Date of Conferral

7-23-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Jamuir Robinson

Abstract

Maternal health disparities among homeless non-Hispanic Black women in Georgia represent a critical public health concern, driven by inequitable access to care and elevated risks of adverse pregnancy outcomes. This study examined how homelessness influences perinatal care utilization (timing and frequency of prenatal visits and postpartum checkups) and pregnancy complications (gestational diabetes, hypertension, and depression), and whether these associations differ by geographic context (urban versus rural). Grounded in the Social Determinants of Health framework, the study used a quantitative cross-sectional design, analyzing secondary data (n = 1,540; weighted ≈ 203,571) from Phase 8 (2017–2021) of the Pregnancy Risk Assessment Monitoring System. Analyses included complex samples logistic and general linear regression, controlling for maternal age, marital status, income, insurance status, and education, limited to non-Hispanic Black women aged 17–45 who gave birth in Georgia. Key findings revealed that geographic context moderated associations between homelessness and maternal outcomes: rural homelessness was linked to fewer prenatal visits, a higher risk of gestational diabetes, and increased odds of postpartum checkup attendance. Homelessness was also significantly associated with a greater risk of postpartum depression. Four field-based products were created: a policy brief, community health intervention plan, visual intervention framework, and fact sheet. The study concluded with recommendations for geographically tailored, equity-driven interventions. Findings may contribute to positive social change by informing public health strategies and policies addressing maternal health disparities among structurally vulnerable populations.

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