Neighborhood Characteristics and Depressive Symptoms Among Black Pregnant Women in Two Midwest Metropolitan Areas

Abstract

Background:

Approximately 15% of women report depressive symptoms during pregnancy, with Black women more likely to report depressive symptoms prenatally compared with White women. Depressive symptoms are associated with small for gestational age infants and preterm birth. Neighborhood affordability, socioeconomic, ethnic, and racial segregation may adversely influence maternal mental health.

Objective:

We sought to estimate the effect(s) of residential racial composition (ie, percentage of Black residents living within the block group) and neighborhood socioeconomic factors on depressive symptoms among Black pregnant women attending prenatal clinics in Detroit, MI and Columbus, OH.

Methods:

This was a secondary analysis of the Biosocial Impact on Black Births study. We analyzed self-reported depressive symptoms in Black women (N = 565) at 8 to 18 weeks’ gestation. The primary measure was the Center for Epidemiological Studies-Depression Scale (CES-D). The primary explanatory variables were neighborhood-level residential racial composition and rates of poverty, homeownership, household assistance, and educational attainment. A 2-level mixed-effects regression model was used to account for clustering of participants within the study areas.

Results:

For each percent increase in residential racial composition, there was a 0.66-point decrease in the Center for Epidemiological Studies-Depression Scale (−0.66; 95% CI, −0.112 to −0.021). Adjusting for individual differences among women, the protective effect of residential racial composition on the CES-D persisted (−0.62; 95% CI, −0.108 to −0.017).

Conclusion:

Our results suggest that living in neighborhoods with a greater proportion of Black individuals may be protective of depressive symptoms for pregnant Black women. These findings were not significant for neighborhood socioeconomic factors.