Alison Stuebe (
Anna Creegan, Rippel Foundation, Morristown, New Jersey.
Health Aff (Millwood). 2024 Apr;43(4):470-476. doi: 10.1377/hlthaff.2023.01452.
Perinatal mental illness is a leading cause of death during pregnancy and the first postpartum year in the United States. Although better acute care services for mental health conditions are desperately needed, urgent services alone cannot create the conditions to thrive. Cultivating well-being requires a sustained commitment to reproductive justice, "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities." To support reproductive justice for pregnant and birthing people, the Rippel Foundation's Vital Conditions for Health and Well-Being framework offers a holistic approach comprising seven domains: a thriving natural world; basic needs for health and safety; humane housing; meaningful work and wealth; lifelong learning; reliable transportation; and, central to all of these, belonging and civic muscle. Here we review the evidence for each of the vital conditions as key drivers of perinatal mental health, and we outline how this public health approach can advance well-being across generations.
围产期精神疾病是美国孕产妇和产后第一年死亡的主要原因。虽然迫切需要更好的心理健康急性护理服务,但仅仅提供紧急服务并不能创造茁壮成长的条件。培养幸福感需要对生殖公正做出持续承诺,“生殖公正即维护个人身体自主权、生育或不生育子女以及在安全和可持续的社区中养育子女的人权。”为了支持孕妇和产妇的生殖公正,里普尔基金会的健康和幸福感基本条件框架提供了一种包含七个领域的整体方法:欣欣向荣的自然世界;健康和安全的基本需求;人道住房;有意义的工作和财富;终身学习;可靠的交通;而所有这些的核心是归属感和公民力量。在这里,我们回顾了每一个基本条件作为围产期心理健康关键驱动因素的证据,并概述了这种公共卫生方法如何促进代际间的幸福感。