Date of Graduation

5-2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Public Policy (PhD)

Degree Level

Graduate

Department

Public Policy

Advisor/Mentor

Kerr, Brinck III

Committee Member

Gonzales, Dana

Second Committee Member

McGehee, Mary

Keywords

Social sciences; Health and environmental sciences; Education; African American; Infant mortality; Low birthweight; Preterm birth

Abstract

This population-based study evaluates the impact that psychoSocial stress has on adverse birth outcomes of low birth weight (LBW) and pre-term birth (PTB) among African American mothers in Arkansas. The relationship between adverse birth outcomes in African American women and stress in comparison to non-Hispanic Caucasian women data was evaluated from the Pregnancy Risk Assessment Monitoring System (PRAMS) quantitative survey. Data from 2005 through 2010 was reviewed to show the impact that psychoSocial stress has on adverse birth outcomes. The study sample was comprised of 14,196 participants.

Ethnic group status is the key maternal-level independent variable in this study. Of the 14,196 participants, 10,712 (75.5%) were White/Caucasian and 3,484 (24.5%) were Black/African American. In addition to examining the impacts of psychoSocial stress, other key independent variables such as cigarette and alcohol use, obesity, lack of prenatal care, marital status, yearly income, and level of education were analyzed through the use of both descriptive and inferential statistics.

The findings of this study support the hypothesis in the bivariate contex that mothers who had higher levels of stress were more likely to have LBW infants as compared to mothers who had lower levels of stress. Mothers who experienced higher numbers of stressors in the past 12 months before their infants were born were significantly more likely to have LBW infants compared to mothers who experienced fewer numbers of stressors in the 12 months before their infants were born. With regard to maternal stress and gestational age status of the infant, results were not significant and did not support the hypothesis. Mothers who had experienced higher numbers of stressors in the 12 months before their infants were born were not significantly more likely to have PTB compared to mothers who experienced fewer numbers of stressors in the past 12 months before their infants were born.

The findings of this study can provide insights for new and innovative healthcare strategies, interventions and support healthcare providers and policy makers in building comprehensive programs and policies aimed at reducing PTB and LBW among African American mothers.

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