A Troubling Combination: Depression, Poverty, and Parenting

BlogHealthJul 31 2013

There is a troubling trend that researchers have identified again and again – low-income parents, especially single mothers, have higher rates of depression and depressive symptoms than their higher-income counterparts. A new Child Trends’ study found that more than half of a group of low-income mothers in Maryland felt down, depressed, or hopeless in the past year and almost a third had those feelings combined with a lack of interest or pleasure in doing things.

That’s a stark contrast to some national estimates showing that less than 7 percent of all adults have experienced a major depressive episode and that only 5 percent of single parents with incomes at or above the federal poverty level report symptoms of depression. While a recent report from the Urban Institute found that, regardless of income, 14.5 percent of all mothers with young children experienced depression, it also reported that mothers with incomes below 200 percent of the federal poverty level were more likely to experience severe depression, while higher income mothers reported mild or moderate symptoms.

In another Child Trends study, 36 percent of a group of low-income parents in Minnesota who reported depressive symptoms described them as persistent or concerning to others.

Depression and poverty is not only a troubling combination for parents, but research has shown that children can get caught in the web of parental depression as well. Parents who suffer from depressive symptoms are less likely to have feelings of self-efficacy and engage in positive parenting behaviors.  Data from the Fragile Families and Child Well Being Study shows that mothers with persistent depression invest less time with their children on positive activities such as reading, outings, trips to the park, and indoor play. Additionally, depressed mothers are less likely to breastfeed, adhere to safety procedures (such as securing children in proper car seats), and control their children’s chronic illnesses. This evidence suggests that children of depressed parents are often denied adult attention and interactions that are crucial for safe and healthy development.

Multiple studies have shown that children with depressed mothers are more likely to have behavior problems, poor academic performance, and delays in cognitive and social development. Not only have studies shown links between parents struggling with depression and increased child injuries and visits to the emergency room, but a recent study conducted in the Bronx suggests that mothers with depressive symptoms are two and a half times more likely to have an overweight or obese child.

Getting help can be a difficult challenge for low-income parents. To start with, some parents may not recognize that they are experiencing depression because they assume their symptoms are just part of everyday life in a stressful environment. Then there are basic barriers like not having a car to get to a treatment location or not having someone to watch the kids while the parent is in treatment. The cost and availability of mental health services can be a more complex challenge, especially when a parent lacks health insurance. Finally, there is some evidence that a distrust of health care providers or skepticism about their ability to understand low income parents’ daily reality keeps parents from seeking treatment.

States are trying a variety of approaches to get care to the people who need it most. For example, some states try to screen parents for depression at the time when they come in for their child’s health care appointments. Many are promoting awareness among low income parents of depressive symptoms and their effect on children, so that treatment is framed as a way to help their children, not just themselves. Others offer mental health services at locations that low-income parents trust – such as during home visiting or in Head Start centers.

While understanding the links between poverty, depression and parenting represents an important first step, the severity of this issue requires a focused and collaborative effort among policymakers, providers and others working to improve the lives of low-income families.