1. INTRODUCTION
Differences in mental health and wellbeing
in women living in Long Beach, Ca.
Angelina Majeno, MPH(c), Maria Morales, B.A., Arlene E. Garcia Lira B.A., Guido Urizar, Ph.D.
California State University, Long Beach
MEASURES RESULTS
PURPOSE
q A multitude of health disparities affect people residing
in the North, West Central, and Southwest regions of
Long Beach, CA. These include shorter life
expectancies, higher hospitalization rates, higher rates
of diabetes and asthma, and higher homicide rates
(City of Long Beach, DHHS, 2013).
q Social, economic, and environmental factors including
income, educational attainment, and access to green
space also differ greatly across areas of Long Beach;
with the North, West Central, and Southwest areas
having lower household incomes, less access to
recreational spaces, and smaller percentage of high
school graduates (City of Long Beach, DHHS, 2013).
q The built environment and neighborhoods in which
mothers live can have a great impact on their mental
health and wellbeing by affecting social relationships,
and capacity to deal with stress (Evans, 2003).
q In this study we sought to explore two questions:
1. How do social and physical determinants of health
(age, marital status, ethnicity, and geographic
region of Long Beach in which women live) impact
women’s mental health (i.e. postnatal depression
and perceived stress)?
2. How do social and physical determinants of health
(age, marital status, ethnicity, and geographic
region of Long Beach in which women live) impact
women’s wellbeing (maternal-infant attachment,
social support, and quality of sleep)?
Mental Health
Depression Stress
Predictor variables B SE(B) Β ∆R2 B SE(B) β ∆R2
Step 1: Social
Determinants of health
Age -.03 1.00 -.04 .00 -.19 .14 -.15 .03
Marital Status -.92 1.26 -.89 .01 -.78 1.76 -.05 .00
Ethnicity -.76 1.38 -.07 .00 -.71 1.92 -.04 .00
Step 2: Physical
determinants of health:
Neighborhood
North Long Beach 5.71 2.57 .38* .03 9.26 3.61 .41* .03*
West Long Beach 3.68 2.16 .35 .01 4.54 3.03 .30 .00
East Long Beach 3.37 2.34 .27 .03 5.02 3.27 .28 .00
*p < .05
Research aim 1: How do social and physical determinants of health impact women’s
mental health (i.e. postnatal depression and perceived stress)?
Wellbeing
Maternal-infant
attachment
Social support Sleep quality
Predictor variables B SE(B) β ∆R2 B SE(B) β ∆R2 B SE(B) β ∆R2
Step 1 :Social
determinants of health
Age .09 .10 .11 .01 .09 .29 .04 .00 .07 .06 .12 .01
Marital Status -1.05 1.22 -.10 .00 -3.80 3.65 -.12 .01 -.20 .75 -.03 .01
Ethnicity -3.19 1.33 -.27* .07* -.08 4.02 -.00 .00 2.40 .83 .32** .10**
Step 2: Physical
determinants of health
North Long Beach -3.59 2.49 -.23 .06* -20.39 7.20 -.45** .14*** 1.72 1.56 .18 .04
West Long Beach .44 2.09 .04 .00 -3.27 6.04 -.11 .00 -.28 1.31 -.04 .00
East Long Beach -.49 2.27 -.04 .00 -3.24 6.56 -.09 .00 -.09 1.43 -.01 .00
*p < .05, **p<.01, ***p<.001METHODS
q Procedure: Women who participated in a longitudinal
study on pregnancy and health completed an
interviewer-administered survey at 3 months post-
partum. Data were coded, entered, and verified by
trained research assistants. Hierarchical multiple
regression analyses were conducted.
q Participants: 100 low-income women (μ age= 26.00,
sd=6.26), 71% Latina. Participants’ zip codes were
coded based on L.B. Police Dept. Patrol Divisions.
Mental
Health
Postnatal
Depression
Edinburgh
Postnatal
Depression
Scale (EPDS)
10-item measure that identifies
risk for perinatal depression.
Higher scores indicate
depressed mood.
Perceived
Stress
Perceived
Stress Scale
(PSS)
14-item measure assessing life
situations that are perceived as
stressful. Higher scores indicate
higher levels of perceived stress.
Wellbeing
Maternal
Attachment
Maternal
Fetal
Attachment
Scale (MFAS)
Measures the interactions
between a mother and their
child. Higher scores indicate a
higher degree of attachment
between mother and baby.
Sleep
Quality
Pittsburgh
Sleep
Quality
Index (PSQI)
19 item measure assesses sleep
quality and disturbances
throughout a one- month
period. Higher scores represent
worse sleep quality.
Social
Support
Medical
Outcomes
Study Social
Support
(MOS)
20-item questionnaire that
measures a variety of different
types of social support. Higher
scores indicate higher levels of
social support.
Research aim 2: How do social and physical determinants of health impact women’s
wellbeing (maternal-infant attachment, social support, and quality of sleep)?
SAMPLE CHARACTERISTICS
Areas of
Long Beach
Higher levels of
depression
and perceived
stress were
associated
with living in
North Long
Beach. Age,
marital status,
and ethnicity
were not
associated
with mental
health
markers.
Lower levels of maternal attachment and worse sleep quality were associated with being a Latina. Lower
levels of maternal attachment and social support were reported by women living in North Long Beach.
CONCLUSIONS
q Latina women and those living in the North region of Long Beach showed worse outcomes compared to
their non-Latina counterparts and those living in other areas of Long Beach or outside Long Beach.
q These findings complement previous literature that has documented negative health outcomes in the
North region of Long Beach. Given that people living in this area already face a myriad of health
challenges, it is important to advance our understanding of what factors are driving these issues.
Acknowledgements: This research was supported by the National Institute on Child Health and Human Development.
Many thanks to the mothers who participated in this study. For more information For more information on this and other related
projects visit: www.csulb.edu/~gurizar/index.htm.