摘要：Objectives. We assessed whether there were associations between maternal mental health and individual and co-occurring parenting stressors related to social and financial factors and child health care access. Methods. We used cross-sectional data from the 2000 National Survey of Early Childhood Health. The 5-item Mental Health Inventory was used to measure self-reported mental health. Results. After we controlled for demographic covariates, we found that the following stressors increased the risk of poor maternal mental health: lack of emotional (odds ratio [OR] = 3.4; 95% confidence interval [CI] = 2.0, 5.9) or functional (OR=2.2; 95% CI=1.3, 3.7) social support for parenting, too much time spent with child (OR=3.5; 95% CI=2.0, 6.1), and difficulty paying for child care (OR=2.3; 95% CI=1.4, 3.9). In comparison with mothers without any parenting stressors, mothers reporting 1 stressor had 3 times the odds of poor mental health (OR = 3.1; 95% CI = 2.1, 4.8), and mothers reporting 2 or more stressors had nearly 12 times the odds (OR = 11.7; 95% CI = 7.1, 19.3). Conclusions. If parenting stressors such as those examined here are to be addressed, changes may be required in community support systems, and improvements in relevant social policies may be needed. Mothers of young children are at considerable risk for mental health problems such as depression and depressive symptoms, with an estimated national prevalence of these mothers reporting 2 or more depressive symptoms at 19%. 1 Depression contributes considerably to the burden of disease and is a chronic disease risk factor. 2 Moreover, a large body of literature suggests that maternal mental health has a strong influence on child health and development. 1 , 3 – 10 Population-level data identifying risks for poor maternal mental health could be useful in efforts to address such problems and their consequences. Rearing young children requires considerable social, financial, and health care resources. 11 , 12 Psychological stress is likely to result if such resources are scarce; for example, evidence shows that low socioeconomic status 1 , 13 – 16 and the absence of social support 17 , 18 are associated with maternal mental health problems such as depression and anxiety. However, although many parents of young children have difficulty paying for basic child-rearing needs, feel they do not spend sufficient time with their children, and have difficulty obtaining adequate access to health care for their children, 19 , 20 information is lacking on whether such stressors are independently associated with poor maternal mental health. We examined individual and co-occurring parenting-related stressors (hereafter “parenting stressors”) from the social (i.e., lack of social support, time spent with children), financial (i.e., difficulty paying for child-rearing needs), and child health care (i.e., lack of health insurance coverage, missed or delayed needed care) domains. We view these stressors as intermediaries between socioeconomic status and parent mental health; that is, low socioeconomic status increases the likelihood of these stressors, which influences parent mental health. We hypothesized that the presence of individual social, financial, and health care parenting stressors would increase the risk of poor maternal mental health and that increasing numbers of stressors would result in increased levels of risk.
