Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Joseph Robare


Severe maternal morbidity (SMM) rates in Michigan have increased over the past 20 years and continue to affect racial and ethnic women disproportionately. Women experiencing health conditions that complicate pregnancy outcomes have a greater risk of having poor obstetric outcomes that result in a SMM event. To evaluate the distribution of women experiencing health conditions that complicate pregnancy and a SMM event, geographic information systems were utilized in this study. The purpose of this study was to depict trends in the prevalence of 4 health conditions and SMM among women hospitalized for obstetric delivery in Michigan from 2016–2017. The 4 health conditions associated with pregnancy complications were obesity, hypertension, mental health diagnosis, and diabetes. This study was supported by the socio-ecological model and the critical race framework that advance the idea that an individual’s health is a consequence of the environment, structural and intrapersonal factors, and the community where they live and seek healthcare services. A retrospective cohort analysis was conducted using the 2016–2017 State Inpatient Database, which is the largest database for delivery hospitalizations with race and ethnicity included. Logistical regression analysis indicated an association with geographic location and race and ethnicity, which were the sociodemographic predictors related to SMM risk. The analysis provided detailed information on the locations with the greatest need for more comprehensive maternal health interventions. This study contributes to social change by focusing on improving the health of women, who are of childbearing age, through equitable interventions that address disparities in SMM.