Annie E. Casey Foundation

To evaluate the predictors of postpartum depression and to examine the effects of maternal racial identity on postpartum depression among women with low incomes in the United States. We conducted a secondary data analysis using baseline data from the Baby's First Years study, including postpartum women living below the federal poverty line who were recruited from four diverse communities in the United States. Postpartum depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were performed to identify associations between pre-identified postpartum depression risk factors and postpartum depression among participants, followed by predictive margins analyses to elaborate on probability of postpartum depression across different racial identity groups in the sample. The sample included 1,051 postpartum women. Almost one-half of participants identified as Black (45.9%), followed by White (20.7%), American Indian (1.8%), and Asian (1.3%). Prevalence of postpartum depression in the sample was 24%. Financial insecurity and alcohol use were positively associated with postpartum depression, whereas level of education and reported physical health were negatively associated with postpartum depression. Mothers who identified as Black had an 8.3% higher probability of postpartum depression than that of White mothers in the sample. Nurses working with populations with low income should assess social determinants of health to provide holistic mental health care. Women with low incomes should be referred to resources which account for their financial burden. Racial disparities exist in perinatal care, and birth and postpartum mental health outcomes. It is crucial to address the systemic racism faced by Black mothers experiencing postpartum depression.

The past 18 months has been filled with transitions for healthcare organizations, for nurses, and for the patients and families they care for. As we transition from the real and virtual confines inflicted by the pandemic, the light shines on gratitude for relationships cultivated and the hope they bring.

The recent pandemic has caused many changes in the professional and personal lives of patients, their families, and the nurses who care for them. Something the pandemic could not change is the profound gratitude that patients, families, and others have for the extraordinary compassionate care that nurses have provided.

What does it mean to patients and families to recognize the extraordinary and compassionate care provided by amazing nurses? The triple aim framework of the Institute for Healthcare Improvement includes the patient/family experience as 1 of the 3 targets contributing to better healthcare outcomes. In this column, the perspective of recognizing "their" nurse with The DAISY Award will be shared by a patient's family.

What does it mean to be a "DAISY nurse"? Moral distress and end-of-life issues are difficult in any situation but, within the context of a pediatric setting, can be even more difficult. In this column, a DAISY nurse shares her thoughts on her role, her professional journey to explore moral distress and ethical decision making, and the lessons learned that led to her recognition with The DAISY Award and the joyful celebration.

Growing numbers of researchers are combining individual indicators of child well-being into overall indices. This research note examines five different methodologies that have been used to construct an overall index of child well-being. All five methods are applied to four datasets and the results are examined in terms of consistency of results across methods. The datasets reflect child well-being indicators at the country, state, county, and neighborhood levels. The results show that all five of the approaches to index construction examined here produce very similar results. This is reflected in very high correlation coefficients with index values and rankings across geographic units. The findings suggest that rankings of geographic units on child well-being indices are likely to be robust regardless of the particular index methodology used.

Because of the complexity and depth of problems facing children and families today, child protection can be best accomplished through a community effort--not simply through the efforts of the traditional child welfare system and other child- and family-serving agencies. Community-based initiatives supporting families and individuals are promising mechanisms through which to efficiently reach a wide range of community members consistent with a public health model. This conceptual paper describes the principles of community-based approaches for the prevention of child maltreatment and briefly describes four initiatives that are providing comprehensive, community-based prevention.