Maternal Depression, Parenting Behaviors and Child Development: Evidence from a Randomized Control Trial

We evaluate the impacts of maternal depression on children's skill accumulation, exploiting randomized variation in depression created by a cluster-randomized control trial that provided cognitive behavioral therapy to women in rural Pakistan who were diagnosed as depressed in pregnancy. We conducted a followup study when the children were age 7 and assessed their cognitive, socio-emotional and physical development, parental investments in children, indicators of the quality of parenting, and of the home environment. The intervention was successful in reducing maternal depression and this effect was sustained. We also find that treated mothers exhibit better parenting behaviors, provide a better home environment and invest more in their children's education. We nevertheless find, on average, no detectible effects on children's cognitive, socio-emotional or physical development at age 7. We show that this is not because of differential attrition, differential shocks to treated vs control clusters or low power. With the odd exception, we find no evidence that the average results conceal large effects in relevant sub-samples, or in a segment of the distribution of outcomes. Since we find reinforcing parental investments in many domains in the treated group, it is also unlikely that the results are explained by unobserved compensating investments in the control group. We conclude that there are possibly positive but latent effects of the intervention that may be detectible in later life

Recollections of Childhood Religious Identity and Behavior as a Function of Adult Religiousness

People have a strong motivation to maintain a self-concept that is coherent and consistent over time. Religion is a central source of social identity for many people, but its importance is prone to dramatic change across the life course. To maintain a consistent perception of self, recollections of one's own past religiousness may shift to better fit with the present. This study examined changes between early and middle adulthood in retrospective perceptions of religious behavior and identity in childhood. Data from a population-based birth cohort sample were matched with data from individuals who participated in at least 2 of 3 adult follow-up studies, at intervals of approximately 10 years. Logistic regression was used to analyze the association of final recollections of childhood behavior and identity with previous recollections and current religious characteristics. Consistent with the predictions of temporal self-appraisal theory, participants' perception of their religious identity as children tended to change over time to match their adult religious identity. Recollections of childhood religious behavior were more stable than recollections of religious identity, and change was unrelated to adult behavior. These results have implications for studying religious characteristics using retrospective measures, regarding their accuracy and their independence from contemporary measures

Religious service attendance and spiritual well-being are differentially associated with risk of major depression

Background: The complex relationships between religiosity, spirituality and the risk of DSM-IV depression are not well understood. Method: We investigated the independent influence of religious service attendance and two dimensions of spiritual well-being (religious and existential) on the lifetime risk of major depression. Data came from the New England Family Study (NEFS) cohort (n=918, mean age=39 years). Depression according to DSM-IV criteria was ascertained using structured diagnostic interviews. Odds ratios (ORs) for the associations between high, medium and low tertiles of spiritual well-being and for religious service attendance and the lifetime risk of depression were estimated using multiple logistic regression. Results: Religious service attendance was associated with 30% lower odds of depression. In addition, individuals in the top tertile of existential well-being had a 70% lower odds of depression compared to individuals in the bottom tertile. Contrary to our original hypotheses, however, higher levels of religious well-being were associated with 1.5 times higher odds of depression. Conclusions: Religious and existential well-being may be differentially associated with likelihood of depression. Given the complex interactions between religiosity and spirituality dimensions in relation to risk of major depression, the reliance on a single domain measure of religiosity or spirituality (e.g. religious service attendance) in research or clinical settings is discouraged

Neighborhood language isolation and depressive symptoms among elderly U.S. Latinos

Purpose: Neighborhood segregation related to cultural factors, such as language use, may influence elderly Latino depression. We examined the association between neighborhood-level Spanish language segregation and individual depressive symptoms among elderly Latinos. Methods: We linked U.S. Census language use data with geocoded population-based data from 1789 elderly Latinos (mean age = 70.6 years) participating in the Sacramento Area Latino Study on Aging (1998–2008). Neighborhood language segregation was measured with the Index of Concentration at the Extremes, which demonstrates the extent to which residents are concentrated at extremes of deprivation and privilege. We fit two-level generalized linear-mixed models with random intercepts for census tracts to quantify the association between neighborhood-level language segregation and depressive symptoms, adjusting for identified confounders. Results: After adjusting for age, sex, and nativity, residents of highly segregated Spanish-speaking neighborhoods had more depressive symptoms than those in highly segregated English-only-speaking neighborhoods (β = −4.410; 95% confidence interval [CI] = −6.851 to −1.970). This association was largely attenuated upon adjustment for individual-level education (β = −2.119; 95% CI = −4.650 to 0.413). Conclusions: Linguistically segregated communities may benefit from targeted outreach given the high depression prevalence in these neighborhoods. Furthermore, our findings suggest that limited access to fundamental social protections, such as education, may drive the segregation-depression association among U.S. Latinos. © 2018 Elsevier Inc

Socio-economic and racial/ethnic disparities in the nutritional quality of packaged food purchases in the USA, 2008-2018

Objective: To determine whether disparities exist in the nutritional quality of packaged foods and beverage purchases by household income, education and race/ethnicity and if they changed over time. Design: We used Nielsen Homescan, a nationally representative household panel, from 2008 to 2018 (n = 672 821 household-year observations). Multivariate, multilevel regressions were used to model the association between sociodemographic groups and a set of nutritional outcomes of public health interest, including nutrients of concern (sugar, saturated fat and Na) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, sugar-sweetened beverages and junk foods). Setting: Household panel survey. Participants: Approximately 60 000 households each year from the USA. Results: Disparities were found by income and education for most outcomes and widened for purchases of fruits, vegetables and the percentage of calories from sugar between 2008 and 2018. The magnitude of disparities was largest by education. Disparities between Black and White households include the consumption of processed meats and the percentage of calories from sugar, while no disparities were found between White and Hispanic households. Disparities have been largely persistent, as any significant changes over time have been substantively small. Conclusions: Policies to improve the healthfulness of packaged foods must be expanded beyond SSB taxes, and future research should focus on what mediates the relationship between education and diet so as not to exacerbate disparities

