Mesenburg
- grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, nº 1160 3º andar, Pelotas, CEP 96020-220 Rio Grande Do Sul Brazil
| | - Alicia Matijasevich
- grid.11899.380000 0004 1937 0722Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Avenida Dr. Arnaldo, 455, 2º andar, sala 2166, São Paulo, CEP 1246-903 Brazil
| | - Marlos Rodrigues Domingues
- grid.411221.50000 0001 2134 6519College of Physical Education, Federal University of Pelotas, R. Luís de Camões, 625-Três Vendas, Pelotas, - RS, CEP 96055-630 Pelotas, Rio Grande Do Sul Brazil
| | - Andréa Dâmaso Bertoldi
- grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, nº 1160 3º andar, Pelotas, CEP 96020-220 Rio Grande Do Sul Brazil
| | - Alan Stein
- grid.4991.50000 0004 1936 8948Institutional address: Department of Psychiatry, University of Oxford, Warneford Lane, Oxford, OX3 7JX UK
| | - Mariangela Freitas Silveira
- grid.411221.50000 0001 2134 6519Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, nº 1160 3º andar, Pelotas, CEP 96020-220 Rio Grande Do Sul Brazil
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Frankham C, Richardson T, Maguire N. Do Locus of Control, Self-esteem, Hope and Shame Mediate the Relationship Between Financial Hardship and Mental Health? Community Ment Health J 2020; 56:404-415. [PMID: 31552540 PMCID: PMC7056732 DOI: 10.1007/s10597-019-00467-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 09/12/2019] [Indexed: 02/04/2023]
Abstract
In a longitudinal study of 104 participants, the psychological factors of economic locus of control, self-esteem, hope and shame were explored for their impact on the relationship between financial hardship and mental health. Participants completed measures of financial hardship, the psychological factors and measures of mental health three times at three-monthly intervals. A hierarchical regression analyses indicated that subjective financial hardship, hope and shame significantly predicted mental health outcomes. Mediation analyses demonstrated that hope mediated the relationship between subjective financial hardship and depression, stress and wellbeing; that shame mediated the relationship between subjective financial hardship and anxiety; and that neither shame nor hope mediated the relationship between subjective financial hardship and suicide ideation.
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Affiliation(s)
- Charlotte Frankham
- School of Psychology, University of Southampton, Southampton, SO17 1BJ, UK.
- Ealing Early Intervention Service, West London NHS Trust, Cherington House, Cherington Road, Hanwell, W7 3HL, UK.
| | - Thomas Richardson
- Mental Health Recovery Teams, Solent NHS Trust, St. Mary's Community Health Campus, Milton Road, Portsmouth, POE 6AD, UK
| | - Nick Maguire
- School of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
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Sun AR, Houle JN. Trajectories of Unsecured Debt across the Life Course and Mental Health at Midlife. SOCIETY AND MENTAL HEALTH 2020; 10:61-79. [PMID: 32742740 PMCID: PMC7394470 DOI: 10.1177/2156869318816742] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this paper, we contribute to a growing literature on debt and mental health and ask whether patterns of unsecured debt accumulation and repayment over two decades are associated with depressive symptoms at age 50. Using data from the National Longitudinal Study of Youth 1979 Cohort and group trajectory models, we have three key findings. First, we find substantial heterogeneity in debt trajectories across the life course. Second, respondents who report consistently high debt levels across the life course or who cycle in and out of high debt report significantly more depressive symptoms than respondents who hold consistently low levels of debt. These findings hold for both absolute and relative (debt-to-income) debt. Third, we find that the association between debt and depressive symptoms is strongest among respondents with less than a college degree, but we find less evidence for heterogeneity by race in this cohort.
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25
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Berger LM, Houle JN. Rising Household Debt and Children's Socioemotional Well-being Trajectories. Demography 2019; 56:1273-1301. [PMID: 31292913 DOI: 10.1007/s13524-019-00800-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Debt is now a substantial aspect of family finances. Yet, research on how household debt is linked with child development has been limited. We use data from the National Longitudinal Survey of Youth 1979 cohort and hierarchical linear models to estimate associations of amounts and types of parental debt (home, education, auto, unsecured/uncollateralized) with child socioemotional well-being. We find that unsecured debt is associated with growth in child behavior problems, whereas this is not the case for other forms of debt. Moreover, the association of unsecured debt with child behavior problems varies by child age and socioeconomic status, with younger children and children from less-advantaged families experiencing larger associations of unsecured debt with greater behavior problems.
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Affiliation(s)
- Lawrence M Berger
- Institute for Research on Poverty and School of Social Work, University of Wisconsin-Madison, Madison, WI, USA.
