Date of Conferral

10-7-2026

Date of Award

October 2026

Degree

Doctor of Public Health (DrPH)

School

Health Sciences

Advisor

Simone  Salandy

Abstract

During the COVID-19 pandemic, disruptions to prenatal and postpartum care exacerbated longstanding racial inequities in maternal and infant health. Guided by the Social Determinants of Health (SDOH) framework, this quantitative, comparative cross-sectional study examined the association between peripartum resource utilization and pregnancy outcomes among Black and White women in Delaware before (2016–2019) and during (2020–2022) the pandemic. Secondary data from Delaware’s Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed in IBM SPSS Statistics using binary logistic regression across a final analytic sample of N = 362 participants (183 Black women and 179 White women), controlling for income, education, employment, stress, and depressive symptoms. Race-stratified inferential modeling yielded no statistically valid conclusions regarding racial differences due to statistical and sample size constraints, specifically perfect separation among Black participants during 2020–2022 and model non-convergence among White participants. This methodological limitation highlights the necessity for larger, racially disaggregated datasets and advanced modeling approaches (such as penalized or Firth regression) in future health disparity research. Nevertheless, the evidence demonstrates that peripartum healthcare inequities persisted and intensified during the COVID-19 pandemic. These findings underscore the critical need for sustained public health interventions and policy reforms that strengthen equitable access to comprehensive prenatal and postpartum care to improve maternal and infant health outcomes.

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