Health disparities in infant mortality: Examining at-risk and low risk Black women

The purpose of this dissertation is to examine racial and socioeconomic disparities in birth outcomes and explore the role of stress in at-risk and lower risk Blacks. The analyses are based on data from the Linked Birth-Infant Death files from the National Center of Health Statistics (NCHS), the Fragile Families Study (FFS), and the National Survey of Family Growth (NSFG). The research hypothesis guiding this study is that Black women have higher IMRs because they experience stressors that negatively influence health birth outcomes. This dissertation includes five chapters. Chapter 1 is the introduction where the research questions are presented as well as an overview of the subsequent chapters. Chapter 2 is the literature review in which the theoretical framework is introduced and existing literature supporting each tenet of the theory. In this chapter, three widely used theoretical frameworks are explored, including the tenets of the theory, current literature using the theoretical frameworks and the relationship to other theories. A comprehensive revised theoretical model is presented. Chapter 3 is the methods. The methods include three aims: (1) explore the racial and socioeconomic trends in birth outcomes in the United States, (2) explore the role of stress using the FFS, and (3) explore the role of stress using the NSFG. Chapter 4 is the results. Our results confirm racial and socioeconomic disparities between Blacks and Whites. Blacks and Whites, regardless of at-risk or lower risk status, have different stress predictors for poor pregnancy outcomes. The results have many implications for the future, which are discussed in Chapter 5 of this dissertation.