| | - Jason N Houle
- Department of Sociology, Dartmouth College, Hanover, NH, USA
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Jessop DC, Reid M, Solomon L. Financial concern predicts deteriorations in mental and physical health among university students. Psychol Health 2019; 35:196-209. [DOI: 10.1080/08870446.2019.1626393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Donna C. Jessop
- School of Psychology, University of Sussex, Falmer, Brighton, UK
| | - Matthew Reid
- School of Psychology, University of Sussex, Falmer, Brighton, UK
| | - Lucy Solomon
- Academic Registry, University of Sussex, Falmer, Brighton, UK
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Prevalence and risk factors of postpartum depression within one year after birth in urban slums of Dhaka, Bangladesh. PLoS One 2019; 14:e0215735. [PMID: 31048832 PMCID: PMC6497249 DOI: 10.1371/journal.pone.0215735] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/08/2019] [Indexed: 11/29/2022] Open
Abstract
Postpartum depression (PPD) is a serious pubic health concern and known to have the adverse effects on mother’s perinatal wellbeing; and child’s physical and cognitive development. There were limited literatures on PPD in Bangladesh, especially in urban slum context. The aim of this study was to assess the burden and risk factors of PPD among the urban slum women. A cross-sectional study was conducted between November-December 2017 in three urban slums on 376 women within first 12 months of postpartum. A validated Bangla version of Edinburgh Postnatal Depression Scale was used to measure the depression status. Respondent’s socio-economic characteristics and other risk factors were collected with structured validated questionaire by trained interviewers. Unadjusted Prevalence Ratio (PR) and Adjusted Prevalence Ratio (APR) were estimated with Generalized Linear Model (GLM) and Generalized Estimating Equation (GEE) respectively to identify the risk factors of PPD. The prevalence of PPD was 39.4% within first 12 months following the child birth. Job involvement after child delivery (APR = 1.9, 95% CI = 1.1, 3.3), job loss due to pregnancy (APR = 1.5, 95% CI = 1.0, 2.1), history of miscarriage or still birth or child death (APR = 1.4, 95% CI = 1.0, 2.0), unintended pregnancy (APR = 1.8, 95% CI = 1.3, 2.5), management of delivery cost by borrowing, selling or mortgaging assets (APR = 1.3, 95% CI = 0.9, 1.9), depressive symptom during pregnancy (APR = 2.5, 95% CI = 1.7, 3.8) and intimate partner violence (APR = 2.0, 95% CI = 1.2, 3.3), were identified as risk factors. PPD was not associated with poverty, mother in law and any child related factors. The burden of postpartum depression was high in the urban slum of Bangladesh. Maternal mental health services should be integrated with existing maternal health services. Research is required for the innovation of effective, low cost and culturally appropriate PPD case management and preventive intervention in urban slum of Bangladesh.
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28
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Silveira MS, Galvão LPL, Gurgel RQ, Barreto IDC, Vargas MM. Ansiedade e Depressão na Morbidade Materna Grave e Near Miss. PSICOLOGIA: TEORIA E PESQUISA 2019. [DOI: 10.1590/0102.3772e35442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Com o objetivo de verificar a prevalência da ansiedade e depressão em mulheres com morbidade materna grave (near miss), foi realizado estudo de coorte transversal, com 549 mulheres. Para tanto, foram utilizados o Inventário de Beck de Depressão (BDI) e o Inventário de Ansiedade (BAI). Na análise estatística, aplicaram-se o teste do qui-quadrado de Pearson e o U-Mann-Whitney, além de Razões de Chances brutas e seus Intervalos com 95% de confiança. Houve maior prevalência e maior chance de desenvolver a ansiedade e depressão na MMG/NM, bem como a relação positiva e significativa entre ambos. Considera-se a associação do ponto de vista psicológico, como um fator grave e impactante na saúde mental da mulher.
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Boyce CJ, Delaney L, Ferguson E, Wood AM. Central bank interest rate decisions, household indebtedness, and psychiatric morbidity and distress: Evidence from the UK. J Affect Disord 2018; 234:311-317. [PMID: 29602060 DOI: 10.1016/j.jad.2018.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 02/09/2018] [Accepted: 03/08/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Central banks set economy-wide interest rates to meet exclusively economic objectives. There is a strong link between indebtedness and psychiatric morbidity at the individual level, with interest rates being an important factor determining ability to repay debt. However, no prior research has explored whether central bank interest rate changes directly influence mental health, nor whether this varies by levels of indebtedness. METHODS We use British data (N = 93,255) to explore whether the Bank of England base-rate affected how perceived burden of non-mortgage debt (low, medium, and high) influenced psychiatric morbidity. Psychiatric morbidity was measured using the General Health Questionnaire (GHQ-12). Our primary outcome measure was a binary indicator of "psychiatric caseness" (>3 on a 0-12 scale). We also used the GHQ-12 as a continuous measure of distress. RESULTS When interest rates are high (low) there is an increased (decreased) risk of psychiatric morbidity only among those with a high debt burden (b = 0.026, p = 0.02). This result was robust to alternative explanations. Thus a 1 percentage point base-rate increase is associated with a 2.6% increase that someone with a high debt burden will experience psychiatric morbidity. LIMITATIONS Our study uses subjective indicators of debt burden. We were unable to determine the mechanism behind our effect. CONCLUSIONS Changes in central bank interest rates to meet economic objectives pose a threat to mental health. Mental health support is needed for those in debt and central banks may need to consider how their decisions influence population mental health.
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Affiliation(s)
- Christopher J Boyce
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling FK9 4LA, Scotland, UK.
| | - Liam Delaney
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling FK9 4LA, Scotland, UK; UCD Geary Institute, University College Dublin, Bellfield, Dublin 4, Ireland
| | | | - Alex M Wood
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling FK9 4LA, Scotland, UK; School of Psychological Sciences, University of Manchester, England, UK
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Sweet E, Kuzawa CW, McDade TW. Short-term lending: Payday loans as risk factors for anxiety, inflammation and poor health. SSM Popul Health 2018; 5:114-121. [PMID: 29922711 PMCID: PMC6005810 DOI: 10.1016/j.ssmph.2018.05.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/15/2018] [Accepted: 05/31/2018] [Indexed: 11/30/2022] Open
Abstract
While research now consistently links consumer financial debt with adverse emotional health outcomes, specific forms of debt and their impact on measures of physical health are underexplored. This gap in knowledge is significant because different forms of loans and debt may have different experiential qualities. In this paper, we focus on a type of unsecured debt - short-term/payday loan borrowing – that has risen dramatically in recent decades in the United States and is characterized by predatory, discriminatory, and poorly regulated lending practices. Using data from a study of debt and health among adults in Boston, MA (n=286), we test whether short-term borrowing is associated with a range of emotional and physical health indicators. We find that short-term loans are associated with higher body mass index, waist circumference, C-reactive protein levels, and self-reported symptoms of physical health, sexual health, and anxiety, after controlling for several socio-demographic covariates. We discuss these findings within the contexts of regulatory shortcomings, psychosocial stress, and racial and economic credit disparities. We suggest that within the broader context of financial debt and health, short-term loans should be considered a specific risk to population health.
