Year of Publication

2024

College

Public Health

Date Available

5-3-2024

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Corrine Williams, ScM, ScD

Committee Member

Mark Swanson, PhD

Committee Member

Jerod Stapleton, PhD

Abstract

Compared to other states in the country, Kentucky has historically poor population health outcomes. While the statewide maternal mortality rate is 16.1 per 100,000 live births, this statistic belies the stark racial disparities that exist. In 2018, the pregnancy-related death rate for Black women was 40.2 per 100,000 live births compared to 13.1 for White women. This pattern is persistent even after controlling for socioeconomic status, prenatal care, and other protective factors. Research shows that institutional and interpersonal racism when receiving obstetric care contributes to poor childbirth and postpartum outcomes for Black women. Additionally, geography and rural status may compound maternal health inequities for Black women, and research shows that negative pregnancy outcomes, including pregnancy-related deaths, are more prevalent in rural communities than in urban areas. While the Black population in Kentucky is largely concentrated in Louisville and Lexington, Black women outside these two urban areas are often overlooked in terms of research projects and other interventions designed to improve health outcomes for the Black population in the state. The Jennie Stuart Health System located in Christian County, KY, which has one of the largest Black populations outside of the two main urban areas in the state, proposes implementing an evidence-informed intervention to change perinatal provider behavior through a social marketing campaign. The goal of this intervention is to reduce Black maternal morbidity and mortality through institutional culture change, community partnership, and investment in the training of our perinatal providers.

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