"Impact of Social Determinants of Health on Preterm Births among Black " by TaShara Coakley

Date of Conferral

1-27-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Nicoletta Alexander

Abstract

Reducing preterm birth (PTB) in Black women is a public health priority. The purpose of this quantitative, cross-sectional study was to analyze the association between selected Social Determinants of Health (SDoH) and PTB types, both spontaneous and provider-initiated in Black women using the SDoH framework. A logistic regression analysis used secondary data from the 2018 Natality Public Use File. In the adjusted models, higher paternal education, college degree or higher (OR = .791, 95% CI [.637, .982]) was associated with reduced odds of provider-initiated PTB. Fewer prenatal visits, seven to eleven visits OR = 2.301 (95% CI [2.034, 2.601]) and six or fewer visits OR = 4.706 (95% CI [4.070, 5.443]) were associated with increased odds of provider-initiated PTB. Prepregnancy diabetes OR = 4.135 (95% CI [3.105, 5.506]) and prepregnancy hypertension OR = 3.758 (95% CI [3.103, 4.552]) were associated with increased odds of provider-initiated PTB. Higher maternal and paternal education were associated with decreased odds of spontaneous PTB with an OR = 0.810 (95% CI [.716, .917]) for mothers with a college degree or higher compared to those with less than a high school education. Similarly, fathers with a college degree compared to those with less than a high school education there was a decreased odds of spontaneous PTB, OR = .800 (95% [.712, .899]). Fewer prenatal care visits six or fewer, OR = 9.273 (95% CI [8.565, 10.040]), prepregnancy diabetes, OR = 3.243 (95% CI [2.649, 3.970]), and prepregnancy hypertension, OR = 2.409 (95% CI [2.106, 2.756]), were associated with increased odds of spontaneous PTB. To promote positive social change, prioritize prenatal care, SDoH, and include fathers in prenatal care to support maternal and infant health.

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