Short-term loans (STL) are associated with multiple indicators of poor health Prior research has explored general debt as a health determinant Specific types of debt, like STL, are understudied STL’s predatory lending practices raise concerns for population health
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Affiliation(s)
- Elizabeth Sweet
- Department of Anthropology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, USA
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, 1810 Hinman Ave., Evanston, IL 60208, USA.,Institute for Policy Research, Northwestern University, 2040 Sheridan Rd., Evanston, IL 60208, USA
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, 1810 Hinman Ave., Evanston, IL 60208, USA.,Institute for Policy Research, Northwestern University, 2040 Sheridan Rd., Evanston, IL 60208, USA
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Sweet E, DuBois LZ, Stanley F. Embodied Neoliberalism: Epidemiology and the Lived Experience of Consumer Debt. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2018; 48:495-511. [DOI: 10.1177/0020731418776580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A growing set of epidemiological data links personal financial debt to negative mental and physical health outcomes. These findings point to debt as a potentially significant socioeconomic determinant of population health, especially given rising rates of household and consumer debt in industrialized nations. However, the political and economic contexts in which rising consumer debt is embedded and the ways in which it is experienced in everyday life are underexplored in this epidemiological literature. This gap leaves open questions about how best to situate and understand debt as a health determinant with both psychosocial and neo-material attributes. In this article, we discuss findings from a qualitative study of personal debt experience in Boston, Massachusetts. Participants’ debt narratives highlight the powerful feelings of shame, guilt, and personal responsibility that debt engenders. The findings point to the influence of neoliberal ideology in shaping emotional responses to debt and suggest that these responses may be important pathways through which debt affects health. We discuss our findings within the broader landscape of American neoliberal economic policy and its role in shaping trends of consumer debt burden.
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Affiliation(s)
- Elizabeth Sweet
- Department of Anthropology, University of Massachusetts, Boston, Massachusetts, USA
| | - L. Zachary DuBois
- Department of Anthropology, California State University, Long Beach, California, USA
| | - Flavia Stanley
- Department of Anthropology, University of Massachusetts, Boston, Massachusetts, USA
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Fitch C, Chaplin R, Trend C, Collard S. Debt and mental health: the role of psychiatrists. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.106.002527] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
One in four people with mental health problems in Britain report debt or arrears, which is nearly three times the rate among individuals without similar conditions. Although health professionals commonly encounter debt among patients, some report that they lack basic knowledge to effectively intervene and that patient debt is often not acted on until a crisis emerges. Our aim in this article is to improve psychiatrists' knowledge and confidence in dealing with patient debt. We provide basic definitions of debt and problem debt; outline the impact that debt can have on patients' health, social and financial well-being; identify the stages and signs that a patient may be accruing problem debt; describe how psychiatrists should respond; and review the instruments available to assess patients' mental capacity to make financial decisions. We do not expect psychiatrists to become ‘debt experts’, but provide working knowledge for engaging more effectively with this problem.
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Maselko J, Bates L, Bhalotra S, Gallis JA, O’Donnell K, Sikander S, Turner EL. Socioeconomic status indicators and common mental disorders: Evidence from a study of prenatal depression in Pakistan. SSM Popul Health 2017; 4:1-9. [PMID: 29349268 PMCID: PMC5769091 DOI: 10.1016/j.ssmph.2017.10.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 01/05/2023] Open
Abstract
There is growing interest in the relationship between socioeconomic status (SES), poverty, and mental health in low and middle-income countries (LMIC). However, it is not clear whether a gradient approach focused on a wider SES distribution or a binary poverty approach is more salient for mental health in LMIC. Yet this distinction has implications for interventions aimed at improving population health. We contribute to the literature by examining how multiple indicators of socioeconomic status, including gradient SES and binary poverty indicators, contribute to prenatal depression symptoms in a LMIC context. Prenatal depression is an important public health concern with negative sequela for the mother and her children. We use data on assets, education, food insecurity, debt, and depression symptoms from a sample of 1154 pregnant women residing in rural Pakistan. Women who screened positive for depression participated in a cluster randomized controlled trial of a perinatal depression intervention; all women were interviewed October 2015-February 2016, prior to the start of the intervention. Cluster-specific sampling weights were used to approximate a random sample of pregnant women in the area. Findings indicate that fewer assets, experiencing food insecurity, and having household debt are independently associated with worse depression symptoms. The association with assets is linear with no evidence of a threshold effect, supporting the idea of a gradient in the association between levels of SES and depression symptoms. A gradient was also initially observed with woman’s educational attainment, but this association was attenuated once other SES variables were included in the model. Together, the asset, food insecurity, and debt indicators explain 14% of the variance in depression symptoms, more than has been reported in high income country studies. These findings support the use of multiple SES indicators to better elucidate the complex relationship between socioeconomic status and mental health in LMIC.
