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Mental health

Poor neighbourhoods linked to memory decline in women

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Women in high-poverty areas saw memory decline of 7 per cent per decade in midlife, with even sharper drops of 10 per cent among Black women.

The study tracked 1,391 women in the US for up to 13.5 years and found that exposure to concentrated neighbourhood poverty was associated with sharper decline in episodic memory – the ability to recall specific personal experiences or information.

Unlike processing speed, which tends to decline naturally with age, episodic memory typically remains stable through midlife. A faster-than-expected drop may signal increased risk of later cognitive problems, including dementia.

The Study of Women’s Health Across the Nation (SWAN) followed participants aged 49 to 60 from Ann Arbor, Boston, Chicago, Alameda and Contra Costa counties in California, Los Angeles, Jersey City and Pittsburgh. Researchers from Albert Einstein College of Medicine repeatedly tested their cognitive abilities while tracking residential history and neighbourhood conditions.

To assess concentrated poverty, researchers used US Census data to evaluate poverty levels in each participant’s census tract and surrounding tracts, classifying neighbourhoods as low, moderate or high poverty.

High-concentration areas were defined as those with unusually high poverty rates that were geographically clustered. These measures also accounted for participants who had moved and changing neighbourhood conditions over time.

Study author Jinshil Hyun is assistant professor in the Saul R. Korey Department of Neurology at Albert Einstein College of Medicine.

The researcher said: “Research has shown that people living in low-income neighbourhoods are more likely to develop various physical and mental illnesses and tend to have shorter lifespans than people living in higher-income areas.

“However, people’s neighbourhood exposures are not restricted to the immediate areas around their homes, as they tend to actively seek resources, such as food, from nearby neighbourhoods to meet their daily needs.

“We hypothesised that individuals living in low-income neighbourhoods might successfully access better resources elsewhere, unless their communities are surrounded entirely by other low-income neighbourhoods.

“In such cases, their access would be severely restricted, potentially harming their health-related behaviours and health outcomes.”

Women in high-concentration poverty areas experienced faster decline in both immediate and delayed episodic memory.

Those in lower-poverty neighbourhoods showed either no decline or only mild reductions. The pattern held even after accounting for menopause status, physical activity, education, smoking and alcohol use.

Processing speed and working memory showed different trends.

Women in poorer areas had lower baseline scores but did not decline faster than women in wealthier areas, suggesting poverty may affect early brain health more than the pace of age-related change.

The steepest decline in delayed memory was found among Black women living in high-poverty areas. Researchers said this may reflect the cumulative impact of systemic inequalities such as racial discrimination and economic segregation.

Hyun told PsyPost: “Experiencing cognitive decline is a natural part of ageing, and different aspects of cognition decline at different rates.

“For example, processing speed typically starts to slow down in early adulthood, while memory usually remains stable until later in life.

“However, our study revealed that women living in areas of concentrated poverty experienced accelerated memory decline even during midlife (approximately 7 per cent per decade).

“Those living in higher income areas did not show significant memory decline.

“This suggests that living in highly concentrated low-income neighbourhoods may be related to increased rates of cognitive ageing, potentially increasing the risk of Alzheimer’s disease and related dementias.”

Cardiovascular health and physical activity – both known to affect cognition – did not fully explain the observed disparities.

Other factors, including chronic stress, pollution, or limited access to enriching environments, may also play a role.

“I was not surprised that living in high-poverty neighbourhoods was associated with faster cognitive decline, but the magnitude of this effect was unexpectedly large,” Hyun said.

“While residents of affluent neighbourhoods showed no significant memory decline, residents of areas with concentrated poverty experienced a 7 per cent decline per decade.

“Greater memory decline in midlife could serve as an early indicator of future Alzheimer’s risk. Alzheimer’s disease currently has no cure, and effective treatment options are limited.

“Therefore, addressing neighbourhood and individual risk factors of Alzheimer’s disease as early as in midlife would be crucial.”

The researchers noted some limitations, including the urban sample, which may not apply to women in rural areas.

They also did not assess childhood neighbourhood exposure or participants’ daily routines outside the home, such as workplaces, which could also influence cognitive health.

