What Do Your Neighbors Think About You? How Perceived Neighbor Attitudes Toward Latinos Influence Mental Health Among a Pregnant Latina Cohort.

Latina women living in the USA experience disproportionately higher rates of psychological distress compared to their non-Latina White counterparts. Poor maternal mental health during pregnancy can contribute to intergenerational mental health disparities. Through this pathway, mothers' experiences, environments, and exposures (henceforth "exposures") during pregnancy become biologically embodied and can negatively affect the fetus and life-long developmental trajectories of her child. One of the exposures that can affect mother-offspring dyads is the neighborhood. With the goal of integrating anthropological and sociological theories to explain mental health disparities among pregnant Latina women, we explored how perceptions of neighbor attitudes may influence mental health during pregnancy. We analyzed self-reported responses from 239 pregnant Latina women in Southern California (131 foreign-born, 108 US-born) on their mental health and perceived attitudes of their neighbors using multiple linear regression models. Among foreign-born Latina women, living in neighborhoods with more favorable views of Latinos was associated with lower depression scores (pooled ß = - .70, SE = .29, p = .019) and lower pregnancy-related anxiety scores (pooled ß = - .11, SE = .05, p = .021), but greater state anxiety scores (pooled ß = .09, SE = .04, p = .021). Among US-born women, there were no associations between neighbor attitudes and mental health. Overall, results suggest that social environments are correlated with mental health and that foreign-born and US-born Latinas have varied mental health experiences in the USA. Our findings highlight the importance of improving aspects of neighborhood cohesion as part of maternal-fetal care management.

Sociopolitical stressors are associated with psychological distress in a cohort of Latina women during early pregnancy.

Research suggests that the 2016 US election was a potential stressor among Latinos residing in the United States. Sociopolitical stressors targeted toward ethnic minority communities and become embodied through psychosocial distress. The current study investigates if and how sociopolitical stressors related to the 45th President, Donald Trump, and his administration are associated with psychological distress in early pregnancy of Latina women living in Southern California during the second half of his term. This cross-sectional analysis uses data from the Mothers' Cultural Experiences study (n = 90) collected from December 2018 to March 2020. Psychological distress was assessed in three domains: depression, state anxiety, and pregnancy-related anxiety. Sociopolitical stressors were measured through questionnaires about sociopolitical feelings and concerns. Multiple linear regression models examined the relationship between sociopolitical stressors and mental health scores, adjusting for multiple testing. Negative feelings and a greater number of sociopolitical concerns were associated with elevated pregnancy-related anxiety and depressive symptoms. The most frequently endorsed concern was about issues of racism (72.3%) and women's rights (62.4%); women endorsing these particular concerns also had higher scores on depression and pregnancy-related anxiety. No significant associations were detected with state anxiety after correction for multiple testing. This analysis is cross-sectional and cannot assess causality in the associations between sociopolitical stressors and distress. These results are consistent with the hypothesis that the 2016 election, the subsequent political environment, and the anti-immigrant rhetoric and policies of former President Trump and his administration were sources of stress for Latinos residing in the United States.

How demographics and concerns about the Trump administration relate to prenatal mental health among Latina women.

RATIONALE: The 2016 U.S. presidential election and its aftermath involved political rhetoric and policies that especially targeted women, Latinos, and immigrants. It is possible that concerns about the political environment could affect mental health of individuals in targeted groups. OBJECTIVE: In a cohort of 148 pregnant Latina women, this study investigated how demographics and political concerns related to each other and to maternal anxiety, depression, and perceived stress, which have been associated with adverse birth and child development outcomes. METHODS: In this cross-sectional, self-report study, participants in Southern California completed a one-time questionnaire from January 2017 to May 2018. RESULTS: The highest rates of endorsement were for concerns regarding President Trump's racism, attitude towards women, and deportation risk for family or friends. From several demographic variables, the only significant predictor of state anxiety was expectant parents' birthplaces. From several political concerns variables, the only significant predictor of state anxiety was President Trump's attitude towards women or women's rights. There were no significant effects on other mental health outcomes. CONCLUSIONS: Results suggest that birthplace and women's issues may be particularly salient anxiety risk factors for Latina pregnant women in this context. Because of the cross-sectional study design, it is possible that, conversely, pregnant women with high anxiety levels are particularly sensitive to the issue of birthplace or women's rights. Results imply that the political climate and events in the U.S. could have deleterious consequences that may cascade across generations of Latino Americans via effects on pregnant women.

Discrimination as a Moderator of the Effects of Acculturation and Cultural Values on Mental Health Among Pregnant and Postpartum Latina Women.

