WMJ Vol 120 Supplement 1: Examining the Association Between Racial Bias Exposure and Postpartum Depression Among Women in Wisconsin
Objective: To analyze the association between racial bias and postpartum depression among women in Wisconsin.
Methods: Analyzed the Wisconsin Pregnancy Risk Assessment Monitoring System with a weighted sample of 125,581 women/mothers who delivered a live birth in 2016-2017. The outcome was self-reported postpartum depression. The independent variable was racial bias exposure. Survey-weighted logistic regression analyses were performed adjusting for confounders in 6 models—socioeconomic position, psychosocial factors, health risk behaviors, health care access, stress/obesity, and disease condition. All analyses were completed using STATA accounting for complex survey design and sample weights.
Results: In this sample, 6.6% of women/mothers experienced racial bias and 11.5% had postpartum depression. In unadjusted analysis, the odds of postpartum depression were higher for women who experienced racial bias than those who did not (OR 2.15; 95% CI, 1.35-3.41). Non-Hispanic Black women had higher odds for racial bias exposure than other racial/ethnic groups (OR 6.01; 95% CI, 1.69-21.41). However, the relationship between racial bias and postpartum depression was not significant after adjusting for socioeconomic position (OR 1.17; 95% CI, 0.69-1.97), psychosocial factors (OR 1.07; 95% CI, 0.63-1.81), health risk behaviors (OR 0.90; 95% CI, 0.55-1.49], health care access (OR 1.01; 95% CI, 0.60-1.70), stress/obesity (OR 0.73; 95% CI, 0.41-1.30), and disease/morbidity (OR 0.85; 95% CI, 0.46-1.57).
Discussion/Conclusion: Racial bias was associated with significantly increased risk of postpartum depression. Black women had higher odds for racial bias exposure than other groups. The relationship between racial bias and postpartum depression was not significant after adjusting for confounders, suggesting that social determinants potentially influenced this relationship. These findings should inform screening and health education interventions to minimize racism and poor maternal health outcomes.
The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.
As a result of this journal-based activity, the healthcare team will be able to:
- Analyze the impact of racial bias exposure (interpersonal racism) on poor maternal health outcomes such as postpartum depression, including risk and protective factors, as well as the influence of social determinants of health on women/mothers.
- Utilize a framework to conceptualize racial and ethnic differences in health, which includes a complex set of variables related to socioeconomic status, psychosocial factors, health risk behaviors, health care access, and disease condition, all of which influence poor maternal health outcomes, including post-partum depression.
- Identify several implications to help inform policies, system changes, and clinical practices to address the impact of racial bias on poor maternal mental health outcomes, particularly for a historically marginalized population.
It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.
For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.
|Name of Individual||Individual's Role in Activity|
Name of Commercial Interest &
|Ronald Anguzu, MBChB, MPH||Author||No relevant relationships with ineligible companies to disclose||No|
|Terese Bailey, BS||Accreditation Specialist||No relevant relationships with ineligible companies to disclose||No|
|David Dwyer, PhD, RN, NE-BC||Reviewer||No relevant relationships with ineligible companies to disclose||No|
|Sheri P. Johnson, PhD||Reviewer|
Triple P America (Contractor)
|John Meurer, MD, MBA||Author||No relevant relationships with ineligible companies to disclose||No|
|Alice Muehlbauer, MSP||Author||No relevant relationships with ineligible companies to disclose||No|
|Sarina Schrager, MD, MS||Editor||No relevant relationships with ineligible companies to disclose||No|
|Abdul Rahman Shour, MSP||Author||No relevant relationships with ineligible companies to disclose||No|
|Earlise Ward, PhD||Reviewer||No relevant relationships with ineligible companies to disclose||No|
|Fiona Weeks, MSPH||Author||No relevant relationships with ineligible companies to disclose||No|
|Jasmine Zapata, MD, MPH||Reviewer||No relevant relationships with ineligible companies to disclose||No|
*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.
The ACCME does not consider providers of clinical services directly to patients to be commercial interests.
|In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.|
Credit Designation Statements
American Medical Association (AMA)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Nurses Credentialing Center (ANCC)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.
Iowa Board of Nursing accepts ANCC contact hours for nursing continuing education requirements.
Continuing Education Units
The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC Contact Hours
- 1.00 University of Wisconsin–Madison Continuing Education Hours
- 1.00 Approved for AMA PRA Category 1 Credit™
Free, current version of Chrome, Firefox, Safari, or Edge. Some older browsers and Microsoft Internet Explorer could produce error messages or not display the content correctly.
Free, current version of Adobe Acrobat Reader or other .pdf reader.