Postpartum Depression in African Americans in Comparison to the General Massachusetts Public By: Karen Cevallos, Narda Bondah UMass Amherst, Quinsigamond Community College

Introduction “Postpartum depression (PPD) is a mood disorder that affects parents especially women after childbirth.” PPD patients experience Extreme sadness Anxiety Exhaustion Change in appetite

Causes of PPD Effects of PPD Drop in hormonal levels causes chemical changes in the brain Sleep deprivation after childbirth History of depression Effects of PPD Interrupts parent-child bonding Infant development. Suicide Ideation Maternal Mortality 3

Mortality due to Postpartum Depression Over 2 years Mental Health Diagnoses has increased by 13% About 50% which were depressive disorders. 17% are PPD Courtesy of Mass Department of Public Health

Health Disparity “The differences in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exist among specific population groups in the United States.” These population groups may include ethnicity, age, geographical location and sexual orientation. 5 4

Proof of Disparity in African Americans. 1 in 7 mothers experience postpartum depression 10% of mothers in MA have PPD 20% of which are African Americans Courtesy of 2017 MA State Health Assessment.

Postpartum Depression in Fathers 1 in 10 fathers experience PPD 24% - 50% of men with PPD have partners with PPD. Men are likely to underreport PPD due to cultural concepts of masculinity.

Why the prevalence in African Americans? Socioeconomic status Poor education Low income Poor healthcare access Inadequate prenatal care Relationship status 8

Courtesy of 2017 MA State Health Assessment. Education Just 23.4% of African Americans attain higher education Most of them dropout of schools. This elongates the income gap with the general public Courtesy of 2017 MA State Health Assessment. 9

Courtesy of 2017 MA State Health Assessment. Low Income 1 in 5 African Americans are below the federal state poverty line (22%) Financial hardships can lead to insufficient health care. Courtesy of PRAMS 10 Courtesy of 2017 MA State Health Assessment.

Poor Healthcare Access Amenable mortality is death that could have been prevented with medical intervention. Blacks have 84% amenable death rate. This signals poor access to quality healthcare. Let me know if you know this is what you are talking about by any chance! Courtesy of Mass State Health Assessment 11

Correlation Between Prenatal Care & PPD Trends in Adequacy of Prenatal Care, by Race/Ethnicity, Massachusetts, 2006-2015 African American women that receive prenatal care have reduced by 6% Inadequate access to healthcare limits resources available for sound prenatal and postnatal health. Courtesy of 2017 MA State Health Assessment. Courtesy Mass State Health Assessment 12

Relationship Status 48% of African American women have never been married 13% have been divorced and 4% are separated Non-married women are twice as likely to get PPD as their married counterparts. (PRAMS) Courtesy of Black Demographics 13

Trends in Postpartum Depression Experts recommend a universal screening of postpartum depression PPD is twice as common as gestational diabetes. (MCPAP) 40% of the population reports PPD symptoms. 72.6% do not seek help Courtesy of PRAMS

Prevention/Treatments Free Early Prevention Programs such as Massachusetts Child Psychiatry Access Program for Moms (MCPAP) Postpartum Special Legislative Commission Report symptoms to physician Seek couple therapy Eat healthy (vitamins and minerals) Get enough rest after childbirth Support parents with PPD

Summary PPD can affect both men and women African Americans have the highest prevalence of PPD in comparison to the general population Low educational level, low income, lack of access to health care and marital status are contributing factors. There are great accessible resources to help families in need; which includes therapy, support groups, and change of lifestyle 16

Works Cited “Postpartum Depression.” Massachusetts Pregnancy Risk Assessment Monitoring Systems 2007/2008 Surveillance Report. “Postpartum Depression Among Women in Massachusetts.” MA PRAMS Fact Sheets vol. 1, no. 22007 “Postpartum Depression.” Massachusetts State Health Assessment.” 2017 "An Overview of Postpartum Depression." PostpartumDepression.org. N.p., n.d. Web. 18 June 2018 "Marriage in Black America." BlackDemographics.com. N.p., n.d. Web. 18 June 2018. “Documented Mental Health Diagnosis in Pregnancy Related Deaths.” Massachusetts Department of Public of Health “New study reveals disturbing PPD statistics.” Seleni. “About the Special Legislative Commission on Postpartum Depression” Mass.gov “Massachusetts Community Health Insurance Plan” “Journal for Family and Mental Health” UMASS Medical School