JAMA: Trends and Disparities in Maternal Self-Reported Mental and Physical Health

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Abstract

Importance  While rising maternal morbidity and mortality have been well documented in the US, national data on general maternal physical and mental health beyond the perinatal period are lacking.

Objective  To examine recent trends and disparities in self-reported maternal physical and mental health.

Design, Setting, and Participants  In this pooled, cross-sectional study, the nationally representative National Survey of Children’s Health was used to assess self-reported mental and physical health of female biological or adoptive parents of children aged 0 to 17 years (hereafter, mothers) from 2016 to 2023.

Main Outcomes and Measures  The main outcomes were self-reported maternal physical and mental health, measured on a 4-point Likert scale (excellent, very good, good, fair/poor). Regression models were used to estimate trends and sociodemographic disparities in self-reported physical and mental health.

Results  A total of 198 417 mothers (mean [SD] age, 39.0 [0.04] years) were included in the sample, representing 42 130 370 individuals nationally in the weighted sample. Among mothers in the study, 89.8% were 30 years and older; 57.9% of mothers had a privately insured child, 35.7% had a publicly insured child, and 6.4% had an uninsured child. The unadjusted prevalence of excellent physical health declined from 28.0% to 23.9%, while good physical health rose from 24.3% to 28.1%, and fair/poor physical health did not significantly change. The unadjusted prevalence of excellent mental health declined from 38.4% to 25.8%, while good mental health rose from 18.8% to 26.1%, and fair/poor mental health rose from 5.5% to 8.5%. After adjusting for secular changes in the sociodemographic characteristics of mothers, excellent physical health decreased by 4.2 percentage points (pp) (95% CI, −5.7 to −2.8 pp), excellent mental health decreased by 12.4 pp (95% CI, −14.0 to −10.7 pp), and fair/poor mental health increased by 3.5 pp (95% CI, 2.6-4.4 pp) over the 8-year study period. Mental health declines occurred broadly across socioeconomic subgroups. However, self-reported physical and mental health status was significantly lower among mothers who were US born, single parents, less educated, and those with publicly insured or uninsured children.

Conclusions and Relevance  In this cross-sectional study, self-reported mental health was found to have significantly declined for female parents. Investments are needed to investigate and address the underlying causes of mental health decline among US mothers, especially those of low socioeconomic status.