Opinion

What Maternal Mental Health Month reveals about where postpartum support actually breaks down

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By Morgan Rose, chief science officer at Ema, and Lauren Scocozza, vice president of product at Willow

May is Maternal Mental Health Month, and every year it surfaces a familiar set of statistics: 1 in 5 new mothers experiences postpartum depression or anxiety, most go unscreened, and the majority who are screened don’t receive adequate follow-up care.

The conversation is important. But the numbers obscure something that anyone who has worked in this space knows to be true: postpartum mental health distress rarely arrives with a label.

It arrives as exhaustion. As “I’m not sure I’m doing this right.”

As a question about supply, pumping, whether it’s okay to feel this disconnected from something you were supposed to love immediately.

Willow integrated Ema, AI built for women’s health, with the goal of closing the maternal care and data gap.

The pattern mentioned above appears consistently in Ema’s conversational data through the Willow app.

A mother reports mastitis symptoms.

Ema walks her through the clinical presentation, confirms she should keep pumping, and then she questions if she is using her pump correctly. In the same thread, within a few exchanges, she says she’s “feeling too sad.” Then: “I don’t know. I think I’m depressed. I am not enjoying my postpartum.”

She did not come to the app to talk about her mental health.

She came about a breast infection. The mental health disclosure came through the already-opened door.

The Weight Underneath the Technical Question

New motherhood involves an enormous amount of problem-solving at a time when cognitive and emotional reserves are depleted. The pump has to work. The baby has to eat. The body has to recover.

Work comes back. Sleep doesn’t. Feeding their babies requires skill, and the learning curve sits atop it all.

What Ema’s conversation data shows is that the emotional load of navigating these challenges is not separate from mental health. It is mental health.

When a mother writes, “I’m postpartum and overwhelmed and tired,” and then, in the same breath, asks about flange sizing, she is telling us what the postpartum experience actually feels like from the inside.

The technical question and the emotional state are one and the same.

Breastfeeding carries particular weight here.

The desire to breastfeed, the guilt when it doesn’t go as planned, and the identity questions that come with feeding choices are not peripheral to the postpartum mental health conversation.

In our conversations, women navigating supply concerns often reveal deeper anxieties: about whether they are good mothers, whether their bodies are “working,” and whether the difficulty they are experiencing means something about them.

These are the signals worth asking about.

What Screening Looks Like in Practice

Ema is trained on the Edinburgh Postnatal Depression Scale and is equipped to offer the EPDS when a conversation warrants it.

The value is being present for the moment when a woman is ready to name what she’s feeling.

That moment rarely comes as a direct request for mental health support. It comes when someone is already in a conversation about something else, and something shifts.

A woman dealing with mastitis says she feels sad. A woman worried about supply says she doesn’t feel like herself. A woman managing the logistics of going back to work with a wearable pump says she’s not sure she can keep up with it all — and the “it all” isn’t about the pump.

Ema is designed to hear that. She doesn’t stay on the clinical or technical track when the conversation moves. She follows the person.

And when the moment is right, she offers the screening as a natural next step.

In one exchange, a woman was offered the EPDS after disclosing depressive feelings. She declined.

Ema acknowledged that and asked if she wanted to talk about something else. That’s the right response. The offer was made without pressure. The door stays open.

Sometimes what matters most is that someone asked at all.

The Continuity Problem

One of the most persistent structural failures in maternal mental health care is fragmentation.

A woman sees her OB at six weeks postpartum for a brief screening. She may get a call from a nurse. She may be given a referral she never follows up on because she doesn’t have the capacity to navigate a new care relationship while managing a newborn.

The clinical touchpoints are too few, too far apart, and too often siloed from one another.

The postpartum period lasts far longer than the six-week checkup implies. Mental health symptoms can emerge weeks or months after delivery, shift in character over time, and interact with physical challenges in ways that don’t fit neatly into any single provider’s lane.

A lactation concern becomes an anxiety spiral. A supply drop triggers a grief response. A difficult return to work surfaces a postpartum depression that wasn’t fully recognized at six weeks.

