Public Health Clinic Study Links ‘Americanization’ and Depression

Science Daily, August 15, 2008

A study of 439 U.S. and Mexican-born Latinas seeking pregnancy and postpartum services at public health clinics in San Antonio uncovered elevated levels of depression among the more “Americanized” women, report researchers from The University of Texas School of Public Health and The University of Texas Health Science Center at San Antonio.

“Americanization” or acculturation is the process by which immigrants adopt the lifestyle and customs of their host nation, and key indicators include preferred language and place of birth, lead author Marivel Davila said. Davila is a graduate student at the UT School of Public Health and a quantitative research analyst at the UT Health Science Center at San Antonio.

Elevated levels of depression were reported by the women born in the United States, as well as those who asked to conduct their interviews in English. Two non-acculturation variables were associated with elevated depression—being single and being pregnant.

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According to the National Center for Health Statistics, single motherhood among Latinas in Texas exceeds the national average. In Texas in 2005, 43 percent of all Latina births were to single women. Nationally, the overall average was 37 percent.

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The women were interviewed in eight family planning clinics and six prenatal clinics of the San Antonio Metropolitan Health District (SAMHD) between May and August of 2003. Of the participants, 318 were born in Mexico and 121 in the United States. They were given the choice of conducting the interview in English or Spanish.

“The higher prevalence rate of depression in Americanized Latina women is of concern in our community as the population demographics clearly indicate a significant rate of growth of this group in their childbearing years,” said Fernando A. Guerra, M.D., director of health for the San Antonio Metropolitan Health District. “Thus, it is important to more clearly understand the circumstances that affect their physical and emotional well-being during pregnancy so that preventive measures can be initiated. This is critical for the overall health of both the mother and child.”

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“Women who were US-born were significantly more likely than Mexican-born women to meet the cutoff score (21 on the CES-D scale),” the authors wrote. “Women who conducted their interview in English were significantly more likely to express depressive symptoms compared to women who conducted their interview in Spanish.”

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[Editor’s Note: “Acculturation and Depressive Symptoms Among Pregnant and Postpartum Latinas,” by Marivel Davila, et al. can be read or downloaded in HTML or PDF formats here. There is a charge.]


Marivel Davila (1) Contact Information, Stephanie L. McFall (2) and Diana Cheng (3)

(1) Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA

(2) University of Texas, School of Public Health, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA

(3) Maryland Department of Health and Mental Hygiene, 201 W. Preston Street, Room 313, Baltimore, MD 21201, USA

Objectives Among childbearing Latinas, higher acculturation has been found to be significantly associated with increased risk for mental health problems (Acevado (Child Abuse Neglect, 24:11–127, 2000)), although these findings have been inconsistent (Beck (Maternal Child Nurs, 31(2), 114–120, 2006)). The aims of this study are to assess and compare the prevalence of elevated depressive symptoms among pregnant and postpartum U.S.- and Mexican-born Latinas, and to describe the relation of elevated depressive symptoms and acculturation indicators.

Methods A convenience sample of 439 pregnant and postpartum Latinas attending Public Health Clinics in San Antonio, Texas was screened for depressive symptoms using the Center for Epidemiologic Studies Depression (CES-D) Scale. Women with a score of 21 or greater were classified as having elevated depressive symptoms. Sociodemographic data, including birth country and language of interview, were collected as indicators of acculturation

Results 21% of the sample had moderate depressive symptoms; 15% met the threshold for high depressive symptoms. Bivariate analysis showed Latinas who were U.S.-born, single, preferred English or were pregnant were more likely to express elevated levels of depressive symptoms. Being U.S.-born, pregnant and single was significantly associated with moderate levels of depressive symptoms in logistic regression analyses controlling for other variables in the model. Controlling for other variables, being pregnant and single was significantly associated with high levels of depressive symptoms. Conclusions Higher acculturation, pregnancy and single status were positively associated with elevated depressive symptoms. Screening for depression during pregnancy is important for this population group, given Latinas’ high rates of fertility and births to single women, particularly among more acculturated, U.S.-born Latinas.

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