Rosenthal Lisa, Earnshaw Valerie A, Lewis Tené T, Reid Allecia E, Lewis Jessica B, Stasko Emily C, Tobin Jonathan N, Ickovics Jeannette R
Lisa Rosenthal is with the Psychology Department, Pace University, New York, NY. Valerie A. Earnshaw, Jessica B. Lewis, and Jeannette R. Ickovics are with the Yale School of Public Health and the Yale Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT. Tené T. Lewis is with the Rollins School of Public Health, Emory University, Atlanta, GA. Allecia E. Reid is with the Psychology Department, Colby College, Waterville, ME. Emily C. Stasko is with the Department of Psychology, Drexel University, Philadelphia, PA. Jonathan N. Tobin is with the Clinical Directors Network, New York, NY.
Am J Public Health. 2015 Apr;105(4):686-93. doi: 10.2105/AJPH.2014.301906. Epub 2014 Jun 12.
We aimed to contribute to growing research and theory suggesting the importance of examining patterns of change over time and critical life periods to fully understand the effects of discrimination on health, with a focus on the period of pregnancy and postpartum and mental health outcomes.
We used hierarchical linear modeling to examine changes across pregnancy and postpartum in everyday discrimination and the resulting consequences for mental health among predominantly Black and Latina, socioeconomically disadvantaged young women who were receiving prenatal care in New York City.
Patterns of change in experiences with discrimination varied according to age. Among the youngest participants, discrimination increased from the second to third trimesters and then decreased to lower than the baseline level by 1 year postpartum; among the oldest participants, discrimination decreased from the second trimester to 6 months postpartum and then returned to the baseline level by 1 year postpartum. Within-subjects changes in discrimination over time predicted changes in depressive and anxiety symptoms at subsequent points. Discrimination more strongly predicted anxiety symptoms among participants reporting food insecurity.
Our results support a life course approach to understanding the impact of experiences with discrimination on health and when to intervene.
我们旨在推动不断发展的研究和理论，这些研究和理论表明，全面理解歧视对健康的影响需要考察随时间变化的模式以及关键生命时期，重点关注孕期和产后阶段以及心理健康结果。
我们使用分层线性模型，研究了纽约市主要为黑人及拉丁裔、社会经济地位不利且接受产前护理的年轻女性在孕期和产后日常歧视的变化情况以及对心理健康的影响。
歧视经历的变化模式因年龄而异。在最年轻的参与者中，歧视从孕中期到孕晚期增加，然后在产后1年降至低于基线水平；在最年长的参与者中，歧视从孕中期到产后6个月减少，然后在产后1年恢复到基线水平。随时间变化的个体内部歧视变化预测了后续抑郁和焦虑症状的变化。在报告粮食不安全的参与者中，歧视对焦虑症状的预测作用更强。
我们的结果支持采用生命历程方法来理解歧视经历对健康的影响以及干预时机。
