Racial/Ethnic Differences in the Correlates of Mental Health Services Use among Pregnant Women with Depressive Symptoms

• Published in: Maternal and child health journal 2016-09, Vol.20 (9), p.1911-1922
• Main Authors: Chang, Jen Jen, Tabet, Maya, Elder, Keith, Kiel, Deborah W., Flick, Louise H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcohol; Analysis; Birth certificates; Care and treatment; Cross-Sectional Studies; Cultural differences; Depression (Mood disorder); Depression - ethnology; Depression - psychology; Education; Ethnicity; European Continental Ancestry Group - psychology; European Continental Ancestry Group - statistics & numerical data; Female; Florida - epidemiology; Gynecology; Health aspects; Health Care Surveys; Health insurance; Health services; Healthcare Disparities; Hispanic Americans; Hispanic Americans - psychology; Hispanic Americans - statistics & numerical data; Humans; Insurance coverage; Low income groups; Maternal Age; Maternal and Child Health; Medicaid; Medicine; Medicine & Public Health; Mental depression; Mental health care; Mental health services; Mental Health Services - utilization; Minority & ethnic groups; Missing data; Pediatrics; Population Economics; Population studies; Pregnancy; Pregnant women; Pregnant Women - ethnology; Pregnant Women - psychology; Prenatal Care; Prevalence; Public Health; Race; Race discrimination; Secondary schools; Services; Socioeconomic Factors; Sociology; Tobacco; White people; Womens health; Young Adult
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-016-2005-1

Objectives To examine correlates of lifetime mental health services (MHS) use among pregnant women reporting prenatal depressive symptoms by race/ethnicity. Methods This cross-sectional population-based study included 81,910 pregnant women with prenatal depressive symptoms using data from the Florida Healthy Start prenatal screening program (2008–2012). Multivariable logistic regression was conducted to ascertain adjusted odds ratios and corresponding 95 % confidence intervals for racial/ethnic differences in the correlates of lifetime MHS use. Results Findings of this study revealed racial/ethnic differences in MHS use among women with prenatal depressive symptoms, the highest rates being among non-Hispanic Whites and the lowest rates among Mexicans and other Hispanics. Most need for care factors, including illness, tobacco use, and physical or emotional abuse, consistently predicted MHS use across racial/ethnic groups after adjusting for covariates. Adjusted associations between predisposing and enabling/restricting factors and MHS use were different for different racial/ethnic groups. Conclusions Racial/ethnic differences in MHS use were found, with pregnant Hispanic women reporting prenatal depressive symptoms being the least likely to use MHS. Our study findings have significant public health implications for targeted intervention for pregnant women with prenatal depressive symptoms.