We compare the association between poverty, gradient measures of SES, and depression. Above the poverty level, SES predict depression in a low income country. Relying on simple, dichotomous, poverty measures in studies of mental health is not recommended.
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Affiliation(s)
- Joanna Maselko
- Dept. of Epidemiology, 2105e McGavran-Greenberg Hall, Campus Box 7435, Gillings School of Global Public Health, UNC, Chapel Hill, NC 27599-7435, USA
- Corresponding author.
| | - Lisa Bates
- Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA
| | - Sonia Bhalotra
- ISER and Department of Economics, University of Essex, Wivenhoe Park CO4 3SQ, UK
| | - John A. Gallis
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2424 Erwin Road, Durham, NC 27705-3819, USA
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
| | - Karen O’Donnell
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2424 Erwin Road, Durham, NC 27705-3819, USA
- Center for Child and Family Health, 1121W Chapel Hill St #100, Durham, NC 27701, USA
| | - Siham Sikander
- Human Development Research Foundation, P.O Box No 516, F 7 Markaz, Islamabad, Pakistan
| | - Elizabeth L. Turner
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2424 Erwin Road, Durham, NC 27705-3819, USA
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27710, USA
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Austin AE, Smith MV. Examining Material Hardship in Mothers: Associations of Diaper Need and Food Insufficiency with Maternal Depressive Symptoms. Health Equity 2017; 1:127-133. [PMID: 29082357 PMCID: PMC5657130 DOI: 10.1089/heq.2016.0023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Material hardship represents a potential mechanism by which poverty influences the mental health of mothers. This study examined the association between two forms of material hardship, diaper need and food insufficiency, and maternal depressive symptoms. Methods: Data were from a cross-sectional study of 296 urban, pregnant or parenting, low-income women. A linear regression model was used to examine the association of maternal depressive symptoms, measured by the Center for Epidemiologic Studies Depression (CES-D) score, with diaper need and food insufficiency, after adjustment for demographic factors. Results: More than half of women reported diaper need (50.3%) and food insufficiency (54.7%). Nearly one-third of women who reported diaper need did not report food insufficiency (32.2%). In bivariate analyses, diaper need and food insufficiency were associated with maternal CES-D score. In multivariate analyses, women who reported diaper need had a significantly higher CES-D score than women who did not report diaper need (β=3.5, p=0.03). Women who reported food insufficiency did not have a significantly higher CES-D score than women who did not report food insufficiency (β=2.4, p=0.15). Conclusions: Diaper need is a form of material hardship that has received little attention in the research literature. Diapers, unlike food, are currently not an allowable expense in U.S. antipoverty programs. Diaper need may contribute to maternal depressive symptoms, beyond the contribution of other forms of material hardship, because there are no supports in place to provide assistance meeting this basic need. Importantly, diaper need is a malleable factor amenable to public health and policy interventions.
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Affiliation(s)
- Anna E Austin
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Department of Maternal and Child Health, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Megan V Smith
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Child Study Center, Yale University School of Medicine, New Haven, Connecticut.,Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Husain N, Chaudhry N, Furber C, Fayyaz H, Kiran T, Lunat F, Rahman RU, Farhan S, Fatima B. Group psychological intervention for maternal depression: A nested qualitative study from Karachi, Pakistan. World J Psychiatry 2017; 7:98-105. [PMID: 28713687 PMCID: PMC5491481 DOI: 10.5498/wjp.v7.i2.98] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 05/17/2017] [Accepted: 05/31/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To understand the experience of maternal depression, the factors implicated in accessing health, and the acceptability of the psychosocial intervention.
METHODS The participants were recruited from the paediatrics outpatient department of Civil Hospital Karachi, Pakistan. The study started in December 2009 and completed in December 2010. Women with maternal depression, aged 18-44 years with children aged 0-30 mo who had received nutritional supplements, and participated in the intervention programme [called Learning through Play (LTP) plus] were included in the study. Qualitative interviews were conducted with 8 participants before the intervention and 7 participants after the intervention. A semi structured topic guide was used to conduct the interviews.
RESULTS Framework analysis procedures were used to analyse the qualitative data. Four themes emerged: (1) the women’s contextual environment: Interpersonal conflicts, lack of social support and financial issues being the major barriers in assessing healthcare; (2) women’s isolation and powerlessness within the environment: Sense of loneliness was identified as a restricting factor to access healthcare; (3) the impact of the intervention (LTP-Plus): Women felt “listened to” and seemed empowered; and (4) empowered transformed women within the same contextual environment: The facilitator provided a “gardening role” in nurturing the women resulting in a positive transformation within the same environment. The women’s homes seemed to be more happy homes and there was a positive change in their behaviour towards their children.
CONCLUSION Findings informed the further development and testing of culturally-appropriate psychosocial intervention (LTP+) for addressing maternal depression.
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Lee TH, Park EC, Kim W, Kim J, Shin J, Kim TH. Depressive symptoms of house-poor persons: Korean panel data evidence. Int J Soc Psychiatry 2016; 62:569-77. [PMID: 27363859 DOI: 10.1177/0020764016653773] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND There are no studies researching the relationship between house-poor persons and mental health. Therefore, this study aimed to investigate the relationship between house-poor status and depressive symptoms. AIM To examine the relationship between the house-poor and depressive symptoms according to household income. METHODS Data from the Korean Welfare Panel Study were used. House-poor were defined as people having possession with over 10% house-related interest in disposable income. About 7,565 participants over the age of 19 years were followed up from 2011 to 2013. The generalized estimating equations were used for analysis. RESULTS Individuals with more house-related debt showed increasingly higher depression scores (possession with under 5% related debt to disposable income β = 0.2024, p = .1544; under 10% β = 0.7030, p = .0008; over 10% β = 1.3207, p < .0001). Individuals possessing houses with over 10% ratio of house-related debts to disposable income had higher depression scores than individuals without house ownership (no possession β = 0.8927, p < .0001). CONCLUSION Individuals without houses and individuals owning houses with higher percentages of house-related interests showed higher levels of depressive symptoms. Therefore, this study affirmed that the importance of considering the most vulnerable groups in addressing the mental health of individual.
