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Association Between Health Insurance Status and Maternal Morbidity Among Women in Mississippi: Policy Implications /

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Association Between Health Insurance Status and Maternal Morbidity Among Women in Mississippi: Policy Implications // Jazmin Christina Adjei.
Author:	Adjei, Jazmin Christina,
Description:	1 electronic resource (113 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 86-05, Section: B.
Contained By:	Dissertations Abstracts International86-05B.
Subject:	Public health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=31564226
ISBN:	9798342746335

Association Between Health Insurance Status and Maternal Morbidity Among Women in Mississippi: Policy Implications /
Adjei, Jazmin Christina,

Association Between Health Insurance Status and Maternal Morbidity Among Women in Mississippi: Policy Implications /Jazmin Christina Adjei. - 1 electronic resource (113 pages)

Source: Dissertations Abstracts International, Volume: 86-05, Section: B.

Objective: This research study examines the association between health insurance status and maternal morbidity among women in Mississippi. Significant predictors of maternal morbidity were identified, and findings will inform policy implications for improving maternal health outcomes for women in Mississippi. The expected outcome of this research is to fill the literature and knowledge gaps by providing a comprehensive understanding of how health insurance status impacts maternal morbidity for women of reproductive age in Mississippi.Methods: A cross-sectional correlational research design used secondary, individual-level, de-identified data from the Centers for Disease Control and Prevention (CDC) Mississippi Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8, 2016-2021 questionnaire. A cross-sectional analysis was performed with maternal morbidity data and various predictor variables, including health insurance status, maternal age, race, income level, education level, smoking status, and alcohol use. The chi-square test of independence was conducted to detect significant statistical relationships between various health insurance statuses (i.e., Medicaid, Private Insurance, Work Insurance, No Insurance, etc.) and the presence or absence of various maternal morbidities (i.e., Gestational Diabetes, Hypertension, Sickle Cell, and Depression). Descriptive/bivariate analysis was also performed, and multivariate logistic regression analysis models assessed the associations between these predictors and the likelihood of experiencing maternal morbidity after adjusting for potential confounders. The data was analyzed using SPSS, an advanced statistical software suite developed for complex data analysis.Results: Findings revealed several significant predictors of maternal morbidity, including health insurance paid by parents, maternal age, income level, smoking status, and alcohol use, after adjusting for potential confounders. Women whose parents paid their health insurance had 45.5% decreased odds of experiencing maternal morbidity compared to those with no insurance (p = .034, Exp(B) = 0.545, 95% CI = 0.311, 0.956). Maternal age was also a significant predictor. As maternal age increased each year, the odds of experiencing maternal morbidity also increased by approximately 2.077% (p <.001, Exp(B) = 2.077, 95% CI = 1.343, 3.212). Income levels were a significant predictor, highlighting mothers in the Middle Class ($48,001-$85,000) and High Income (>$85,001) having 18.5% and 35.2% decreased odds of experiencing maternal morbidity, respectively (p = .054, Exp(B) = 0.815, 95% CI = 0.662, 1.004; p < .001, Exp(B) = 0.648, 95% CI = 0.502, 0.0837). Lastly, Smoking status (p = .008, Exp(B) = 1.284, 95% CI = 1.066, 1.5469) and Alcohol use (p = .007, Exp(B) = 1.168, 95% CI = 1.044, 1.307) were proven to pose as significant behavioral risk factors for increasing the likelihood of maternal morbidity by 1.284% and 1.168% respectively.Strengths and Limitations: This study has several strengths, including its comprehensive analysis of multiple predictors, focus on a high-risk population in Mississippi, and timely policy-relevant findings and implications for Mississippi. However, it also has limitations, such as the cross-sectional design, potential residual confounding, and reliance on self-reported data. Despite these limitations, the study offers valuable insights and actionable policy implications to address maternal morbidity in Mississippi.Conclusions: Similarly, evidence from the Mississippi State Department of Health highlights persistently rising rates of maternal morbidity and mortality cases within the state, which begs the question of what solutions can be implemented to render this effect powerless. By conducting this study, this dissertation assesses the association between health insurance status and maternal morbidity among women in Mississippi. This research further addresses an acute knowledge gap on the influence and implications of health policy initiatives that critically impact health outcomes among women of childbearing age. This population, for over a century, has been negatively and severely affected by maternal morbidity and mortality, especially Black women. The findings will inform healthcare providers and policymakers about the dire need for inclusive and immediate health policy reforms that place the welfare of historically marginalized communities primarily to progress maternal health equity for women in Mississippi and the broader United States.Policy Implications: Precursory findings underscore the importance of health insurance as a critical health policy intervention in mitigating adverse maternal morbidity risks in Mississippi, where women without adequate insurance coverage were more likely to experience maternal morbidity. The findings of this study underline the need for policymakers in Mississippi to (1) expand Medicaid coverage postpartum and bolster prenatal and postnatal care funding, (2) strengthen presumptive eligibility measures for pregnant women, (3) invest in accessible healthcare infrastructure, especially in rural communities, that addresses social determinants of health, (4) mandate continuous cultural competency and anti-racism training for healthcare providers, and (5) implement targeted interventions for vulnerable populations including smoking cessation and alcohol use public health campaigns and community-based interventions for pregnant women. These policy implications are necessary measures for reducing racial disparities and improving the maternal health outcomes for women in Mississippi, especially those most severely impacted by the social determinants of health living in underserved, marginalized, and high-risk communities.