Ema sits inside these moments because she’s embedded in the platform women are already using. She doesn’t require a separate appointment, a referral, or the cognitive bandwidth to seek out a new resource.

She’s in the Willow app that mom is already using multiple times a day to manage her pump.

When Ema identifies a woman who may need more support than she can provide, she routes to the right resource — whether that’s a SimpliFed lactation consultant for feeding-related concerns or a clinical professional for mental health follow-up.

The conversation leads to the handoff with someone who can do more.

What the Month of May Means for the Rest of the Year

Maternal Mental Health Month is a useful moment of attention. The awareness campaigns, the social media posts, and the statistics shared in newsletters matter.

But the gap in postpartum mental health care is not really an awareness problem.

Most people in the perinatal space and beyond know the statistics. The problem is access, timing, and continuity.

AI doesn’t close that gap on its own.

What it can do is be present in the spaces where women already are, at the times when they need something, and attentive enough to recognise that a conversation about a pump, a clogged duct, or a supply concern is also a conversation about how someone is doing.

The question behind the question is often the more important one.

For Willow, the conversation data Ema generates is a map of where mothers are struggling, what they reach for when they need help, and when they are ready to say more than they came to say.

That information, used well, shapes better resources, better onboarding, and a more connected experience across the full arc of the postpartum year and beyond.

Building the infrastructure to support maternal mental health is a year-round project.

Willow is doing one part of that, and the conversations happening on the Willow platform every day are evidence that women want support that meets them where they are… in their app, in their moment, without having to ask for it twice.

About the authors

Morgan Rose is Chief Science Officer at Ema, an AI platform for women’s health. Ema partners with healthcare organisations and femtech companies to deliver clinically grounded AI support across the perinatal journey.

Lauren Scocozza is the Vice President of Product at Willow Innovations, Inc. For women by women, Willow is building a maternal care platform to address the interconnected challenges of postpartum.

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Insight

Online abuse and deepfakes ‘pushing women out of public life’

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Deepfakes, AI-assisted rape and unwanted advances are pushing women out of public life, a report has found.

Online violence against women in public life is becoming increasingly technologically sophisticated, with perpetrators able to use AI tools to fabricate intimate images of their targets.

Survey responses suggest these attacks are often deliberate and coordinated, aiming to silence women in public life while undermining their professional credibility and personal reputations.

The report, “Tipping point: Online violence impacts, manifestations and redress in the AI age”, was published by UN Women and produced in partnership with City St George’s, University of London, and TheNerve, a digital forensics lab founded by Nobel laureate Maria Ressa.

It analysed the experiences of 641 women journalists and media workers, activists and human rights defenders from 119 countries. The women were surveyed between 27 August and 13 November 2025.

Researchers found that 27 per cent of women respondents were targeted with unsolicited sexual advances via direct message, receiving unwanted intimate images, “cyberflashing”, sexual innuendos or non-consensual sexting.

A further 12 per cent had their personal images, including those of an intimate nature, shared without their consent, while 6 per cent had been subjected to deepfakes or manipulated images and videos.

The impacts included an alarming rate of mental health diagnoses and self-censorship. Nearly one-quarter, or 24 per cent, of respondents had experienced anxiety and/or depression linked to online violence, while 13 per cent reported being diagnosed with post-traumatic stress disorder, or PTSD.

The findings also pointed to widespread self-censorship, with 41 per cent of respondents saying they self-censored on social media to avoid being abused, and 19 per cent doing so at work.

The study found that while 25 per cent of respondents had reported incidents of online violence to the police and 15 per cent had taken legal action, justice still eluded them. Some 24 per cent of the women who had reported online violence felt victim-blamed by the police, having been asked questions such as “What did you do to provoke the violence?” The same proportion said the police made them feel responsible for shielding themselves from further violence.

Julie Posetti, professor of journalism and chair of the Centre for Journalism and Democracy at City St George’s, is the project’s principal researcher and the report’s lead author.

She said: “AI-assisted ‘virtual rape’ is now at the fingertips of perpetrators. This phenomenon accelerates the harm from online violence inflicted on women in public life.”

“This violence serves to fuel the reversal of women’s hard-won rights in a climate of rising authoritarianism, democratic backsliding and networked misogyny.”