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Affiliation(s)
- Tae-Hoon Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Woorim Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Juyeong Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
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Hojman DA, Miranda Á, Ruiz-Tagle J. Debt trajectories and mental health. Soc Sci Med 2016; 167:54-62. [PMID: 27598550 DOI: 10.1016/j.socscimed.2016.08.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 08/09/2016] [Accepted: 08/18/2016] [Indexed: 01/22/2023]
Abstract
In the last few decades, there was a marked increase in consumer debt in the United States, Latin America and other emerging countries, spurring a debate about the real costs and benefits of household credit. Using a unique longitudinal dataset with detailed health and balance sheet information from a large sample of 10,900 Chilean households we study the relationship between debt trajectories in a three-year time window and mental health. We find that depressive symptoms are higher for those who have been persistently over-indebted, followed by those who transit from moderate to high debt levels. We also find that those who transition from over-indebtedness to moderate debt levels have no additional depressive symptoms compared to those with trajectories of moderate debt throughout (never over-indebted). This suggests that the debt-related contribution to depressive symptoms vanishes as debt levels fall. The association between debt and depressive symptoms seems to be driven by non-mortgage debt -primarily consumer credit- or late mortgage payments; secured debt (secured by collateral) per se is not associated with depressive symptoms. Policy interventions to reduce the negative association of over-indebtedness on mental health are discussed.
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Affiliation(s)
- Daniel A Hojman
- Department of Economics, University of Chile, Diagonal Paraguay 257, Santiago, 8330015, Chile.
| | - Álvaro Miranda
- School of Economics and Business, Diego Portales University, Santiago, Chile
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Campbell-Grossman C, Hudson DB, Kupzyk KA, Brown SE, Hanna KM, Yates BC. Low-Income, African American, Adolescent Mothers' Depressive Symptoms, Perceived Stress, and Social Support. JOURNAL OF CHILD AND FAMILY STUDIES 2016; 25:2306-2314. [PMID: 28413312 PMCID: PMC5389114 DOI: 10.1007/s10826-016-0386-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this descriptive repeated-measures study was to describe depressive symptom patterns and report changes over time in levels of perceived stress and social support depending on patterns of depressive symptoms in single, low-income, African American, adolescent mothers during the initial, 6-month postpartum period. Thirty-five adolescent subjects between the ages of 16 and 22 years old were recruited at health care clinics in two Midwestern cities. Data collections by advanced practice nurses were completed at 1 week, 6 weeks, 3 months, and 6 months postpartum at mothers' homes. Established instruments were used to measure depressive symptoms, perceived stress and social support. Results indicated 63% of adolescent mothers' experienced depressive symptoms sometime during this transition period and 11.4% of these subjects had depressive symptoms at all 4 time points. Depressive symptoms were associated with perceived stress at each time point. Emotional support was inversely associated with depressive symptoms at 2 of the 4 time points. Depressive symptoms and problematic support were significantly related at 3 months and 6 months. Although single, low-income, African American, adolescent mothers are considered a high risk group, some are at even greater risk. This extremely high risk group have depressive symptoms throughout the first 6 months postpartum with the highest level of perceived stress and the most variability in social support relative to groups that were never depressed or were in and out of depression. More studies are needed to understand how to best help these high risk adolescents successfully transition to motherhood.
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Affiliation(s)
| | | | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Sara E Brown
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Kathleen M Hanna
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
| | - Bernice C Yates
- College of Nursing, University of Nebraska Medical Center, Omaha, NE
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The Education-health Nexus: Fact and fiction. Soc Sci Med 2016; 150:112-6. [DOI: 10.1016/j.socscimed.2015.12.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 12/15/2015] [Accepted: 12/23/2015] [Indexed: 11/24/2022]
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40
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Berger LM, Houle JN. Parental Debt and Children's Socioemotional Well-being. Pediatrics 2016; 137:e20153059. [PMID: 26798042 PMCID: PMC6043894 DOI: 10.1542/peds.2015-3059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We estimated associations between total amount of parental debt and of home mortgage, student loan, automobile, and unsecured debt with children's socioemotional well-being. METHODS We used population-based longitudinal data from the National Longitudinal Study of Youth 1979 Cohort and Children of the National Longitudinal Study of Youth 1979 Cohort. Our analytic sample consisted of 29 318 child-year observations of 9011 children and their mothers observed annually or biennially from 1986 to 2008. We used the Behavioral Problems Index to measure socioemotional well-being. We used ordinary least squares regressions to estimate between-child associations of amounts and types of parental debt with socioemotional well-being, net of a host of control variables, and regressions with child-specific fixed effects to estimate within-child associations of changes in parental debt with changes in socioemotional well-being, net of all time-constant observed and unobserved confounders. RESULTS Greater total debt was associated with poorer child socioemotional well-being. However, this association varied by type of debt. Specifically, higher levels of home mortgage and education debt were associated with greater socioemotional well-being for children, whereas higher levels of and increases in unsecured debt were associated with lower levels of and declines in child socioemotional well-being. CONCLUSIONS Debt that allows for investment in homes (and perhaps access to better neighborhoods and schools) and parental education is associated with greater socioemotional well-being for children, whereas unsecured debt is negatively associated with socioemotional development, which may reflect limited financial resources to invest in children and/or parental financial stress. This suggests that debt is not universally harmful for children's well-being, particularly if used to invest in a home or education.
