A Mixed Methods, Explanatory Study Examining Geographic Disparities in Postpartum Depression: A Social Work Perspective

摘要

Limited research exists examining geographic disparities in postpartum depression (PPD) particularly from a social work perspective. This dissertation research sought to address current gaps and limitations in the empirical literature by conducting a mixed methods study focusing on geographic disparities in PPD. The study was informed by ecological systems theory and a social work perspective. For this study, a quantitative secondary data analysis of the Pregnancy Risk Assessment Monitoring System (PRAMS) dataset from the Centers for Disease Control and Prevention (CDC) was followed by qualitative semi-structured interviews of social workers working with mothers experiencing PPD from diverse geographic areas. Results indicate that 10.9% of mothers residing in urban areas and 12.1% of mothers residing in rural areas met the indicator criteria for PPD. Further, results provided support for geographic disparities in PPD; specifically, a statistically significant difference in the affective aspect of PPD by geographic location was determined. The number of stressors experienced seems to be influential in the observed relationship between geographic location and the affective and cognitive components of PPD. Further, based on their practice experiences, social workers report that rural women can experience PPD differently due to lack of resources, access challenges, and isolation. Although there are services that work well for women experiencing PPD, there are approaches to care and services still needed particularly for rural women experiencing PPD. Implications for social work ethics, theory, assessment, screening, practice, intervention, advocacy, community, federal initiatives, and policy are discussed.