It is important to consider how identity, culture, and social adversity influence maternal mental health among Latina women both because this community faces unique cultural stressors and also because factors that undermine women's mental health during pregnancy and postpartum could have injurious consequences that cascade across generations. This study uses data from a questionnaire administered to Latina pregnant and postpartum women in Southern California, examining cultural orientation, discrimination, and mental health. Results demonstrate mental health benefits for both American and Latino cultural orientations, but the latter's benefit of lower anxiety was only apparent with high discrimination. American and Latino cultural values systems had opposite relationships with depression, with the latter protective and also positively associated with happiness. More traditional gender roles values were associated with greater perceived stress and lower happiness. Different aspects of familism had opposite effects as obligation was associated with less anxiety and referent (defining oneself communally with kin) with more. Results suggest that social adversity and cultural identity and values influence maternal psychology. This study makes a unique contribution by integrating anthropological and biopsychosocial methods and theories towards addressing an issue of public-health importance.

Es importante considerar cómo la identidad, la cultura y la adversidad social influyen en la salud mental materna entre mujeres latinas tanto porque esta comunidad enfrenta factores culturales únicos causantes de estrés como porque factores que socavan la salud mental de las mujeres durante el embarazo y el postparto podrían tener consecuencias perjudiciales en cadena a través de las generaciones. Este estudio utiliza información de una encuesta administrada a mujeres latinas en embarazo o en posparto en el sur de California examinando la orientación cultural, la discriminación y la salud mental. Los resultados demuestran los beneficios de la salud mental tanto para orientaciones culturales estadounidenses como latinas, pero el beneficio de la más baja ansiedad de las últimas fue sólo aparente con baja discriminación. Sistemas de valores culturales estadounidenses y latinos tienen relaciones opuestas con la depresión, con los últimos siendo protectores y también asociados positivamente con la felicidad. Valores más tradicionales sobre los roles de género fueron asociados con un mayor estrés percibido y más baja felicidad. Aspectos diferentes del familismo tuvieron efectos opuestos en la medida en que la obligación estuvo asociada con menor ansiedad y el referente (definirse uno mismo comunalmente con parientes) con mayor. Los resultados sugieren que la adversidad y la identidad cultural y los valores influyen en la psicología materna. Este estudio hace una contribución única al integrar métodos y teorías antropológicas y biopsicosociales hacia el abordaje de una cuestión de importancia en salud pública.

Prenatal and Postnatal Mother-to-Child Transmission of Acculturation's Health Effects in Hispanic Americans.

BACKGROUND: Hispanic Americans consistently exhibit an intergenerational increase in the prevalence of many noncommunicable chronic physical and mental disorders. METHODS: We review and synthesize evidence suggesting that a constellation of prenatal and postnatal factors may play crucial roles in explaining this trend. We draw from relevant literature across several disciplines, including epidemiology, anthropology, psychology, medicine (obstetrics, neonatology), and developmental biology. RESULTS: Our resulting model is based on evidence that among women, the process of postmigration cultural adjustment (i.e., acculturation) is associated, during pregnancy and after delivery, with psychological and behavioral states that can affect offspring development in ways that may alter susceptibility to noncommunicable chronic disease risk in subsequent-generation Hispanic Americans. We propose one integrated process model that specifies the biological, behavioral, psychological, and sociocultural pathways by which maternal acculturation may influence the child's long-term health. We synthesize evidence from previous studies to describe how acculturation among Hispanic American mothers is associated with alterations to the same biobehavioral systems known to participate in the processes of prenatal and postnatal developmental programming of disease risk. In this manner, we focus on the concepts of biological and cultural mother-to-child transmission across the prenatal and postnatal life phases. We critique and draw from previous hypotheses that have sought to explain this phenomenon (of declining health across generations). We offer recommendations for examining the transgenerational effects of acculturation. CONCLUSION: A life course model with a greater focus on maternal health and well-being may be key to understanding transgenerational epidemiological trends in minority populations, and interventions that promote women's wellness may contribute to the elimination or reduction of health disparities.

Acculturation and health: the moderating role of socio-cultural context.