“The rollback of women’s rights is enabled and exacerbated by technologies which, by design, amplify misogynistic hate speech for profit.”

Co-author Lea Hellmueller, associate professor of journalism and associate dean for research and innovation at City St George’s, added: “The chilling effect of online violence is pushing women out of public life.”

“Law enforcement is outsourcing the responsibility for protection to the survivors by telling women to remove themselves from social media, to avoid speaking publicly about controversial issues, to move into less visible roles at work, or to take leave from their respective careers.”

“This shows that avoidance techniques, self-censorship or quitting, are still significantly more likely to be used by women rather than resistance techniques such as reporting online attacks to the police.”

Pauline Renaud, lecturer in journalism at City St George’s and fellow co-author of the study, said: “Going to the police or taking legal action do not necessarily lead to justice for survivors.”

“We need more effective education and training of law enforcement and judicial actors to support action in cases of technology-facilitated violence against women and girls.”

“This needs to be matched by political will to effectively regulate Big Tech companies that use their outsized financial and political power to undermine progress in this area.”

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Pregnancy

More than half of women with gestational diabetes face harmful stigma, research reveals

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More than half of women with gestational diabetes report stigma from healthcare staff, family, friends and wider society, new research shows.

A survey of 1,800 UK women found widespread emotional distress at diagnosis of the condition, a form of high blood sugar that develops during pregnancy, with effects lasting beyond birth.

Gestational diabetes affects around one in 20 pregnancies in the UK, and the findings highlight the wider toll on women diagnosed with the condition.

The study was funded by Diabetes UK and led by researchers at King’s College London and University College Cork.

Dr Elizabeth Robertson, director of research and clinical at Diabetes UK, said: “Stigma can have a dangerous and devastating impact on pregnant women diagnosed with gestational diabetes, particularly at a time when emotions and anxieties may already be heightened.

“We know that stigma can lead to shame, isolation and poorer mental health, and may discourage people from attending healthcare appointments, potentially increasing the risk of serious complications.

“This research highlights the urgent need for better support systems, based on understanding and empathy to ensure no one feels blamed or judged during their pregnancy.”

More than two-thirds of women, 68 per cent, reported anxiety at diagnosis, while 58 per cent felt upset and 48 per cent experienced fear.

The psychological impact continued beyond birth, with 61 per cent saying the condition negatively affected their feelings about future pregnancies.

Nearly half of women, 49 per cent, felt judged for having gestational diabetes, while 47 per cent felt judged because of their body size.

More than 80 per cent felt other people did not understand gestational diabetes, and more than a third, 36 per cent, concealed their diagnosis from others.

Gestational diabetes stigma was also common in healthcare settings, with 48 per cent reporting that professionals made assumptions about their diet and exercise, and more than half, 52 per cent, feeling judged based on their blood glucose results.

Many women described a loss of control and a sense of disruption during pregnancy.

Nearly two-thirds, 64 per cent, felt they were denied a normal pregnancy, while 76 per cent reported a lack of control over their pregnancy.

More than a third, 36 per cent, felt abandoned by healthcare services after giving birth, and one in four, 25 per cent, continued to experience depression or anxiety postpartum.

Focus group participants described harmful stereotypes, including assumptions that they were ‘lazy’, had ‘poor eating habits’ or ‘lacked willpower’.

Comments from family and friends included remarks such as “should you be eating that?” and “you must have eaten too much, that’s why you have gestational diabetes.”

The researchers are calling for targeted interventions alongside structured emotional support for women during and after pregnancies affected by gestational diabetes, to improve both mental and physical health outcomes.

Professor Angus Forbes, lead researcher from King’s College London, said: “Stigma and emotional distress are far more common in women diagnosed with gestational diabetes than many realise.

“Everyday interactions, even with those who mean well, can deepen this harm, shaping women’s emotional wellbeing and the choices they feel able to make.

“It’s clear that meaningful action is needed to protect women’s mental and physical health.”

Risk factors for gestational diabetes include living with overweight or obesity, having a family history of type 2 diabetes, and being from a South Asian, Black or African Caribbean or Middle Eastern background.

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