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Affiliation(s)
- Lawrence M. Berger
- Department of Social Work, University of Wisconsin-Madison School of Social Work and Insitute for Research on Poverty, Madison, Wisconsin; and Department of Sociology, Dartmouth College Department of Sociology, Hanover, New Hampshire,Address correspondence to Lawrence M. Berger, MSW, PhD, Institute for Research on Poverty, University of Wisconsin-Madison, 3420 William H. Sewell Social Sciences Building, 1180 Observatory Dr, Madison, WI 53706. E-mail:
| | - Jason N. Houle
- Department of Social Work, University of Wisconsin-Madison School of Social Work and Insitute for Research on Poverty, Madison, Wisconsin; and Department of Sociology, Dartmouth College Department of Sociology, Hanover, New Hampshire
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41
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New evidence on breastfeeding and postpartum depression: the importance of understanding women's intentions. Matern Child Health J 2015; 19:897-907. [PMID: 25138629 PMCID: PMC4353856 DOI: 10.1007/s10995-014-1591-z] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to identify the causal effect of breastfeeding on postpartum depression (PPD), using data on mothers from a British survey, the Avon Longitudinal Study of Parents and Children. Multivariate linear and logistic regressions were performed to investigate the effects of breastfeeding on mothers' mental health measured at 8 weeks, 8, 21 and 32 months postpartum. The estimated effect of breastfeeding on PPD differed according to whether women had planned to breastfeed their babies, and by whether they had shown signs of depression during pregnancy. For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies, while the highest risk was found among women who had planned to breastfeed and had not gone on to breastfeed. We conclude that the effect of breastfeeding on maternal depression is extremely heterogeneous, being mediated both by breastfeeding intentions during pregnancy and by mothers' mental health during pregnancy. Our results underline the importance of providing expert breastfeeding support to women who want to breastfeed; but also, of providing compassionate support for women who had intended to breastfeed, but who find themselves unable to.
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42
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Mathias K, Goicolea I, Kermode M, Singh L, Shidhaye R, Sebastian MS. Cross-sectional study of depression and help-seeking in Uttarakhand, North India. BMJ Open 2015; 5:e008992. [PMID: 26589428 PMCID: PMC4663438 DOI: 10.1136/bmjopen-2015-008992] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study sought to use a population-based cross-sectional survey to describe depression prevalence, healthcare seeking and associations with socioeconomic determinants in a district in North India. SETTING This study was conducted in Sahaspur and Raipur, administrative blocks of Dehradun district, Uttarakhand, in July 2014. PARTICIPANTS A population-based sample of 960 people over the age of 18 years was selected in 30 randomised clusters after being stratified by rural:urban census ratios. PRIMARY OUTCOME MEASURES The survey used a validated screening tool, Patient Health Questionnaire, to identify people with depression, and collected information regarding socioeconomic variables and help-seeking behaviours. Depression prevalence and health seeking behaviours were calculated, and multivariable logistic regression was used to assess associations between risk factors and depression. RESULTS Prevalence of depression was 6% (58/960), with a further 3.9% (37/960) describing a depressive episode of over 2 weeks in the past 12 months. Statistically significant adjusted OR for depression of more than 2 were found for people who were illiterate, classified as Scheduled Caste/Tribe or Other Backward Castes, living in temporary material housing and who had recently taken a loan. While over three quarters of people with depression (79%) had attended a private or government general medical practitioner in the past 3 months, none had received talking therapy (100% treatment gap) and two people (3.3%) had been prescribed antidepressants. CONCLUSIONS There are clear associations between social, educational and economic disadvantage and depression in this population. Strategies that address the social determinants of depression, such as education, social exclusion, financial protection and affordable housing for all are indicated. To address the large treatment gap in Uttarakhand, we must ensure access to primary and secondary mental health providers who can recognise and appropriately manage depression.
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Affiliation(s)
- Kaaren Mathias
- Department of Community Health and Development, Emmanuel Hospital Association, New Delhi, India
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Isabel Goicolea
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Michelle Kermode
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rahul Shidhaye
- Centre for Mental Health, Public Health Foundation of India, New Delhi, India
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Acri M, Gopalan G, Lalayants M, McKay MM. Depression and Service Use Among Caregivers Dually Involved in the Child Welfare and Mental Health Systems. SOCIAL WORK IN MENTAL HEALTH 2015; 13:481-494. [PMID: 26366130 PMCID: PMC4565603 DOI: 10.1080/15332985.2014.997956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The purpose of this study was to investigate the prevalence of depression, use of mental health services, and correlates of service use among caregivers who are dually involved in the child welfare and child mental health systems. METHODS This study analyzed baseline data from 129 caregivers who reported child welfare system involvement and were participating in a Multiple Family Group service delivery model to reduce childhood disruptive behavior disorders. RESULTS Seventy-eight (60.5%) of caregivers met or exceed the clinical-cut off for depression; of them 50 (64.1%) reported utilizing mental health services for their emotional health. Race, employment status, and CES-D score were significantly associated with lifetime mental heath services use. DISCUSSION Depression rates exceeded those found among caregiver involved in either the child welfare or child mental health systems. Rates of service use were higher than found in existing research. As expected, racial differences and depression were associated with service use; contrary to expectations, full time employment was not associated with service use. Discrepancies between this study and existing research are discussed, as are practice, policy, and research implications.
