Deaf and hard of hearing individuals who use ASL experience significantly more challenges and health disparities, discrimination, and poorer quality of care within the U.S. health system.
Specific modes of communication play an important role in health outcomes among people who are deaf and hard of hearing. However, culturally and linguistically responsive research on substance use among people who are deaf and hard of hearing is lacking, particularly among people who have given birth and are experiencing mental health challenges.
Researchers at the University of Michigan, University of Massachusetts Chan Medical School, and the Lurie Institute for Disability Policy at Brandeis University investigated depression and drug use post-birth among deaf and hard-of-hearing (DHH) birthing parents who use ASL, spoken language, or use both ASL and English.
Results were recently published in the Archives of Women’s Mental Health with the paper, “Antenatal depression and drug use among deaf and hard-of-hearing birthing parents: results from a U.S. National Survey.”
Authors from the University of Michigan’s Department of Family Medicine include Assistant Professor Tyler G. James, PhD, MCHES, Assistant Professor Kimberly McKee, PhD, MPH, and Professor Michael M. McKee, MD, MPH. First author is Nasya S. Tan, MPH, BA, a PhD student in the Department of Epidemiology at U-M's School of Public Health. Fellow authors also include Tiffany A. Moore Simas, MD, MPH, MEd, of Chan Medical School; and Lauren D. Smith, MPH and Monika Mitra, PhD, both from the Lurie Institute.
The research team surveyed 587 respondents, 238 of whom used ASL; 111 who spoke English; and 238 who spoke English and used ASL. Mean age was approximately 35 years and participants were predominantly non-Hispanic white (80%), college educated (59.87%), and married (74.03%).
Among all people surveyed, nearly 15% reported an antenatal depression diagnosis. When adjusting for demographics, deaf and hard of hearing ASL users had lower prevalence of reporting antenatal depression compared to DHH English-speakers. DHH birthing parents who reported a depression diagnosis had a higher prevalence of drug use than those without a depression diagnosis.
The team also found that approximately one-fifth of those surveyed had used drugs during their last pregnancy, with most reporting they used only one drug. Thirteen percent of DHH birthing parents reported using pain relievers during pregnancy, with all but one reporting the pain relievers were prescribed by a doctor.
Nearly 10% of respondents reported cannabis use during their most recent pregnancy, while 2.91% of respondents reported using illicit drugs. There were no significant associations between preferred language and post-natal drug use.
“Our findings indicate that DHH birthing parents have higher prevalence of antenatal depression than studies of the general U.S. population,” the authors wrote. “Identifying subgroups of DHH people who are at risk of experiencing poorer mental health during pregnancy can inform healthcare intervention priorities.”
Furthermore, the authors speculated that while DHH English speaking patients had the highest prevalence of reporting an antenatal depression diagnosis, those who use ASL are at higher risk of mental health conditions, as compared to the general population, according to previous studies. Depression could lead to drug use, which can have negative consequences on both the birthing parent and fetal development, and could increase the risk of perinatal mental health conditions. The authors also speculate that DHH ASL users may not be adequately screened for antenatal depression.
“Future studies should consider incorporating more measures of substance use and mental health conditions that are linguistically appropriate for DHH birthing parents,” the authors wrote. “More work is needed to further health equity for DHH patients, from clarifying preferred language in electronic health records to training healthcare professionals on more successful methods of interacting with DHH patients.”
The study was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under award R01HD090103 (PIs: Mitra/M. McKee), National Institute on Disability, Independent Living, and Rehabilitation Research under award 90DPGE0001 (PI: Mitra), and the National Institute on Aging under award F31AG079636 (PI: Tan).
Article cited: Tan, N. S., James, T. G., McKee, K. S., Moore Simas, T. A., Smith, L. D., McKee, M. M., & Mitra, M. (2024). Antenatal depression and drug use among deaf and hard-of-hearing birthing parents: Results from a U.S. national survey. Archives of Women’s Mental Health. https://doi.org/10.1007/s00737-024-01512-7
