Civil Unrest in the Context of Chronic Community Violence: Impact on Maternal Depressive Symptoms

• Published in: American journal of public health (1971) Vol. 107; no. 9; pp. 1455 - 1462
• Main Authors: Yimgang, Doris P, Wang, Yan, Paik, Grace, Hager, Erin R, Black, Maureen M
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01.09.2017
• Subjects: Adult; African Americans; African Americans - psychology; African Americans - statistics & numerical data; Aggression; AJPH Research; Baltimore - epidemiology; Child, Preschool; Children; Children & youth; Childrens health; Civil Disorders - ethnology; Clinics; Community Health; Confidence intervals; Criminal investigations; Cross-Sectional Studies; Depression - epidemiology; Depression - ethnology; Depression - psychology; Emergency medical care; Emergency Service, Hospital; Endorsements; Families & family life; Family Health; Female; Food; Gray, Freddie; Health care; Health insurance; Humans; Infant; Infant, Newborn; Injury/Emergency Care/Violence; Low income groups; Maternal & child health; Maternal-Child Health Services - statistics & numerical data; Mediation; Mental depression; Mental Health; Mothers; Mothers - psychology; Mothers - statistics & numerical data; Neighborhoods; Nutrition; Pediatrics; Police; Postal codes; Primary care; Public Health; Regression analysis; Residence Characteristics; Routines; Social unrest; Stress; Surveys and Questionnaires; Trend analysis; Trust; Urban Health; Violence; Violence - ethnology; United States > US; Maryland; Baltimore Maryland
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2017.303876

To examine changes in maternal-child health surrounding the April 2015 civil unrest in Baltimore, Maryland, following Freddie Gray's death while in police custody. We conducted cross-sectional Children's HealthWatch surveys January 2014 through December 2015 in pediatric emergency departments and primary care clinics on maternal-child health and June 2015 through October 2015 on daily and community routines. We used trend analysis and piecewise logistic regression to examine effects of time, residential proximity moderation, and mediation analysis to assess proximity and maternal-child health relations via maternal concerns. Participants comprised 1095 mothers, 93% of whom were African American and 100% of whom had public or no insurance; 73% of participants' children were younger than 24 months. Following the unrest, prevalence of maternal depressive symptoms increased significantly in proximal, but not distal, neighborhoods (b = 0.41; 95% confidence interval [CI] = 0.03, 0.79; P = .03). Maternal concerns were elevated in proximal neighborhoods and associated with depressive symptoms; mediation through maternal concern was not significant. Five months after the unrest, depressive symptoms returned to previous levels. Civil unrest has an acute effect on maternal depressive symptoms in neighborhoods proximal to unrest. Public Health Implications. To mitigate depressive symptoms associated with civil unrest, maintain stability of community routines, screen for maternal depressive symptoms, and provide parent-child nurturing programs.