Date of Conferral

3-30-2026

Degree

Doctor of Public Health (DrPH)

School

Health Sciences

Advisor

Jennifer Gadarowski

Abstract

Surgical site infections (SSIs) remain one of the most frequent and preventable complications following abdominal hysterectomy. Existing literature has focused on clinical and procedural risk factors, while less is known about how social conditions shape surgical outcomes. This gap is especially concerning for women in New York State (NYS) where differences in income, marital status, primary payer, rurality, and county-level food insecurity may influence postoperative outcomes and subsequent care. The socioecological model provided the foundation for this retrospective cohort study by examining how social drivers of health (SDoH) are associated with SSI incidence following abdominal hysterectomy, and whether food insecurity contributes to infection risk. Secondary data were drawn from the 2022 NYS State Inpatient Database (SID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ) and linked county-level indicators from Feeding America’s Map the Meal Gap. After applying inclusion and exclusion criteria, the final sample included 3,897 patients, and descriptive and inferential analyses were used to characterize the cohort and estimate adjusted odds ratios for significant predictors of SSI. It was found that there was no significant association between the selected SDoH and food insecurity, and the incidence of SSI following abdominal hysterectomy. Findings from this study will advance understanding of how socioeconomic conditions intersect with surgical outcomes, by quantifying the relationship between selected SDoH and SSI risk, and supporting targeted interventions to reduce preventable postoperative complications among diverse communities across NYS.

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