University of Wisconsin–Madison Medical College of Wisconsin

Examining the Association Between Racial Bias Exposure and Postpartum Depression Among Women in Wisconsin

Abdul Rahman Shour, MSP; Alice Muehlbauer, MSP; Ronald Anguzu, MBChB, MPH; Fiona Weeks, MSPH; John Meurer, MD, MBA

WMJ. 2021;120(Suppl 1):S24-S30.

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ABSTRACT

Objective: To analyze the association between racial bias and postpartum depression among women in Wisconsin.

Methods: Analyzed the Wisconsin Pregnancy Risk Assessment Monitoring System with a weighted sample of 125,581 women/mothers who delivered a live birth in 2016-2017. The outcome was self-reported postpartum depression. The independent variable was racial bias exposure. Survey-weighted logistic regression analyses were performed adjusting for confounders in 6 models—socioeconomic position, psychosocial factors, health risk behaviors, health care access, stress/obesity, and disease condition. All analyses were completed using STATA accounting for complex survey design and sample weights.

Results: In this sample, 6.6% of women/mothers experienced racial bias and 11.5% had postpartum depression. In unadjusted analysis, the odds of postpartum depression were higher for women who experienced racial bias than those who did not (OR 2.15; 95% CI, 1.35-3.41). Non-Hispanic Black women had higher odds for racial bias exposure than other racial/ethnic groups (OR 6.01; 95% CI, 1.69-21.41). However, the relationship between racial bias and postpartum depression was not significant after adjusting for socioeconomic position (OR 1.17; 95% CI, 0.69-1.97), psychosocial factors (OR 1.07; 95% CI, 0.63-1.81), health risk behaviors (OR 0.90; 95% CI, 0.55-1.49], health care access (OR 1.01; 95% CI, 0.60-1.70), stress/obesity (OR 0.73; 95% CI, 0.41-1.30), and disease/morbidity (OR 0.85; 95% CI, 0.46-1.57).

Discussion/Conclusion: Racial bias was associated with significantly increased risk of postpartum depression. Black women had higher odds for racial bias exposure than other groups. The relationship between racial bias and postpartum depression was not significant after adjusting for confounders, suggesting that social determinants potentially influenced this relationship. These findings should inform screening and health education interventions to minimize racism and poor maternal health outcomes.


Author Affiliations: Institute for Health and Equity, Medical College of Wisconsin (MCW), Milwaukee, Wis (Shour, Anguzu, Meurer); Masters of Sustainable Peacebuilding Program, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wis (Shour, Muehlbauer); Center for Advancing Population Science, MCW, Milwaukee, Wis (Shour, Anguzu); Wisconsin Pregnancy Risk Assessment Monitoring System, Maternal and Child Health Unit, Wisconsin Division of Public Health, Madison, Wis (Weeks).
Corresponding Author: Abdul Rahman Shour, MSP, Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226; phone 414.955.8394; email ashour@mcw.edu; ORCID ID 0000-0001-6884-9535.
Funding/Support: Funding for the Wisconsin PRAMS program is provided in part by the Centers for Disease Control and Prevention, Atlanta, Georgia (Grant #5 U01DP006229-05). Additional support for Wisconsin PRAMS comes from the Title V Maternal and Child Health Block Grant Program and the State Systems Development Initiative.
Financial Disclosures: None declared.
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