Date of Conferral

2022

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Loretta Shields

Abstract

Infant mortality is a significant public health issue that provides insight into the health of a community. The purpose of this study was to examine whether a relationship existed between infant mortality and median income by zip code, maternal factors, and/or infant factors in the affluent, African American community of Prince George’s County, Maryland. The research theory chosen for this study was the conceptual framework for action on the social determinants of health based upon its action-oriented focus. The secondary data used for this study was linked birth and infant death data for 2010 to 2016 collected by the Department of Vital Statistics at the Maryland Department of Health. A logistic regression showed no clear relationship between income and infant mortality but did show a relationship between infant mortality and several of the maternal and infant factors studied when all births from 2010 to 2016 were analyzed. The odds of infant mortality was higher amongst mothers: ≤ 18 years of age (OR=0.84 95% CI [0.74, 0.96]), with no diploma or GED (OR=1.07 95% CI [1.00, 1.14]), without PNC (OR=1.12 95% CI [1.13, 1.27]), who had multiple terminations or losses (OR=1.23 955 CI [1.15, 1.31]), and were obese at delivery (OR=1.22 95% CI [1.11, 1.35]). The odds of infant mortality was higher amongst infants: ≤ 23 weeks gestation (OR=0.27 95% CI [0.22, 0.34]), weighing < 1000grams (OR=0.46 95% CI [0.39, 0.54]), and were identified as not breastfed at discharge (OR=1.72 95% CI [1.50, 1.99]). Key stakeholders working to improve infant mortality in Prince George’s County, Maryland can apply the results of this study to develop new public health programs, engage the community in prevention activities, and enhance current programmatic activities. Supporting non-Hispanic Black women of childbearing age and future generations through improved maternal and infant outcomes will be a platform for positive social change to be replicated.

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