{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:15:46Z","timestamp":1791321346386,"version":"4.3.1"},"reference-count":45,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,29]],"date-time":"2024-12-29T00:00:00Z","timestamp":1735430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010001","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["CFDA**93.110AJ"],"award-info":[{"award-number":["CFDA**93.110AJ"]}],"id":[{"id":"10.13039\/100010001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010001","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["1111698-1-65217"],"award-info":[{"award-number":["1111698-1-65217"]}],"id":[{"id":"10.13039\/100010001","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fahs-Beck Fund for Research and Experimentation, the New York Community Trust","award":["CFDA**93.110AJ"],"award-info":[{"award-number":["CFDA**93.110AJ"]}]},{"name":"Fahs-Beck Fund for Research and Experimentation, the New York Community Trust","award":["1111698-1-65217"],"award-info":[{"award-number":["1111698-1-65217"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>This article focuses on the impact of trauma experienced by individuals, families and groups, and neighborhoods in Rochester and Syracuse, New York. Using the levels of analysis put forward in Bronfenbrenner\u2019s ecological systems theory (i.e., individual, family, and community), we argue that trauma operates at each of those levels. This mixed-methods study reviews the findings of seven previously published studies (with data collection ranging from 2000 to 2019), each of which addresses trauma among low-income residents. Specific methods include secondary analyses of births, qualitative interviews of persons who delivered a baby within the past two years, a community survey of residents living in high-crime areas, and secondary birth data to document the impact of socio-ecological risk factors on the trauma of birthing persons, their children, and their partners. Individuals and families living in high-risk neighborhoods (e.g., where residents experience frequent gun shots, racially disproportionate incarceration, and poverty) had more negative health outcomes including posttraumatic stress disorder, intrauterine growth restriction, and depression. Interventions focused on community-based practices that address individual, family, and community-level trauma must also address the multiple risk factors for trauma located in the environmental and social stressors.<\/jats:p>","DOI":"10.3390\/bs15010020","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T07:51:57Z","timestamp":1735631517000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Addressing the Triple Trauma of Factors Leading to Perinatal Health and Mental Health Consequences in Two Upstate New York Communities"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2008-7193","authenticated-orcid":false,"given":"Robert H.","family":"Keefe","sequence":"first","affiliation":[{"name":"School of Social Work, University at Buffalo, Buffalo, NY 14260, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4789-0496","authenticated-orcid":false,"given":"Robert A.","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"Department of Anthropology, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY 13244, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiara","family":"Van Brackle","sequence":"additional","affiliation":[{"name":"Department of Sociology, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY 13244, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanid","family":"Music","sequence":"additional","affiliation":[{"name":"Liverpool High School, Liverpool, NY 13090, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zikora","family":"Nnam","sequence":"additional","affiliation":[{"name":"Department of Public Health, Syracuse University, Syracuse, NY 13244, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9909-8172","authenticated-orcid":false,"given":"Sandra D.","family":"Lane","sequence":"additional","affiliation":[{"name":"Public Health & Anthropology, Syracuse University, Syracuse, NY 13244, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,29]]},"reference":[{"key":"ref_1","unstructured":"American Psychological Association (2024, August 30). Updated 04\/19\/2018. Trauma., Available online: https:\/\/dictionary.apa.org\/trauma."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"5485","DOI":"10.1113\/JP276299","article-title":"Challenges and controversies in perinatal physiology","volume":"596","author":"Bennet","year":"2018","journal-title":"The Journal of Physiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1080\/19371918.2018.1543627","article-title":"Community gun violence as a social determinant of elementary school achievement","volume":"33","author":"Lane","year":"2018","journal-title":"Social Work in Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2307\/201916","article-title":"The true nature of anomie","volume":"6","author":"Besnard","year":"1988","journal-title":"Sociological Theory"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1038\/s41398-022-02178-4","article-title":"The effects of social isolation stress and discrimination on mental health","volume":"12","author":"Brandt","year":"2022","journal-title":"Translational Psychiatry"},{"key":"ref_6","unstructured":"Zigler, E., Kagan, S., and Klugman, E. (1983). Beyond policies without people: An ecological perspective on child and family policy. Children, families, and government: Perspectives on American social policy, Cambridge University Press."