Racism-related stress and mental health among black women living in Los Angeles County, California: A comparison of postpartum mood and anxiety disorder screening scales

Kortney Floyd James; Keren Chen; Sasha S Hindra; Sydney Gray; Milllicent N Robinson; Courtney S Thomas Tobin; Kristen Choi; Denise Saint Arnault

doi:10.1007/s00737-024-01458-w

Racism-related stress and mental health among black women living in Los Angeles County, California: A comparison of postpartum mood and anxiety disorder screening scales

Arch Womens Ment Health. 2024 Apr 2. doi: 10.1007/s00737-024-01458-w. Online ahead of print.

Authors

Kortney Floyd James^{1

2}, Keren Chen³, Sasha S Hindra⁴, Sydney Gray⁵, Milllicent N Robinson⁶, Courtney S Thomas Tobin⁷, Kristen Choi^{8

9}, Denise Saint Arnault¹⁰

Affiliations

¹ School of Nursing, University of California Los Angeles, Los Angeles, CA, USA. kjames@rand.org.
² RAND Corporation, Santa Monica, CA, USA. kjames@rand.org.
³ David Geffen School of Medicine, Department of Medicine Statistics Core, University of California, Los Angeles, Los Angeles, CA, USA.
⁴ University of California Irvine, Sue & Bill Gross School of Nursing, Irvine, CA, USA.
⁵ , Long Beach, CA, USA.
⁶ School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁷ Jonathan and Karin Fielding School of Public Health, Department of Community Health Sciences), University of California Los Angeles, Los Angeles, CA, USA.
⁸ School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.
⁹ Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA, USA.
¹⁰ School of Nursing, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, USA.

PMID: 38561564
DOI: 10.1007/s00737-024-01458-w

Abstract

Purpose: To assess Black women's exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms.

Methods: Data from the Black Mothers' Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15.

Results: The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R² = 0.58, p = < 0.001) compared to the EPDS-3 (R² = 0.46, p = < 0.001) or the PHQ-15 (R² = 0.14, p = 0.035).

Conclusions: Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women's postpartum mental health.

Keywords: Black women; Mental health; Motherhood; Postpartum; Racism.

Grants and funding

UL1TR001881/Clinical and Translational Science Institute, University of California, Los Angeles