Master's Project Title:

Association between Structural Racism and Maternal Morbidity in the Twin Cities Metro

MCH Student:

Asha Hassan

Date of Defense:

November 27, 2018


Research evidence has consistently shown that the burden for both maternal mortality and morbidity disproportionately affects Black mothers and families. To better understand the complex reasons for these disparities, public health researchers have shifted focus from simply exploring the existence of inequities and interpersonal racial discrimination to measuring how structural racism and institutional barriers may lead to or exacerbate the problem. In this paper, we utilized electronic medical records of Fairview Health System to identify singleton births from Black and white mothers residing in the Twin-Cities metro and giving birth in the year 2016 (n=5,248). Descriptive characteristics of mothers was analyzed and stratified by race and ethnicity. Additionally, generalized estimate equations (GEE) models were implemented to counter the confounding effect of county-level factors. The results show that African American mothers had the greatest odds of maternal morbidity, followed by white mothers, and African mothers with the smallest odds.  Mothers who are African American are 1.876 times the odds of developing a chronic disease compared to non-African American mothers among 2016 Fairview System Patients. These results support the need for public health departments, academic researchers, and non-profits should consider ethnicity and community indicators more closely in the distribution of resources and services to better alleviate maternal mortality and morbidity concerns.