},{"key":"ref_7","unstructured":"Husen, T., and Postlethwite, T. (1994). Ecological models of human development. The international encyclopedia of education, Elsevier. [2nd ed.]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.socscimed.2015.10.013","article-title":"The impact of neighborhood disorganization on neighborhood exposure to violence, trauma symptoms, and social relationships among at-risk youth","volume":"146","author":"Butcher","year":"2015","journal-title":"Social Science and Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jad.2017.07.045","article-title":"Maternal posttraumatic stress disorder during the perinatal period and child outcomes: A systematic review","volume":"225","author":"Cook","year":"2018","journal-title":"Journal of Affective Disorders"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"170","DOI":"10.33790\/jphip1100170","article-title":"Ecological systems theory: Exploring the development of the theoretical framework as conceived by Bronfenbrenner","volume":"4","author":"Crawford","year":"2020","journal-title":"Journal of Public Health Issues and Practice"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1080\/09540261.2018.1563529","article-title":"Perinatal depression, PTSD, and trauma: Impact on mother\u2013infant attachment and interventions to mitigate the transmission of risk","volume":"31","author":"Erickson","year":"2019","journal-title":"International Review of Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s42844-021-00048-4","article-title":"Historical and race-based trauma: Resilience through family and community","volume":"2","author":"Fitzgerald","year":"2021","journal-title":"Adversity and Resilience Science"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1177\/1077801220975495","article-title":"Second-order sexual harassment: Violence against the silence breakers who support the victims","volume":"27","author":"Flecha","year":"2021","journal-title":"Violence Against Women"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.childyouth.2016.06.020","article-title":"Maternal victimization and child trauma: The mediating role of mothers\u2019 affect","volume":"67","author":"Fusco","year":"2016","journal-title":"Children and Youth Services Review"},{"key":"ref_15","unstructured":"Garzone, C. (2024, August 30). Rochester\u2019s homicide rate up 126% in past 5 years, higher than Buffalo and Syracuse, Available online: https:\/\/www.rochesterfirst.com\/news\/local-news\/mcso-rochesters-homicide-rate-up-126-higher-than-buffalo-and-syracuse."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1007\/s10995-023-03694-5","article-title":"Refugee births and the migrant health effect in Syracuse NY","volume":"27","author":"Goble","year":"2023","journal-title":"Maternal and Child Health Journal"},{"key":"ref_17","unstructured":"Hayes, A. (2024, August 30). Mom\u2019s message to man who killed 11-year-old Bexi: I can\u2019t forgive you, you should pay (video)., Available online: https:\/\/www.syracuse.com\/crime\/2024\/07\/moms-message-to-man-who-killed-11-year-old-brexi-i-cant-forgive-you-you-should-pay-video.html."},{"key":"ref_18","unstructured":"Hayes, A. (2024, August 30). See the faces of Syracuse\u2019s 21 murder victims in 2023: More than 60% were shot to death, Available online: https:\/\/www.syracuse.com\/crime\/2024\/01\/see-the-faces-of-syracuses-21-murder-victims-in-2023-more-than-60-were-shot-to-death.html."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s11524-015-9978-8","article-title":"The Trauma Response Team: A community intervention for gang violence","volume":"92","author":"Lane","year":"2015","journal-title":"Journal of Urban Health: Bulletin of the New York Academy of Medicine"},{"key":"ref_20","unstructured":"Joseph, S., Tanous, O., Hosney, N., and Koga, P. M. (2022). Whose trauma? De-colonizing post-traumatic stress disorder and refugee mental health frameworks, Center for Primary Care."},{"key":"ref_21","unstructured":"Justice Policy Institute, Beatty, P., Petteruti, A., and Ziedenberg, J. (2007). The vortex: The concentrated racial impact of drug imprisonment and the characteristics of punitive counties, Justice Policy Institute."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1606\/1044-3894.2017.98.13","article-title":"African American fathers: Disproportionate incarceration and the meaning of involvement","volume":"98","author":"Keefe","year":"2017","journal-title":"Families and Society"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1177\/1044389419837028","article-title":"The normative nature of depression among impoverished mothers of color: \u201c\u2026going around this big old circle\u2026it always remain the same\u201d","volume":"100","author":"Keefe","year":"2019","journal-title":"Families and Society"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"176","DOI":"10.18060\/23937","article-title":"\u201cI gotta carry the burden by myself:\u201d Impoverished new mothers of color discuss living with postpartum depression","volume":"21","author":"Keefe","year":"2021","journal-title":"Advances in Social Work"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1\u201348-1060","DOI":"10.1001\/archpsyc.1995.03950240066012","article-title":"Posttraumatic stress disorder in the National Comorbidity Survey","volume":"52","author":"Kessler","year":"1995","journal-title":"Archives of General Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/j.jad.2021.01.027","article-title":"COVID-19 and mental health during pregnancy: The importance of cognitive appraisal and social support","volume":"282","author":"Khoury","year":"2021","journal-title":"Journal of Affective Disorders"},{"key":"ref_27","unstructured":"Kielar, M. (2024, August 30). Syracuse has largest rate of child poverty among large New York cities, report shows, Available online: https:\/\/13wham.com\/news\/local\/syracuse-child-poverty-rate-buffalo-rochester-albany-new-york-comptroller-thomas-dinapolo-new-york-children-in-need."