Sociodemographic, Psychosocial, and Physical Health Predictors of Depression in African-American Mothers

Background/Purpose:  Maternal depression is a public health issue that has negative consequences for mothers’ health, as well as their children’s development and well-being. Despite abundant research on postpartum depression, depression among mothers who have children across a range of ages is understudied. The inattention to depression among African American mothers is of particular concern, as much of what is known about maternal depression is based on the experiences of white mothers. Potential risk and protective factors for African American mothers’ depression have not been sufficiently explored. The purpose of this study is to increase our understanding of African American mothers’ depression by identifying sociodemographic, psychosocial, and physical health factors associated with Major Depressive Disorder (MDD) among this population. We also examined what, if any, factors were consistently related to lifetime, 12-month, and 30-day Major Depressive Disorder, as these may be particularly relevant for informing prevention and intervention efforts.

Methods: We used National Survey of American Life (NSAL) data to examine the association between sociodemographic, psychosocial, and physical health factors, and lifetime, 12-month, and 30-day MDD among 1040 African American women who reported having at least one child, age 12 or under, in their households. The NSAL is the first and only national household probability sample of African Americans. MDD was assessed via the World Mental Health Composite International Diagnostic Interview 3.0. Bivariate and multiple logistic regression analyses were performed. Data were adjusted for disproportionate sampling probabilities, nonresponse, and sociodemographic differences between the sample and the 2000 U.S. Census population. Significance tests, confidence intervals, and standard errors were adjusted for the NSAL’s complex sample design.

Results: Two psychosocial factors, mastery and social support, were consistently associated with lifetime, 12-month, and 30-day MDD among African American women with at least one child living in their household. Higher levels of mastery were associated with decreased odds of meeting criteria for lifetime (OR=.42; CI=.27-.64), 12-month (OR=.26; CI=.14-.46), and 30-day (OR=.14; CI=.06-.31) MDD, whereas higher levels of social support were associated with increased odds of meeting criteria for lifetime (OR=1.04; CI=1.01-1.07), 12-month (OR=1.04; CI=1.02-1.07), and 30-day (OR=1.05; CI=1.02-1.09) MDD. Sociodemographic and physical health factors were not consistently related to African American mothers’ MDD. However, family status, specifically single motherhood, was associated with increased odds of meeting criteria for 12-month (OR=2.79; CI=1.24-6.31) and 30-day (OR=2.78; CI=1.21-6.38) MDD.

Implications: Findings reveal psychosocial factors related to African American mothers’ depression that require further study. Mastery emerged as a protective factor for MDD among this population, which supports literature identifying mastery and control as potentially important resources and coping strategies developed by African American women dealing with stressful situations. Though inconsistent with existing literature, our results indicate higher social support is associated with increased odds of meeting criteria for MDD. This may suggest family and friends are more likely to rally around depressed mothers, or could suggest that while mothers are receiving a lot of support, the quality may be negative. Results provide an important first step toward understanding correlates of MDD among African American mothers.