Current data highlight significant disparities in infant and maternal health (IMH) outcomes both when comparing outcomes to other countries and between groups within the U.S. Previous studies indicate that disparities in health outcomes are caused by health inequities. Health inequities are a result of marginalized groups historically being denied resources and exposed to increased risk directly impacting health. These resources and risks are considered social determinants of health (SDoH), such as income, housing, transportation, and access to care. Although SDoH influence individuals across multiple levels of society, communities are sites where individuals directly access protective resources and are potentially exposed to risk. Therefore, given the persistence of poor IMH outcomes and the role communities play as sites in which social factors directly impact health, this study sought to understand the relationship between local-level SDoH and IMH outcomes in Florida as well as the role local health departments play in improving outcomes. To do this, a mixed methods analysis was conducted using secondary quantitative and qualitative data. The secondary quantitative data was compiled to create a dataset for variables that represent community-level SDoH and IMH outcomes, which were all analyzed statistically and utilizing geospatial visualizations. The secondary qualitative data consisted of county-level content from Healthy Start Coalition websites as well as Community Health Needs Assessments and Health Improvement Plans. Findings suggest that there are statistically significant relationships between variables utilized to measure racial residential segregation, neighborhood deprivation, housing stability, rurality and access to care and the variables utilized to measure infant health outcomes. Further, the qualitative data suggest that less than half the sample considered IMH a priority issue. Of the counties who did, many focused on implementing strategies to impact individual behaviors, however all counties in the sample did discuss SDoH and health equity to varying degrees.
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Doctor of Philosophy (Ph.D.)
College of Sciences
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Reiss, Jacquelyn, "Local-Level Maternal and Infant Health: A Mixed-Methods Analysis of the Relationship Between Social Determinants of Health, Maternal and Infant Health Outcomes, and Public Health Programs in Florida" (2023). Electronic Theses and Dissertations, 2020-. 1780.