Objectives The role of perceived discrimination in postpartum depression is largely unknown. We investigate whether perceived discrimination reported in pregnancy contributes to postpartum depression, and whether its impact varies by education level. Methods Prospective data are a part of European Longitudinal Study of Pregnancy and Childhood, the Czech Republic. Surveys were collected in mid-pregnancy and at 6 months after delivery. Depression was measured using Edinburgh Postnatal Depression Scale. Generalized linear models were estimated to test the effects of perceived discrimination on postpartum depression. Results Multivariate models revealed that among women with low education, discrimination in pregnancy was prospectively associated with 2.43 times higher odds of postpartum depression (p < .01), after adjusting for antenatal depression, history of earlier depression, and socio-demographic background. In contrast, perceived discrimination was not linked to postpartum depression among women with high education. Conclusions Perceived discrimination is a risk factor for postpartum depression among women with low education. Screening for discrimination and socio-economic disadvantage during pregnancy could benefit women who are at risk for mental health problems.

• Klíčová slova
• Education, Perceived discrimination, Postpartum depression, Socio-economic status,
• MeSH
• deprese diagnóza   psychologie   MeSH
• diskriminace (psychologie) * MeSH
• dospělí MeSH
• komplikace těhotenství psychologie   MeSH
• lidé MeSH
• percepce * MeSH
• poporodní deprese diagnóza   psychologie   MeSH
• poporodní období MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• psychiatrické posuzovací škály MeSH
• rizikové faktory MeSH
• socioekonomické faktory MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

INTRODUCTION: This study examined how perceived racial privilege and perceived racial discrimination in health care varied with race and socioeconomic status (SES). METHODS: The sample consisted of white, black, and Native American respondents to the Behavioral Risk Factor Surveillance System (2005-2013) who had sought health care in the past 12 months. Multiple logistic regression models of perceived racial privilege and perceived discrimination were estimated. Analyses were performed in 2016. RESULTS: Perceptions of racial privilege were less common among blacks and Native Americans compared with whites, while perceptions of racial discrimination were more common among these minorities. In whites, higher income and education contributed to increased perceptions of privileged treatment and decreased perceptions of discrimination. The pattern was reversed in blacks, who reported more discrimination and less privilege at higher income and education levels. Across racial groups, respondents who reported foregone medical care due to cost had higher risk of perceived racial discrimination. Health insurance contributed to less perceived racial discrimination and more perceived privilege only among whites. CONCLUSIONS: SES is an important social determinant of perceived privilege and perceived discrimination in health care, but its role varies by indicator and racial group. Whites with low education or no health insurance, well-educated blacks, and individuals who face cost-related barriers to care are at increased risk of perceived discrimination. Policies and interventions to reduce these perceptions should target structural and systemic factors, including society-wide inequalities in income, education, and healthcare access, and should be tailored to account for racially specific healthcare experiences.

• MeSH
• Behavioral Risk Factor Surveillance System MeSH
• běloši psychologie   statistika a číselné údaje   MeSH
• černoši nebo Afroameričané psychologie   statistika a číselné údaje   MeSH
• diskriminace (psychologie) * MeSH
• disparity zdravotní péče statistika a číselné údaje   MeSH
• dospělí MeSH
• dostupnost zdravotnických služeb etika   statistika a číselné údaje   MeSH
• indiáni Severní Ameriky psychologie   statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• menšiny psychologie   statistika a číselné údaje   MeSH
• mladý dospělý MeSH
• percepce * MeSH
• průřezové studie MeSH
• rasismus psychologie   statistika a číselné údaje   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• společenská třída * MeSH
• zdravotní stav MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Spojené státy americké etnologie   MeSH

OBJECTIVE: Perceived discrimination is an important risk factor for minority health. Drawing from the scholarship on multidimensionality of race, this study examines the relationships between perceived discrimination in health care and two dimensions of racial identity: self-identified race/ethnicity and perceived attributed race/ethnicity (respondents' perceptions of how they are racially classified by others). METHODS: We used Behavioral Risk Factor Surveillance System data collected in 2004-2013 and we specifically examined the data on perceived racial discrimination in health care during the past 12 months, perceived attributed race/ethnicity, and self-identified race/ethnicity. RESULTS: In models adjusting for sociodemographic and other factors, both dimensions of racial/ethnic identity contributed independently to perceived discrimination in health care. After controlling for self-identified race/ethnicity, respondents who reported being classified as Black, Asian, Hispanic, and Native American had higher likelihood of perceived discrimination than respondents who reported being classified as White. Similarly, after taking perceived attributed race/ethnicity into account, self-identified Blacks, Native Americans, and multiracial respondents were more likely to report perceived discrimination than counterparts who self-identified as White. The model using only perceived attributed race/ethnicity to predict perceived discrimination showed a superior fit with the data than the model using only self-identified race/ethnicity. CONCLUSION: Perceived attributed race/ethnicity captures an aspect of racial/ethnic identity that is correlated, but not interchangeable, with self-identified race/ethnicity and contributes uniquely to perceived discrimination in health care. Applying the concept of multidimensionality of race/ethnicity to health disparities research may reveal understudied mechanisms linking race/ethnicity to health risks.

• Klíčová slova
• Health Care, Measures of Race, Perceived Discrimination, Racial Identity,
• MeSH
• Behavioral Risk Factor Surveillance System MeSH
• disparity zdravotní péče MeSH
• disparity zdravotního stavu MeSH
• dospělí MeSH
• etnicita * MeSH
• Hispánci a Latinoameričané statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• menšiny * MeSH
• percepce * MeSH
• poskytování zdravotní péče * MeSH
• rasismus * MeSH
• rasové skupiny MeSH
• rizikové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Spojené státy americké MeSH