Acculturation represents an important construct for elucidating the determinants and consequences of health disparities in minority populations. However, the processes and mechanisms underlying acculturation's effects on health are largely undetermined and warrant further study. We integrate concepts from anthropology and statistics to describe the role of sociocultural context as a putative modifier of the relationship between acculturation and health. Sociocultural context may influence the extent to which exposure to host culture leads to internalization of host cultural orientation, and may influence the extent to which acculturation leads to stress and adoption of unhealthy behaviors. We focus on specific aspects of sociocultural context: (1) neighborhood ethno-cultural composition; (2) discrimination; (3) discrepancy between origin and host environments; (4) discrepancy between heritage and host cultures; (5) origin group, host group, and individual attitudes towards assimilation; (6) variation in targets of assimilation within host community; (7) public policy and resources; (8) migration selection bias. We review and synthesize evidence for these moderation effects among first- and later-generation immigrants, refugees, and indigenous populations. Furthermore, we propose best-practices data-collection and statistical-analysis methods for this purpose, in order to improve our understanding of the complex, multilevel aspects of the relationship between acculturation and health.

Assessment of acculturation in minority health research.

Acculturation represents an important construct in the context of health disparities. Although several studies have reported relationships between various aspects of acculturation and health in minority populations, crucial inconsistencies remain. One likely reason for these inconsistencies may relate to limitations in the conceptualization and operationalization of acculturation, particularly in the context of health research. The acculturation construct underwent major conceptual and operational change when it was adapted from anthropology to psychology, and we argue another major shift is now required for use of this construct in health research. Issues include determining whether acculturation measures should focus on an individual's internal attitudes or overt behaviors; whether they should characterize cultural orientation status at a given point in time or change over time; whether measures should be culture-specific or more global in nature; how the issue of multiculturalism should be addressed; how measures can optimally incorporate multiple dimensions of acculturation; and whether proxy measures should be used. These issues are important in the context of health research because of their implications for determining the direct and indirect effects of cultural change on health-related biological and behavioral processes. We elaborate on and address each of these issues from a perspective that spans multiple disciplines across the biological and social sciences, and offer concrete recommendations with the ultimate goal of achieving a better understanding of the role of acculturation in minority health and health disparities.

Intra-Individual Consistency in Endocrine Profiles Across Successive Pregnancies.

CONTEXT: It is yet unknown how similar women's hormone levels are during successive pregnancies, and very little is known about the degree to which siblings experience similar prenatal environments. Given the importance of understanding how women's reproductive life histories exert cumulative effects on health via hormone exposure, and the importance of understanding how fetal programming via endocrine signaling affects sibling trait concordance, here, we address this important lacuna in the literature. OBJECTIVE: This study aimed to investigate how consistent women's hormone profiles are across two successive pregnancies. DESIGN AND MAIN OUTCOME MEASURES: This longitudinal, prospective study followed a cohort of 28 women across two pregnancies (PREG 1 and PREG 2). Women's circulating hormone levels were assessed from blood samples at 25, 31, and 37 weeks' gestation for adrenocorticotropic hormone (ACTH), placental corticotropin-releasing hormone (pCRH), cortisol, estradiol, and progesterone. ACTH and cortisol levels were assessed 3 months postpartum. Research questions include: Are hormone levels in PREG 2 significantly different from levels in PREG 1? What proportion of variance in PREG 2 hormone levels is attributable to variance in PREG 1 levels? Are hormone levels more stable between PREG 1 and PREG 2 compared with postpartum phases following these pregnancies? Is pCRH, which is completely placentally derived, less similar than other hormones across successive pregnancies? PARTICIPANTS AND SETTING: Pregnant women attended study visits at a university psychobiology laboratory in Southern California. RESULTS AND CONCLUSIONS: Comparisons of hormone concentrations across women's successive pregnancies via paired t test revealed substantial consistency from one pregnancy to another, with only significant differences between pregnancies for pCRH. Regressions revealed substantial predictability from one pregnancy to another, with between 17-56% of PREG 2 variances accounted for by PREG 1 values. Women exhibited lower degrees of consistency and predictability in hormone levels across postpartum phases compared with gestational concentrations. This is the first study to describe maternal and placental hormone levels across successive pregnancies.

Intergenerational transmission of the effects of acculturation on health in Hispanic Americans: a fetal programming perspective.

We propose a transdisciplinary, life span framework for examining the underlying cause of the observed intergenerational decline in health among Hispanic Americans. We focus on acculturation, and we posit that acculturation-related processes in first-generation Hispanic immigrant mothers may affect the intrauterine development of an unborn child, via the process of fetal programming, to produce phenotypic effects that may alter the susceptibility for noncommunicable chronic diseases. In this manner, an intergenerational cascade of perpetuation may become established. Our framework may shed light on the biological, behavioral, and social causes of intergenerational cycles of vulnerability among immigrant minority groups, with public health and policy implications for primary prevention and intervention.