Structural racism and pandemic stressors associated with postpartum
depression and anxiety among Black individuals, study finds

Date:
April 13, 2022
Source:
Children's Hospital of Philadelphia
Summary:
A study found the combined effects of structural racism and the
pandemic, known as a 'syndemic,' were associated with negative
postpartum mental health.



FULL STORY ==========================================================================
The combined effects of systemic and interpersonal racism layered on
top of negative experiences within the COVID-19 pandemic were associated
with depression and anxiety among Black people in the postpartum period, according to a new study by researchers in The Intergenerational Exposome Program (IGNITE) of Children's Hospital of Philadelphia (CHOP) and
the Perelman School of Medicine at the University of Pennsylvania. The
findings were published today in JAMA Psychiatry.


==========================================================================
"The COVID-19 pandemic has had a disproportionate impact on the Black community, in large part due to structural racism and its impact on
the social determinants of health, and our study shows this impact
extended to the effects on the postpartum period," said study first
author Wanjikũ F.M. Njoroge, MD, Medical Director of the Young
Child Clinic, Associate Chair of Diversity, Equity, and Inclusion in the Department of Child and Adolescent Psychiatry and Behavioral Sciences,
and PolicyLab Faculty at Children's Hospital of Philadelphia. "Not only
does this research point to an urgent need for policies that address
the pandemic's mental health effects on Black pregnant people, but it
also highlights the need to follow the babies and toddlers of these
people through early childhood to understand any potential impacts
on their development and intervene where necessary." The researchers
sought to examine how the joint effects of structural and interpersonal
racism, two endemic conditions, and the COVID-19 pandemic, an epidemic condition, contributed to postpartum mental health outcomes in Black individuals before and after birth. To do so, they analyzed data from a
large birthing cohort participating in a longitudinal study related to
the pandemic and perinatal health. Participants delivered in one of two
urban hospitals within the University of Pennsylvania Health System in Philadelphia. The researchers looked at data from a total of 151 Black
patients to understand the impacts of multiple forms of racism on their postpartum mental health.

Participants answered a series of questions about their COVID-19 pandemic experiences, interpersonal racism, and mental health status. The
researchers also used geocoding of zip codes based on census data as
well as examinations of electronic medical record data to assess factors
like income inequality, home ownership, education level and insurance
type. Additionally, they mapped participants based on Home Owners' Loan Corporation (HOLC) redlining boundaries and assigned participants a risk
grade from A (minimal) to D (hazardous) based on their street address.

The researchers found that nearly all participants (91%) expressed
at least one significant pregnancy-related COVID-19 worry, and a large
majority (81%) reported at least one moderate concern related to delivery
and the postpartum period. A total of 44 participants (29%) screened
positive for postpartum depression.

In their analysis, the researchers found that worse experiences during
the COVID-19 pandemic, reports of interpersonal racism, and living in an
area of greater historical redlining were all uniquely associated with postpartum depression. Additionally, the association between racism
and poor postpartum mental health was magnified with worse COVID-19 experiences. Indeed, those with more negative COVID-19 experiences
combined with higher interpersonal and systemic general racism scores
were at the highest risk of meeting screening criteria for postpartum depression and anxiety.

"These findings underscore that the key to better serving Black patients
is to appreciate the cascading effect structural racism has on all aspects
of life, including pregnancy," said co-author Michal A. Elovitz, MD, co-Principal Investigator of the primary study and the Hilarie L. Morgan
and Mitchell L Morgan President's Distinguished Professor in Women's
Health in the Perelman School of Medicine at Penn. "Importantly, we,
as a medical community, have failed to adequately address and attend to
mental health issues among birthing individuals. This study emphasizes
an even additional need to focus on the mental health among Black
birthing people. We are hopeful that there will be increased efforts --
both clinically and in research -- to address the impact of structural
racism on the mental and physical well-being of Black individuals"

========================================================================== Story Source: Materials provided by
Children's_Hospital_of_Philadelphia. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Wanjikũ F. M. Njoroge, Lauren K. White, Rebecca Waller,
Markolline
Forkpa, Megan M. Himes, Kadina Morgan, Jakob Seidlitz, Barbara H.

Chaiyachati, Ran Barzilay, Sara L. Kornfield, Julia Parish-Morris,
Yuheiry Rodriguez, Valerie Riis, Heather H. Burris, Michal
A. Elovitz, Raquel E. Gur. Association of COVID-19 and Endemic
Systemic Racism With Postpartum Anxiety and Depression Among
Black Birthing Individuals. JAMA Psychiatry, 2022; DOI:
10.1001/jamapsychiatry.2022.0597 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220413131145.htm

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