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Postpartum Depression and Health Services Expenditures Among Employed Women

Dagher, Rada K. PhD, MPH; McGovern, Patricia M. PhD, MPH, RN; Dowd, Bryan E. PhD, MS; Gjerdingen, Dwenda K. MD, MS

Journal of Occupational and Environmental Medicine: February 2012 - Volume 54 - Issue 2 - p 210–215
doi: 10.1097/JOM.0b013e31823fdf85
Original Articles

Objective: To investigate the association of postpartum depression with health services expenditures among employed women.

Methods: Women, aged 18 years and older, were recruited from three community hospitals in Minnesota while hospitalized for childbirth in 2001. Using Andersen's Behavioral Model, we regressed the natural log of the price-weighted sum of self-reported health services used from hospital discharge until 11 weeks postpartum on depression status at 5 weeks postpartum (Edinburgh Postnatal Depression Scale).

Results: Five percent of the women met the depression threshold. Two-stage least squares analyses showed that depressed women incurred 90% higher health services expenditures than nondepressed women. Older age, poverty, non–public assistance insurance status, and increased maternal symptoms also were associated with higher expenditures.

Conclusions: Higher health expenditures among postpartum depressed women highlight the importance of addressing mental health issues in the workplace.

From the Department of Health Services Administration (Dr. Dagher), School of Public Health, University of Maryland, College Park, MD; Division of Environmental Sciences (Dr. McGovern) and Division of Health Policy and Management (Dr. Dowd), School of Public Health; and Department of Family Medicine & Community Health, Medical School (Dr. Gjerdingen), University of Minnesota, Minneapolis, MN.

Address correspondence to: Rada Dagher, PhD, MPH, Department of Health Services Administration, School of Public Health, University of Maryland, 3310B School of Public Health Building, College Park, MD 20742 (

Copyright © 2012 by the American College of Occupational and Environmental Medicine