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/GRF.0b013e3181b52df1","article-title":"Impact of maternal stress, depression and anxiety on fetal neurobehavioral development","volume":"52","author":"Kinsella","year":"2009","journal-title":"Clinical Obstetrics and Gynecology"},{"key":"ref_29","unstructured":"Lane, S. D. (2008). Why are our babies dying? Pregnancy, birth, and death in America, Paradigm Publishers."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1525\/maq.2004.18.4.405","article-title":"Marriage promotion and missing men: African American women in a demographic double bind","volume":"18","author":"Lane","year":"2004","journal-title":"Medical Anthropology Quarterly"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.healthplace.2007.08.008","article-title":"Structural violence, urban retail food markets, and low birth weight","volume":"14","author":"Lane","year":"2008","journal-title":"Health and Place"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1353\/hpu.2017.0033","article-title":"Neighborhood trauma due to violence: A multilevel analysis","volume":"28","author":"Lane","year":"2017","journal-title":"Journal of Health Care for the Poor and Underserved"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1089\/jwh.2009.1716","article-title":"Effects of intimate partner violence on pregnancy trauma and placental abruption","volume":"19","author":"Leone","year":"2010","journal-title":"Journal of Women\u2019s Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"19985","DOI":"10.3402\/ejpt.v4i0.19985","article-title":"Prevalence of interpersonal trauma exposure and trauma related disorders in severe mental illness","volume":"213","author":"Mauritz","year":"2013","journal-title":"European Journal of Psychotraumatoly"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1080\/19371918.2016.1160344","article-title":"Prenatal depression: Screening and referral for women who are low income during antenatal care","volume":"31","author":"Mestad","year":"2016","journal-title":"Social Work in Public Health"},{"key":"ref_36","unstructured":"Misiaszek, E. (2024, August 30). Trial of man accused of killing baby Dior Harris continues with emotional testimony, Available online: https:\/\/cnycentral.com\/news\/local\/murder-trial-dior-harris-syracuse-desiree-seymore-2021-fatal-drive-by-shooting-onondaga-county-court."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.jad.2016.08.035","article-title":"Psychopathology and parenting: An examination of perceived and observed parenting in mothers with depression and PTSD","volume":"207","author":"Muzik","year":"2017","journal-title":"Journal of Affective Disorders"},{"key":"ref_38","unstructured":"New York State Department of Corrections and Community Supervision--Division of Planning Research and Evaluation (2024, August 30). Under custody report: Profile of under custody population as of January 1, 2021, Available online: https:\/\/doccs.ny.gov\/system\/files\/documents\/2022\/04\/under-custody-report-for-2021.pdf."},{"key":"ref_39","unstructured":"Pelisek, C. (2024, August 30). 11-year-old honor student getting quart of milk is killed in shooting that targeted teenager, Available online: https:\/\/people.com\/crime\/honor-student-buying-quart-milk-killed-shooting-targeted-teenager\/."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1055\/a-2260-5051","article-title":"Trauma and posttraumatic stress disorder as important risk factors for gestational metabolic dysfunction","volume":"41","author":"Rocha","year":"2024","journal-title":"American Journal of Perinatology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1086\/698956","article-title":"Blood in the rust belt: Mourning and memorialization in the context of community violence","volume":"59","author":"Rubinstein","year":"2018","journal-title":"Current Anthropology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1037\/ort0000101","article-title":"Posttraumatic stress symptoms in context: Examining trauma responses to violent exposures and homicide death among Black males in urban neighborhoods","volume":"86","author":"Smith","year":"2016","journal-title":"American Journal of Orthopsychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.chiabu.2017.06.023","article-title":"A systematic review of risk and protective factors associated with family related violence in refugee families","volume":"70","author":"Timshel","year":"2017","journal-title":"Child Abuse and Neglect"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1377\/hlthaff.2019.00563","article-title":"Social isolation, loneliness, and violence exposure in urban adults","volume":"38","author":"Tung","year":"2019","journal-title":"Health Affairs"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1177\/1524838015584355","article-title":"Relational patterns between caregivers with PTSD and their nonexposed children: A review","volume":"17","author":"Kleber","year":"2016","journal-title":"Trauma, Violence, and Abuse"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/1\/20\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:56:06Z","timestamp":1760115366000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/1\/20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,29]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["bs15010020"],"URL":"https:\/\/doi.org\/10.3390\/bs15010020","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,29]]}}}