Journal of Rural Mental Health, Vol 49(2), Apr 2025, 77-88; doi:10.1037/rmh0000288
This study sought to determine the impact of social determinants of health (SDH) at the individual (race/ethnic identity, income, education, employment, social support) and population levels (area of residence) on severity of maternal antenatal depressive (AD) symptoms. Additionally, researchers examined the interactive effect of residing in a health professional shortage area for primary care or mental health on the relation between SDH and maternal AD symptoms. Participants (n = 77) completed a two-part Qualtrics survey including the Multidimensional Scale of Perceived Social Support and Edinburgh Postnatal Depression Scale (EPDS). Participants were predominantly White, assigned female at birth, and between age 18 and 44. People of the global majority had greater EPDS scores than people of European origin. Greater perceived difficulty paying household expenses, more hours worked, and less social support were associated with more AD symptoms. When examining all SDH as predictors, the model explained a statistically significant amount of variance in EPDS scores (R² = .411), but only social support was a statistically significant individual predictor. In moderation analyses, the relation between racial–ethnic group and EPDS score was only statistically significant for those who did not reside in a health professional shortage area for mental health. Results support existing and novel relations among individual-level SDH and AD with social support demonstrating a robust main effect. Preliminary analyses also suggest that one’s area of residence may interact with racial–ethnic identity to help further understand how SDH impact AD and guide future prevention and intervention strategies. (PsycInfo Database Record (c) 2025 APA, all rights reserved)