Defying the odds

Abstract

Preventing poor health in childhood is a national social work and public health priority in the United States. Importantly, child health and wellbeing is explicitly linked with maternal health. Thus, maternal depression, a common mental illness, is a concern not only for the mother, but for the health of her offspring. The purpose of this three-paper dissertation was to extend the understanding of child health and wellbeing at age 9 years old in the context of maternal depression. Analyses utilized data from the Fragile Families and Child Wellbeing study and were guided by a resilience perspective, life course perspective, family systems theory, and ecological systems theory. Paper 1 examined the unique impact of maternal depression on child physical health outcomes utilizing a series of logistic regression analyses. Findings indicated that multiple individual-, maternal-, and family-level risk and protective factors influenced the association between maternal depression and child physical health. Paper 2 utilized latent profile analysis and multinomial logistic regression analyses to examine child physical health and psychosocial wellbeing in the context of maternal depression. Five distinct profiles of child health and wellbeing were identified, suggesting the traditional dichotomy of healthy versus unhealthy may fail to capture the complex nature of child health and wellbeing for those experiencing maternal depression. Results showed that maternal depression was associated with increased risk of poor health and wellbeing, yet also emphasized the ability for children to achieve resilient functioning. Paper 3 explored the impact of maternal depression on the maternal-child relationship and the protective nature of interpersonal supports and community resources. Findings indicated that interpersonal and community resources directly and indirectly supported a positive maternal-child relationship for mothers with depression. Altogether, results extend the literature base by providing a more nuanced and complete examination of child health and wellbeing in the context of maternal depression, with a focus on the potential for resilient functioning among this at-risk population. Findings provide evidence that even in the context of risk, protective factors exist that support resilient functioning. Results have important policy and practical implications, including continued screenings for maternal depression in a primary care setting.