1. Section Editor(s): Giurgescu, Carmen PhD, RN

Article Content

It is well known that taking care of ourselves by eliminating unhealthy behaviors (e.g., smoking), eating healthy, and staying active improves our health. However, our health is also determined in part by access to economic resources, the neighborhoods we live in, and our social interactions. Our health is influenced by economic, social, and physical conditions in our environment. According to the Healthy People 2020, "social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks" (U.S. Department of Health and Human Services [US DHHS], n.d.). Some examples of social determinants include: socioeconomic conditions (e.g., concentrated poverty); social norms and attitudes (e.g., discrimination, racism); residential segregation; exposure to crime, violence, and disorder (e.g., presence of trash in the neighborhood); built environment (e.g., buildings, sidewalks); and culture (US DHHS). These conditions may explain, in part, why some Americans are healthier than others. This special topics series on Social Determinants of Maternal Health and Birth Outcomes presents three articles on how social determinants influence minority women's health.


African American women are more likely to experience racial discrimination compared with non-Hispanic white women. Giurgescu et al. found racial discrimination affects psychological well-being of pregnant African American women. Women with psychological distress reported twice as much racial discrimination compared with women without psychological distress. Results suggest racial discrimination affects mental health of pregnant African American women.


African American women are more likely to live in disadvantaged neighborhoods and experience negative birth outcomes (preterm birth, low birthweight infants) compared with non-Hispanic white women. Nowak and Giurgescu suggest poor-quality built environments such as housing vacancy, structural deterioration, and physical disorder are related to preterm birth and low birthweight infants.


Postpartum depression is one of the most disabling mental health conditions among women of childbearing age. Immigrant women are at higher risk for postpartum depression, possibly due to immigration and acculturative stress, the stress experienced in response to immigration. Alhasanat and Giurgescu suggest that acculturation may increase risk of postpartum depressive symptoms in immigrant Hispanic women.


Social determinants of health such as racial discrimination, poor-quality neighborhoods, and acculturation may increase risk of negative mental health and birth outcomes for minority women in the United States. Nurses need to take leadership roles in creating policies that promote economic development, reduce poverty, reduce residential segregation, promote healthier neighborhoods, and support immigrant women. By working together to establish policies that positively influence social and economic conditions, nurses can improve the health of minority women that can be sustained over time. By improving the conditions in which women live and the quality of their social interactions, nurses will improve the health of the next generation.




U.S. Department of Health and Human Services. (n.d.). Healthy People 2020. Retrieved from Accessed September 2, 2016.