Online Exclusives

The impact of community on postnatal depression

Heather Rudow February 13, 2013

CCU_MeAttendees of next month’s 2013 American Counseling Association Conference & Expo in Cincinnati will be treated to a new series of conference sessions aimed at shedding light on research gathered by ACA members on topics that uniquely benefit clients. 

Called the Client-Focused Research Series, these 30-minute presentations aim to increase awareness of research that focuses on improving the services that professional counselors provide to clients. 

In the weeks leading up to the conference, Counseling Today is speaking with some of the presenters about their research and why they believe it enhances the work of the profession. Next up is counseling student and public health advocate David Jones, who will be presenting on “Advocacy Outside the Box: A Multilevel Spatial Analysis of First-Time Mothers With Postpartum Depression.”

What would you like attendees to take away from your session? 

A greater knowledge of individual and community risk factors associated with postnatal depression (PND). Additionally, they will have an expanded conceptualization and tools for working with their clients and community.

Why is it important for counselors to learn the difference between community and individual risk factors associated with postpartum depression?

From an ecological perspective or other social models, there is a conjugal dance between individual and community risk factors. To effect lasting change, the counselor needs to see within but also beyond the individual risk factors toward the context: community. This context is a powerful influence on the individual’s affect, mood, cognition and behavior. Further, the individual’s choices have collateral. This collateral affects the family, which impacts neighborhood, which influences the community and vice versa.

How did you get involved with this subject?

My career is in public health, but I am also a counseling student. Through my work at Cincinnati Children’s Hospital and Medical Center and my studies emerged a passion around improving the outcomes of children.

Further, counseling and public health have a natural marriage: prevention. Therefore, through the lens of life course theory, the best approach is to intervene before the birth of the child to change the trajectory of lifelong outcomes for the child. Hence, a counselor seeks interventions before womb, secondarily when the child is in the womb and, tertiary, postpartum.

What inspired you to present this session at the conference?

It is a desire to bring about awareness and advancing the field of counseling. I believe that research is imperative for improving the health of our clients and their communities. Furthermore, there is a call for the counseling profession to get more serious about research. By doing so, it will advance our identity as counselors. 

Did anything surprise you as you were compiling information for your session?

The sample was drawn from a home visiting program for first-time mothers. The program contracts with seven agencies within Hamilton County, Ohio, to conduct their services. Each agency provides services in a specific catchment based on ZIP code. What was of particular interest was the severity of these rates and that the majority had rates higher than the national averages [of] 10 to 15 percent. Yet, conversely, the Hamilton County rate was high as well.

When looking at the individual risk factors, several became salient. For example, race and ethnicity were significantly different between those at risk for PND  (EPDS score < 10) than those not at risk. Another risk factor associated with the risk of PND was years of education.

Besides these finding above, what was remarkable was the many risk factors that were not found to be significant. This study linked the home visitation client record data with hospital discharge data, Ohio birth certificate data and 2010 Census tract data. After the linkage, there were over 300 variables associated with each case. Through analysis, no significant association was found for preterm birth and infant loss among others.

When examining the area level (Census tract) variables, it was a surprise that median home value was not significant. Yet, other area level variables did have an association such as percent of vacant housing units, percent on SNAP and GINI Index score.

This is the initial step in our investigation. Our study group plans on digging deeper into the data and looks forward to seeing what we will find.

Who do you feel is the best audience for this session?

This is important for a variety of audiences. One is the counselor who works with this specific population. Others that become prominent are counselors who take prevention and community outreach to heart, such as those who are passionate about social justice. It is relevant for counselors-in-training to expand their conceptualization of their profession. Finally, based on ACA’s call, it is imperative for all counselors [to take part] in a concerted effort to advance the counseling profession’s presence in research.

Heather Rudow is a staff writer for Counseling Today. Contact her at hrudow@counseling.org.

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