Ethnic Differences in Head Start Impact on Maternal Mental Health: Moderating Effects of Social Service Use and Social Capital

Purpose:   Under the Head Start Program Performance Standards, Head Start programs are required to collaborate with families to identify family goals and connect with community resources. Depression is prevalent worldwide, affecting more women than men, and African-American and Latina women more often than White women. The latter disparity has been attributed to socioeconomic factors, such as poverty, low education, and culturally-specific risk. The purpose of this study is to examine ethnic differences in Head Start impact on mental health and associations with social service and social capital among low income families. Specific questions are: 1) Are there ethnic differences in maternal mental health? 2) After controlling for family characteristics, do mothers who participated in Head Start have better mental health than parents who do not?  3) Do social service use and social capital affect maternal mental health, and does this association differ across ethnicity?

Methods:  The present study used the Head Start Impact data (HSIS, Puma et al., 2006) collected from 2002-2006 (n = 4442, control group = 1796, HS group = 2646). The data includes 1,496 White, 1,348 Black, and 1,598 Hispanic mothers. Maternal depression was measured by the Center for Epidemiologic Studies Depression (CES-D) scale, both at pre- and post-Head Start enrollment.  Social service usage included maternal receipt of: income assistance, housing assistance, job-training, drug/substance rehabilitation, family violence service, foster care payment, and/or mental health service. Social capital was measured by whether mothers sought help from: spouse, mother, father, grandparents, friend/others, religious group, and/or professionals.  Baseline variables for mothers (age, education, marital status, employment, bilingual speaking, income, residential location) were controlled. Logistic regression analyses were used to answer the research questions.

Results: Compared to White mothers, Black and Hispanic mothers had lower rates of depression. Bilingualism, lower education, and lower family income were associated with higher depression. Head Start did not reduce maternal depression. However, sub-group effects were found; depression was reduced for mothers with high baseline depression, and Black mothers. Regardless of ethnicity, lower family income, income assistance (TANF/SSI) and help-seeking from professionals were associated with higher depression.  Help-seeking from spouses was associated with less depression. White mothers who used job training and experienced family violence had higher depression.  Black and Hispanic mothers sought help from religious groups more than Whites.

Implications:  First, ethnic differences in maternal depression and different Head Start impacts indicate that Head Start should provide more targeted parental intervention, by considering parental characteristics and needs. Second, higher Head Start impacts on mothers with higher pre-depression scores suggests that Head Start should identify at-risk mothers earlier, and provide appropriate intervention. Third, higher depression rates associated with income assistance suggests that anti-poverty intervention might alleviate maternal depression for low income families. Fourth, White mothers living in low income families with younger children might yield the greatest benefit from mental health intervention. Lastly, those who used professional social services were reported to have higher rates of depression. Social services provided by social workers should be geared to provide more preventative and no-stigma attached intervention programs.