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Affiliation(s)
- Mary Acri
- New York University School of Medicine
| | | | | | - Mary M McKay
- McSilver Institute for Poverty, Policy, and Research
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44
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Clayton M, Liñares-Zegarra J, Wilson JO. Does debt affect health? Cross country evidence on the debt-health nexus. Soc Sci Med 2015; 130:51-8. [DOI: 10.1016/j.socscimed.2015.02.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Drentea P, Reynolds JR. Where Does Debt Fit in the Stress Process Model? SOCIETY AND MENTAL HEALTH 2015; 5:16-32. [PMID: 31106006 PMCID: PMC6521877 DOI: 10.1177/2156869314554486] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This paper contrasts two money-related stressors—debt and economic hardship—and clarifies where debt fits into the stress process model. Debt may be a direct or indirect stressor, as something mediated by psychosocial resources, and may be a potential buffer, interacting with economic hardship. The analyses use data from a two-wave panel study of 1,463 adults. One way debt is distinct from economic hardship is that debt is more common among economically advantaged groups. Further, though debt and economic hardship are both associated with negative mental health, the influence of hardship is partly mediated by mastery. This is not true of debt. Finally, debt does not buffer the negative effects of economic hardship, nor does its influence vary by income. We conclude debt is best conceptualized as an unmediated stressor and not as a coping resource. Future research should determine whether different types of debt have distinct mental health consequences.
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Affiliation(s)
| | - John R. Reynolds
- Pepper Institute on Aging and Public Policy, Florida State University, 636 W. Call St, PCB #207, Tallahassee, FL 32306-1121, Phone: 850-644-8825
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Flouri E, Midouhas E, Joshi H. Family poverty and trajectories of children's emotional and behavioural problems: the moderating roles of self-regulation and verbal cognitive ability. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 42:1043-56. [PMID: 24473936 DOI: 10.1007/s10802-013-9848-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Socio-economic disadvantage is strongly associated with children's emotional (internalising) and behavioural (externalising) problems. Self-regulation and verbal cognitive ability have been related to children's emotional and behavioural resilience to socio-economic disadvantage. Despite being inter-related, self-regulation and verbal cognitive ability have not been examined jointly as promoting resilience in young children. This study investigated the roles of self-regulation and verbal cognitive ability in children's emotional and behavioural resilience to family socio-economic disadvantage from early to middle childhood (ages 3, 5, and 7 years; N = 16,916; 49 % girls). Using multivariate response growth curve modelling, we found that the relationship between socio-economic disadvantage and internalising problems was stronger for children with lower verbal cognitive ability. Also, poor children with high and low levels of self-regulation showed a widening gap in both emotional and behavioural problems over time. Poor and non-poor children alike benefited from self-regulation, but poor children appeared to be more vulnerable to low self-regulation. Self-regulation and verbal cognitive ability seem to be important protective factors for young children growing up in poor families.
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Affiliation(s)
- Eirini Flouri
- Department of Psychology and Human Development, Institute of Education, University of London, 25 Woburn Square, London, WC1H 0AA, UK,
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Richardson T, Elliott P, Roberts R. The impact of tuition fees amount on mental health over time in British students. J Public Health (Oxf) 2015; 37:412-8. [PMID: 25670684 DOI: 10.1093/pubmed/fdv003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous studies have shown a relationship between debt and mental health problems in students. This study aimed to examine the effect of differences in tuition fees amount on changes in mental health over time. METHODS A prospective cohort study followed 390 first-year British students who differed on their tuition fees level at 4 time points across their first 2 years at university. Participants completed measures of global mental health, depression, anxiety, stress, alcohol-related problems at up to four time points in their first two years at university. Mixed-factorial ANOVAs were used to assess the impact of tuition fees amount on changes in scores over time. RESULTS There was no difference based on fees at Time 1 for anxiety, stress, depression and global mental health. At Time 2, those charged £0-2.9k or £3-4k improved while those charged £8-9k stayed the same. However, this trend reversed by Times 3 and 4. CONCLUSIONS Undergraduates mental health is partially affected by the level of tuition fees; however, the recent increase in tuition fees does not appear to have had a lasting impact at present.
