Author ORCID Identifier

https://orcid.org/0000-0001-8384-1021

Date of Award

5-4-2021

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Public Management and Policy

First Advisor

John C. Thomas

Second Advisor

Gregory B. Lewis

Third Advisor

Karen J. Minyard

Fourth Advisor

Angela B. Snyder

Fifth Advisor

Juan D. Rogers

Abstract

This dissertation is an in-depth analysis of the prevalence and risk factors of maternal depression in Alaska. I study a cohort of women who gave birth in Alaska between 2012 and 2014, using statewide population-based survey data collected shortly after birth and three years after birth. Multiple regression analyses confirm previous studies’ findings that history of depression, stressful life events, and lack of social support are strong risk factors for symptoms of maternal depression (SMD). In addition, after controlling for sociodemographic, perinatal health, and psychosocial variables, first-time mothers had greater odds of reporting SMD. Age was also a significant predictor of SMD. In contrast to the U-shaped relationship between age and maternal depression shown in other studies, I observe an inverted U-shaped curve: the odds of reporting SMD are lowest for women 19 and under, increases for those 20–34, and decreases slightly for women age 35 and older. Surprisingly, teenage moms 19 years and under had the lowest odds of reporting SMD. Asian/Pacific Islander women have significantly higher odds of reporting SMD, including persistent and possibly overlooked and untreated depression three years after giving birth. Findings from this study can be used to design policy and create systems change to improve the health and well-being of mothers and families. Any strategy addressing maternal depression would require a two-pronged screening approach: (1) screening to identify women at risk of developing depression, and (2) screening for maternal depression symptoms. Further, expanding Medicaid coverage for mothers from 60 days postpartum to at least 1 year postpartum, preferably 2 years, is one strategy that may help increase opportunities for healthcare providers to treat women with maternal depression.

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