HYPERTENSIVE DISORDERS OF PREGNANCY AND SOCIAL DETERMINANTS OF HEALTH IN MEMPHIS, TENNESSEE

This dissertation investigates the impact of social determinants of health (SDOH) on hypertensive disorders of pregnancy (HDP), with a focus on marginalized populations in Memphis, Tennessee. It highlights significant disparities in maternal and infant health outcomes, particularly among Black women who experience disproportionately high rates of obstetric complications. The research reveals that these disparities are not merely the result of individual risk factors but are deeply rooted in structural inequities, including historical injustices such as redlining, which persistently affect health across generations.

Through analytical methods including random forest and Bayesian network analysis, this study uncovers the complex interplay between neighborhood disadvantage, socioeconomic status, and racial segregation in shaping health outcomes. It identifies key SDOH—such as housing instability, employment privileges, and access to residential loans—as critical risk factors for HDP, suggesting that interventions targeting these social disparities could significantly improve maternal health. The findings also indicate that the COVID-19 pandemic exacerbated existing inequalities, intensifying the incidence of adverse pregnancy outcomes in already vulnerable communities.

Moreover, the dissertation challenges the conventional view of race as a biological risk factor for HDP, advocating for a nuanced understanding that considers the role of systemic racism and social context. By framing race as a social construct influenced by historical and contemporary factors, the research calls for a shift toward race-conscious medicine and policies that address the root causes of health disparities.

In conclusion, this study emphasizes the need for comprehensive strategies that incorporate SDOH into maternal health interventions. By addressing the multifaceted nature of health disparities and advocating for targeted community-level policies, it aims to foster equitable health outcomes for all pregnant individuals, particularly those from marginalized backgrounds. This research contributes to a growing body of literature that seeks to illuminate the critical role of social determinants in maternal health, ultimately informing public health approaches to reduce disparities in HDP.