Postpartum depression among Arab and Jewish women in Israel: Ethnic inequalities and risk factors

Objective: The aim of the current study was to compare the prevalence of, and risk factors for postpartum depression (PPD) among Jewish and Arab women in Israel. Design: Data were obtained from a study on 'Family Relations and Violence' conducted in Israel in 2014-2015 using a multilayered nationwide representative sample of mothers who were interviewed face to face using a structured questionnaire in each woman's native language (Arabic / Hebrew) 6 weeks to 6 months postpartum. Setting: 63 Maternal and Child Health (MCH) clinics from five geographical districts. Participants: Jewish (N = 853) and Arab (N = 275) women aged 16-48 who were 6 weeks to 6 months postpartum. Measurements: PPD was measured by the Edinburgh Postnatal Depression Scale with a cutoffof >= 10. We examined a range of risk factors using multivariate logistic regression analysis and Generalized Estimating Equations (GEE) for the total sample, then separately for each ethnic group. Results: For the total sample (n = 1128). Prevalence of PPD was 10.3%. Prevalence among Arab women was significantly higher compared to Jewish women (20.8% vs 7%, respectively). In the multivariable analysis, chronic stress, low social support, and unwanted pregnancy were major risk factors for PPD for Arab women. Among Jewish women the risk factors for PPD included chronic stress, low level of education, and intimate partner violence. Conclusions: Our findings indicate ethnic inequalities in the prevalence of, and risk factors for PPD in Israel that should be considered in health planning and policymaking. Implications for practice: Maternal health care nurses and other professionals should be aware of these inequalities and provide culturally sensitive health care services and programs to protect women in these population groups from PPD.