NEIGHBORHOOD ADVERSITY, ETHNIC DIVERSITY, AND WEAK SOCIAL COHESION AND SOCIAL NETWORKS PREDICT HIGH RATES OF MATERNAL DEPRESSIVE SYMPTOMS: A CRITICAL REALIST ECOLOGICAL STUDY IN SOUTH WESTERN SYDNEY, AUSTRALIA

• Published in: International journal of health services Vol. 43; no. 2; pp. 241 - 266
• Main Authors: Eastwood, John Graeme, Kemp, Lynn Ann, Jalaludin, Bin Badrudin, Phung, Hai Ngoc
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Baywood Publishing Company, Inc 01-01-2013; SAGE Publications
• Subjects: Adult; Australia; Cross-Sectional Studies; Depression; Depression, Postpartum - diagnosis; Depression, Postpartum - epidemiology; Depression, Postpartum - psychology; Ethnic Groups - statistics & numerical data; Factor analysis; Factor Analysis, Statistical; Female; Health Behavior; Housing - statistics & numerical data; Humans; Interpersonal Relations; Mothers; New South Wales; New South Wales - epidemiology; Public Assistance - statistics & numerical data; Residence Characteristics - statistics & numerical data; Risk Factors; Social cohesion; Social Environment; Social networks; Social services; Social Support; Socioeconomic Factors; The Political Context of Inequalities; New South Wales; Australia, New South Wales; Australia, New South Wales, Sydney; British Isles, Scotland, Edinburgh
• ISSN: 0020-7314; 1541-4469
• DOI: 10.2190/HS.43.2.d

The aim of the study reported here is to explore ecological covariate and latent variable associations with perinatal depressive symptoms in South Western Sydney for the purpose of informing subsequent theory generation of perinatal context, depression, and the developmental origins of health and disease. Mothers (n = 15,389) delivering in 2002 and 2003 were assessed at two to three weeks after delivery for risk factors for depressive symptoms. The binary outcome variables were Edinburgh Postnatal Depression Scale (EPDS) > 9 and > 12. Aggregated EPDS > 9 was analyzed for 101 suburbs. Suburb-level variables were drawn from the 2001 Australian Census, New South Wales Crime Statistics, and aggregated individual-level risk factors. Analysis included exploratory factor analysis, univariate and multivariate likelihood, and Bayesian linear regression with conditional autoregressive components. The exploratory factor analysis identified six factors: neighborhood adversity, social cohesion, health behaviors, housing quality, social services, and support networks. Variables associated with neighborhood adversity, social cohesion, social networks, and ethnic diversity were consistently associated with aggregated depressive symptoms. The findings support the theoretical proposition that neighborhood adversity causes maternal psychological distress and depression within the context of social buffers including social networks, social cohesion, and social services.