Social and Physical Environmental Factors and Maternal Mental Health

ISEE-0570 Background and Objective: Associations between the physical environment and adult mental health have been documented. Studies, however, have failed to account for social factors that affect mental health and that may be correlates of deteriorated environments. We examined associations among maternal mental health, intimate partner violence (IPV), and housing quality in the Fragile Families and Child Wellbeing Study (N = 2115). Methods: Maternal reports of IPV were obtained shortly after delivery and when the children were 12 and 36 months of age. At the 36-month assessment, interviewers rated indoor housing conditions, including housing deterioration (e.g. peeling paint, holes in floor) and housing disarray (e.g. dark, crowded, noisy house). Mothers also reported on housing hardships (e.g. moving repeatedly, difficulty in keeping house warm). A screening for depression and generalized anxiety was obtained from questions derived from the Composite International Diagnostic Interview–Short Form (CIDI-SF) administered to mothers during the 36-month assessment. Scores from the CIDI-SF provided probable diagnoses of major depressive and generalized anxiety disorders consistent with DSM-IV diagnostic criteria. Results: In this sample of women (55% Black, 23% Hispanic) 17% reported IPV, 16% were classified as having probable depression and 5% as having probable generalized anxiety. In adjusted analyses, depression was independently associated with women experiencing chronic IPV (1.94 95%CI: 1.1, 3.3), housing instability (1.72 95%CI: 1.3, 2.2), and housing disarray (1.28 95%CI: 1.0, 1.6). Housing instability (3.31 95%CI: 2.2, 5.0) and chronic IPV (2.9 95%CI: 1.4, 6.0) were also associated with increased odds for generalized anxiety. In stratified analyses, a greater effect of chronic IPV on depression was noted among women living in disarrayed or deteriorated housing and among women experiencing housing hardship. Conclusions: Our understanding of the relationship between the physical environment and mental health may be improved by considering aspects of the physical environment and the social environment together.