BACKGROUND: Perceived discrimination is associated with poor mental health and health-compromising behaviors in a range of vulnerable populations, but this link has not been assessed among pregnant women. We aimed to determine whether perceived discrimination was associated with these important targets of maternal health care among low-income pregnant women. METHODS: Face-to-face interviews were conducted in English or Spanish with 4,454 multiethnic, low-income, inner-city women at their first prenatal visit at public health centers in Philadelphia, Penn, USA, from 1999 to 2004. Perceived chronic everyday discrimination (moderate and high levels) in addition to experiences of major discrimination, depressive symptomatology (CES-D >or= 23), smoking in pregnancy (current), and recent alcohol use (12 months before pregnancy) were assessed by patients' self-report. RESULTS: Moderate everyday discrimination was reported by 873 (20%) women, high everyday discrimination by 238 (5%) women, and an experience of major discrimination by 789 (18%) women. Everyday discrimination was independently associated with depressive symptomatology (moderate = prevalence ratio [PR] of 1.58, 95% CI: 1.38-1.79; high = PR of 1.82, 95% CI: 1.49-2.21); smoking (moderate = PR of 1.19, 95% CI: 1.05-1.36; high = PR of 1.41, 95% CI: 1.15-1.74); and recent alcohol use (moderate = PR of 1.23, 95% CI: 1.12-1.36). However, major discrimination was not independently associated with these outcomes. CONCLUSIONS: This study demonstrated that perceived chronic everyday discrimination, but not major discrimination, was associated with depressive symptoms and health-compromising behaviors independent of potential confounders, including race and ethnicity, among pregnant low-income women.
BACKGROUND: Perceived discrimination is associated with poor mental health and health-compromising behaviors in a range of vulnerable populations, but this link has not been assessed among pregnant women. We aimed to determine whether perceived discrimination was associated with these important targets of maternal health care among low-income pregnant women. METHODS: Face-to-face interviews were conducted in English or Spanish with 4,454 multiethnic, low-income, inner-city women at their first prenatal visit at public health centers in Philadelphia, Penn, USA, from 1999 to 2004. Perceived chronic everyday discrimination (moderate and high levels) in addition to experiences of major discrimination, depressive symptomatology (CES-D >or= 23), smoking in pregnancy (current), and recent alcohol use (12 months before pregnancy) were assessed by patients' self-report. RESULTS: Moderate everyday discrimination was reported by 873 (20%) women, high everyday discrimination by 238 (5%) women, and an experience of major discrimination by 789 (18%) women. Everyday discrimination was independently associated with depressive symptomatology (moderate = prevalence ratio [PR] of 1.58, 95% CI: 1.38-1.79; high = PR of 1.82, 95% CI: 1.49-2.21); smoking (moderate = PR of 1.19, 95% CI: 1.05-1.36; high = PR of 1.41, 95% CI: 1.15-1.74); and recent alcohol use (moderate = PR of 1.23, 95% CI: 1.12-1.36). However, major discrimination was not independently associated with these outcomes. CONCLUSIONS: This study demonstrated that perceived chronic everyday discrimination, but not major discrimination, was associated with depressive symptoms and health-compromising behaviors independent of potential confounders, including race and ethnicity, among pregnant low-income women.
Authors: Jennifer M Watson; Isabel C Scarinci; Robert C Klesges; Deborah Slawson; Bettina M Beech Journal: J Womens Health Gend Based Med Date: 2002-06
Authors: Catherine Cubbin; Paula A Braveman; Kristen S Marchi; Gilberto F Chavez; John S Santelli; Brenda J Colley Gilbert Journal: Matern Child Health J Date: 2002-12
Authors: Amy J Schulz; Clarence C Gravlee; David R Williams; Barbara A Israel; Graciela Mentz; Zachary Rowe Journal: Am J Public Health Date: 2006-05-30 Impact factor: 9.308
Authors: Jennifer F Culhane; Virginia Rauh; Kelly Farley McCollum; Irma T Elo; Vijaya Hogan Journal: Am J Obstet Gynecol Date: 2002-11 Impact factor: 8.661
Authors: Ryan Saelee; Viola Vaccarino; Samaah Sullivan; Muhammad Hammadah; Amit Shah; Kobina Wilmot; Naser Abdelhadi; Lisa Elon; Pratik Pimple; Belal Kaseer; Oleksiy Levantsevych; J D Bremner; Tené T Lewis Journal: J Psychosom Res Date: 2019-07-19 Impact factor: 3.006