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Military and Veterans Psychology

(PS6-C74) Context Matters: The Relationship Between Depressive Symptoms and Environment in Postpartum Veterans

Friday, November 17, 2023
4:00 PM – 5:00 PM PST
Location: Regency Ballroom, Level 7
Environmental factors, such as neighborhood deprivation, impact many aspects of health, though associations with postpartum depression have not been explored thoroughly. Rural areas are often considered to be more deprived due to isolation from resources that urban areas have in close proximity, such as access to health information, reliable transportation, and specialized healthcare providers. Veterans are overrepresented in rural areas in the U.S., creating a demand for accessible services, including specialty services, like perinatal mental health care. This is noteworthy due to the higher prevalence of mental health disorders among Veterans, including postpartum depression. The current study examines the relationship between depressive symptoms experienced by postpartum Veterans and the resource richness and population density of their respective communities. This will be done using two distinct neighborhood-level geographic indices: the Area Deprivation Index and the Rural-Urban Commuting Areas. Veterans aged 18-55 years nationwide were recruited following record of delivery up to 18 months postpartum for a postpartum depression online CBT intervention study between March 2015-August 2019. Data presented herein include all Veterans screened as related to geographic indices. Veterans were assessed using the PHQ-9, and item-level data will allow for examination of specific symptoms. Address, latitude, and longitude were used to derive RUCA and ADI codes. Preliminary analyses to characterize the sample have been conducted. All participants were female biological sex. The mean age of participants was 32.29 years. PHQ-9 severity indicated that 9.6% of the sample had none/minimal severity, 18.4% mild, 29.8% moderate, 29.1% moderately severe, and 13% severe depressive symptoms. RUCA categories were stratified as follows: 83.6% urban, 9.5% large rural, 3.2% small rural, and 3.4% isolated. Structural equation modeling will be utilized prior to presentation to answer the central question: how do resource-richness of one's neighborhood, population density, and specific depressive symptoms relate to one another in a sample of postpartum female Veterans? The outcome of this study will help inform future community healthcare initiatives by providing information regarding depressive symptoms common to postpartum Veterans, as well as determine the utility of ADI and RUCA codes in identifying at-risk individuals. This is meaningful in that these codes may be used to identify individuals who may benefit from supplemental monitoring. Additionally, the results of this study will add to the literature regarding rural health among Veterans which can provide support for preventative services targeted toward rural perinatal Veterans.