Social determinants of perinatal mental health

Abstract

Social inequities and mental health are public health and medical conditions that are inextricably linked. Perinatal mental health is influenced by social, physical, and biological factors, with additional stressors related to pregnancy. The social determinants of health (SDOH) encompasses all conditions in which people live and grow, inclusive of cultural norms that reflect the diverse populations we serve. To best understand the mechanisms by which the SDOH affects perinatal mental health, we introduce the Urban Stress Model and describe the link between urban realities to stress response and potential mechanisms that link urban living to increased risk of adverse perinatal mental health. Given the increased diversity of patient populations, cultural considerations are paramount in understanding the utility and best practices in screening and interventions among ethnically diverse communities. Building on our Urban Stress Model and a structural determinants of health framework, we present examples of interventions to address the social inequities of perinatal mental health from the policy to community levels.