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Affiliation(s)
- T Richardson
- Professional Training Unit, School of Psychology, University of Southampton, Southampton SO17 1BJ, UK Mental Health Recovery Team South, Solent NHS Trust, Portsmouth PO3 6AD, UK
| | - P Elliott
- Professional Training Unit, School of Psychology, University of Southampton, Southampton SO17 1BJ, UK
| | - R Roberts
- Department of Psychology, Kingston University, Surrey KT1 2EE, UK
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Gong Y, Zhang X, Zou H, Tian D, Qu Z, Zhang W, Chu Y. Debt and depression among the Dibao population in northwestern China. Int J Soc Psychiatry 2014; 60:637-45. [PMID: 24296965 DOI: 10.1177/0020764013511068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND With the rapid development of economy, depression disorder is not only a public health issue but also a socioeconomic problem and attracting more and more attention in China. AIMS The target of this study is to examine the prevalence of depression and the related risk factors in the Dibao population in northwestern China. METHOD A cross-sectional analysis in a random sample survey conducted in three northwestern Chinese cities in 2007. The data from 4459 respondents with completed Center for Epidemiological Studies-Depression (CES-D) scales were evaluated to explore the key risk factors for depression. Using depression as a binary variable according to the cutoff of the CES-D score and then as a continuous variable, multiple logistic and line regression analysis were performed to compare the odds ratio and the weight of different risk factors for depression. RESULTS The prevalence of depression in non-Dibao population was 34.7% but that in the Dibao population was 50.0% (p < .001). After adjusting for important confounders, Dibao population had an odds ratio (OR) of 1.38 (95% confidence interval (CI): 1.16-1.63) to have possible depression compared to those non-Dibao people. Furthermore, depression was associated with a higher OR of indebtedness (OR: 1.59, 95% CI: 1.31-1.93), and a small amount of debt would increase the possibility of depression for Dibao people (OR: 1.69, 95% CI: 1.28-2.23). In addition, gender, body mass index (BMI), tobacco use and social network were also important risk factors for depression in the Dibao population. Using depression as a continuous variable, being a member of the Dibao population and being indebted will add 2.06 and 1.83 to the CES-D score, respectively, compared with the non-Dibao population and not being indebted. A comparison of the odds ratios of depression between the Dibao and the non-Dibao population showed that factors such as gender, BMI, tobacco use, social network and indebtedness were statistically significant in the Dibao population but were not statistically significant in the non-Dibao population. Additionally, having a savings account was statistically significant in the non-Dibao population but not in the Dibao population. CONCLUSIONS It was not surprising, as proved by other studies, that gender, obesity and social network were risk factors associated with depression in the Dibao population. Our findings indicated that a small amount of indebtedness was also closely related to depression in the Dibao population.
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Affiliation(s)
- Yanhong Gong
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R. China School of Psychology, Beijing Normal University, Beijing, P.R. China
| | - Xiulan Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R. China
| | - Hong Zou
- School of Psychology, Beijing Normal University, Beijing, P.R. China
| | - Donghua Tian
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R. China
| | - Zhiyong Qu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R. China
| | - Weijun Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R. China
| | - Yongqiang Chu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P.R. China
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Yamamoto N, Abe Y, Arima K, Nishimura T, Akahoshi E, Oishi K, Aoyagi K. Mental health problems and influencing factors in Japanese women 4 months after delivery. J Physiol Anthropol 2014; 33:32. [PMID: 25351243 PMCID: PMC4228093 DOI: 10.1186/1880-6805-33-32] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 10/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postpartum mental health problems are a major public health issue; however, studies on the mental health status of mothers and its influencing factors between 8 weeks and 1 year postpartum are scarce. Furthermore, it would be necessary to examine the factors influencing mothers' mental health in order to evaluate their physiological adaptations to the nursing environment. METHODS We examined the mental health status of postpartum women and the factors influencing poor mental health at 4 months after delivery. A cross-sectional study of 584 postpartum women was conducted. Information on mental health status, delivery, and other factors was collected using a self-administered questionnaire. Women were asked about their age, height, weight, gestational or marital status, whether they were eating regular meals, appetite, frequency of going out, financial difficulty, stressful life events, and history of depression. The Japanese version of the 12-item General Health Questionnaire (GHQ-12) was used to identify potential poor mental health status. Participants with GHQ-12 scores of ≥4 were classified as the high GHQ-12 score group (poor mental health status) and participants with GHQ-12 scores of ≤3 were classified as the low GHQ-12 score group (good mental health status). RESULTS Forty-five women (7.7%) were classified as having high GHQ-12 scores. Multiple logistic regression analysis revealed that older age, not eating meals regularly, and history of depression were significantly associated with poor mental health. Financial difficulty had a borderline association with poor mental health in this model. CONCLUSIONS These risk factors might help practitioners identify women at high risk of poor mental health after delivery.
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Affiliation(s)
| | - Yasuyo Abe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4, Sakamoto, Nagasaki 852-8523, Japan.
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Brook JS, Lee JY, Balka EB, Finch SJ, Brook DW. Utilization of mental health services by minority urban adults: psychosocial predictors. J Urban Health 2014; 91:720-35. [PMID: 24865801 PMCID: PMC4134453 DOI: 10.1007/s11524-014-9878-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Although most mental disorders have their first onset by young adulthood, there are few longitudinal studies of these problems and related help-seeking behavior. The present study examined some early and current predictors of the use of mental health services among African-American and Puerto Rican participants in their mid-30s. The 674 participants (52.8 % African Americans, 47.2 % Puerto Ricans; 60.1 % women) in this study were first seen in 1990 when the participants attended schools serving the East Harlem area of New York City. A structural equation model controlling for the participants' gender, educational level in emerging adulthood, and age at the most recent data collection showed significant standardized pathways from both ethnicity (β = -0.28; z = -4.82; p < 0.001) and psychological symptoms (β = 0.15; z = 2.41; p < 0.05), both measured in emerging adulthood, to smoking in the early 30s. That, in turn, was associated with certain physical diseases and symptoms (i.e., respiratory) in the mid-30s (β = 0.16; z = 2.59; p < 0.05). These physical diseases and symptoms had a cross-sectional association with family financial difficulty in the mid-30s (β = 0.21; z = 4.53; p < 0.001), which in turn also had a cross-sectional association with psychiatric disorders (β = 0.30; z = 5.30; p < 0.001). Psychiatric disorders had a cross-sectional association with mental health services utilization (β = 0.65; z = 13.25; p < 0.001). Additional pathways from the other domains to mental health services utilization in the mid-30s were also supported by the mediating role of psychiatric disorders. Results obtained from this research offer theoretical and practical information regarding the processes leading to the use of mental health services.
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Affiliation(s)
- Judith S Brook
- Department of Psychiatry, New York University School of Medicine, 215 Lexington Ave., 15th Fl., New York, NY, 10016, USA,
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