Religious social capital: Its measurement and utility in the study of the social determinants of health

As a social determinant of health, religiosity remains not well understood, despite the prevalence of religious activity and prominence of religious institutions in most societies. This paper introduces a working measure of Religious Social Capital and presents preliminary associations with neighborhood social capital and urban stressors. Religious social capital is defined as the social resources available to individuals and groups through their social connections with a religious community. Domains covered include group membership, social integration, values/norms, bonding/bridging trust as well as social support. Cross-sectional data come from a convenience sample of 104 community dwelling adults residing in a single urban neighborhood in a large US city, who also provided information on neighborhood social capital, and experiences of urban stressors. Results suggest that religious social capital is a valid construct that can be reliably measured. All indicators of religious social capital were higher among those who frequently attended religious services, with the exception of bridging trust (trust of people from different religious groups). A weak, inverse, association was also observed between religious and neighborhood social capital levels. Levels of religious social capital were correlated with higher levels of reported urban stressors, while neighborhood social capital was correlated with lower urban stressor levels. A significant percent of the sample was unaffiliated with a religious tradition and these individuals were more likely to be male, young and more highly educated. Social capital is a promising construct to help elucidate the influence of religion on population health

Educational mobility across generations and depressive symptoms over 10 years among US latinos

Few studies have collected intergenerational data to assess the association between educational mobility across multiple generations and offspring depression. Using data from the Sacramento Area Latino Study on Aging (1998-2008), we assessed the influence of intergenerational education on depressive symptoms over 10 years among 1,786 Latino individuals (mean age = 70.6 years). Educational mobility was classified as stable-low (low parental/low offspring education), upwardly mobile (low parental/high offspring education), stable-high (high parental/ high offspring education), or downwardly mobile (high parental/low offspring education). Depressive symptoms were measured with the Center for Epidemiological Studies-Depression Scale (CES-D); higher scores indicated more depressive symptoms. To quantify the association between educational mobility and CES-D scores over follow-up, we used generalized estimating equations to account for repeated CES-D measurements and adjusted for identified confounders. Within individuals, depressive symptoms remained relatively stable over follow-up. Compared with stable-low education, stable-high education and upward mobility were associated with significantly lower CES-D scores (β = -2.75 and -2.18, respectively). Downwardly mobile participants had slightly lower CES-D scores than stable-low participants (β = -0.77). Our results suggest that sustained, low educational attainment across generations may have adverse mental health consequences, and improved educational opportunities in underresourced communitiesmay counteract the adverse influence of low parental education on Latino depression

Maternal depression, women’s empowerment, and parental investment: Evidence from a randomized controlled trial†

We evaluate the medium-term impacts of treating maternal depression on women’s mental health, financial empowerment, and parenting decisions. We leverage variation induced by a cluster-randomized controlled trial that provided psychotherapy to 903 prenatally depressed mothers in rural Pakistan. It was one of the world’s largest psychotherapy interventions, and it dramatically reduced postpartum depression. Seven years after psychotherapy concluded, we returned to the study site to find that impacts on women’s mental health had persisted, with a 17 percent reduction in depression rates. The intervention also improved women’s financial empowerment and increased both time- and money-intensive parental investments by between 0.2 and 0.3 standard deviations

Mother's affection at 8 months predicts emotional distress in adulthood

Background Long-standing theory suggests that quality of the mother's (or primary caregiver's) interaction with a child is a key determinant of the child's subsequent resilience or vulnerability and has implications for health in adulthood. However, there is a dearth of longitudinal data with both objective assessments of nurturing behaviour during infancy and sustained follow-up ascertaining the quality of adult functioning. Methods We used data from the Providence, Rhode Island birth cohort of the National Collaborative Perinatal Project (mean age 34 at follow-up, final N=482) to conduct a prospective study of the association between objectively measured affective quality of the mothereinfant interaction and adult mental health. Infantemother interaction quality was rated by an observer when infants were 8 months old, and adult emotional functioning was assessed from the Symptom Checklist-90, capturing both specific and general types of distress. Results High levels of maternal affection at 8 months were associated with significantly lower levels of distress in adult offspring (1/2 standard deviation; b=-4.76, se=1.7, p<0.01). The strongest association was with the anxiety subscale. Mother's affection did not seem to be on the pathway between lower parental SES and offspring distress. Conclusion These findings suggest that early nurturing and warmth have long-lasting positive effects on mental health well into adulthood

Generativity and Engagement in Grandparenting Activities Among Older Adults in Northern Sri Lanka

Generativity refers to the desire to pass on one's skills, knowledge, and wisdom to future generations; this may be a clear indicator of the likelihood of older adults investing time and effort in engagement with their grandchildren. This cross-sectional study examines the relationship between generative beliefs and an index of multiple potential grandparenting activities. The data come from a convenience sample of 79 grandparents (aged 55+) living in Sri Lanka, a society experiencing rapid growth in its population of older adults. Regression analyses demonstrate that more endorsement of generative beliefs among older adults is associated with increased engagement in various grandparenting activities, with the strongest associations with reading, singing songs, and helping grandchildren with schoolwork or teaching them. Our findings suggest that generativity may be important for understanding the relationship between grandparenting and improved well-being for older adults