Advocates for Evidence-Based Health Policy Speakers
Civil Unrest in Communities of Color
Civil unrest is on the rise as communities of color continue to experience discriminatory practices in policymaking, resource distribution, and treatment by authority figures. Civil unrest can be thought of as a visual representation of the frustration felt by members of marginalized communities, typically related to the inaction of our society to remedy the injustices that have occurred. During each episode of civil unrest, we see and hear images and stories of the violence and destruction that takes place in these communities. However, we often overlook the impact of the civil unrest on the most vulnerable of these communities – young children and their caregivers.
The authors of a recent article attempt to bring these vulnerable populations out of the shadows by examining the well being of the mothers and children living in communities affected by civil unrest. The study found that maternal depression increases during periods of civil unrest, which is particularly troubling given the negative impact maternal depression has on the development of young children. When a young child’s relationship with his or her primary caregiver is disrupted, the child’s developmental milestones, future learning, and relationship-building skills can be delayed.
Given that episodes of civil unrest are likely to continue, barring sweeping legislative changes, we need to develop programs and policies aimed at minimizing the harmful effects civil unrest has on young children and their caregivers. Although mothers and children may not be directly affected by the violence and destruction within the community, they are impacted by the stress and disruption of their daily routines and cannot be overlooked when responding to civil unrest. Some potential policy prescriptions include: (1) physicians working in these communities should be regularly screening for maternal depression and providing information regarding resources that improve the well-being of mother and child when mothers screen positive for depressive symptoms, (2) programs that integrate mental health services into primary care and emergency room services should be considered, and (3) funding for parent-child nurturing programs, such as Nurse-Family Partnerships, should be increased in communities that are experiencing unrest.
This Health Policy Journal Club review is a collaboration between Policy Prescriptions® and the Satcher Health Leadership Institute. It is written by Alyssa Lee, Psy.D. She is a Health Policy Leadership Fellow.
Abstract
OBJECTIVES: To examine changes in maternal-child health surrounding the April 2015 civil unrest in Baltimore, Maryland, following Freddie Gray’s death while in police custody.
METHODS: We conducted cross-sectional Children’s HealthWatch surveys January 2014 through December 2015 in pediatric emergency departments and primary care clinics on maternal-child health and June 2015 through October 2015 on daily and community routines. We used trend analysis and piecewise logistic regression to examine effects of time, residential proximity moderation, and mediation analysis to assess proximity and maternal-child health relations via maternal concerns.
RESULTS: Participants comprised 1095 mothers, 93% of whom were African American and 100% of whom had public or no insurance; 73% of participants’ children were younger than 24 months. Following the unrest, prevalence of maternal depressive symptoms increased significantly in proximal, but not distal, neighborhoods (b?=?0.41; 95% confidence interval [CI]?=?0.03, 0.79; P?=?.03). Maternal concerns were elevated in proximal neighborhoods and associated with depressive symptoms; mediation through maternal concern was not significant. Five months after the unrest, depressive symptoms returned to previous levels.
CONCLUSIONS: Civil unrest has an acute effect on maternal depressive symptoms in neighborhoods proximal to unrest. Public Health Implications. To mitigate depressive symptoms associated with civil unrest, maintain stability of community routines, screen for maternal depressive symptoms, and provide parent-child nurturing programs.
PMID: 28727535
You must be logged in to post a comment.