English

ISBN: 9798342746335Subjects--Topical Terms:

560998
Public health.
Subjects--Index Terms:

Health insurance status

Association Between Health Insurance Status and Maternal Morbidity Among Women in Mississippi: Policy Implications /
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520 $a Objective: This research study examines the association between health insurance status and maternal morbidity among women in Mississippi. Significant predictors of maternal morbidity were identified, and findings will inform policy implications for improving maternal health outcomes for women in Mississippi. The expected outcome of this research is to fill the literature and knowledge gaps by providing a comprehensive understanding of how health insurance status impacts maternal morbidity for women of reproductive age in Mississippi.Methods: A cross-sectional correlational research design used secondary, individual-level, de-identified data from the Centers for Disease Control and Prevention (CDC) Mississippi Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8, 2016-2021 questionnaire. A cross-sectional analysis was performed with maternal morbidity data and various predictor variables, including health insurance status, maternal age, race, income level, education level, smoking status, and alcohol use. The chi-square test of independence was conducted to detect significant statistical relationships between various health insurance statuses (i.e., Medicaid, Private Insurance, Work Insurance, No Insurance, etc.) and the presence or absence of various maternal morbidities (i.e., Gestational Diabetes, Hypertension, Sickle Cell, and Depression). Descriptive/bivariate analysis was also performed, and multivariate logistic regression analysis models assessed the associations between these predictors and the likelihood of experiencing maternal morbidity after adjusting for potential confounders. The data was analyzed using SPSS, an advanced statistical software suite developed for complex data analysis.Results: Findings revealed several significant predictors of maternal morbidity, including health insurance paid by parents, maternal age, income level, smoking status, and alcohol use, after adjusting for potential confounders. Women whose parents paid their health insurance had 45.5% decreased odds of experiencing maternal morbidity compared to those with no insurance (p = .034, Exp(B) = 0.545, 95% CI = 0.311, 0.956). Maternal age was also a significant predictor. As maternal age increased each year, the odds of experiencing maternal morbidity also increased by approximately 2.077% (p <.001, Exp(B) = 2.077, 95% CI = 1.343, 3.212). Income levels were a significant predictor, highlighting mothers in the Middle Class ($48,001-$85,000) and High Income (>$85,001) having 18.5% and 35.2% decreased odds of experiencing maternal morbidity, respectively (p = .054, Exp(B) = 0.815, 95% CI = 0.662, 1.004; p < .001, Exp(B) = 0.648, 95% CI = 0.502, 0.0837). Lastly, Smoking status (p = .008, Exp(B) = 1.284, 95% CI = 1.066, 1.5469) and Alcohol use (p = .007, Exp(B) = 1.168, 95% CI = 1.044, 1.307) were proven to pose as significant behavioral risk factors for increasing the likelihood of maternal morbidity by 1.284% and 1.168% respectively.Strengths and Limitations: This study has several strengths, including its comprehensive analysis of multiple predictors, focus on a high-risk population in Mississippi, and timely policy-relevant findings and implications for Mississippi. However, it also has limitations, such as the cross-sectional design, potential residual confounding, and reliance on self-reported data. Despite these limitations, the study offers valuable insights and actionable policy implications to address maternal morbidity in Mississippi.Conclusions: Similarly, evidence from the Mississippi State Department of Health highlights persistently rising rates of maternal morbidity and mortality cases within the state, which begs the question of what solutions can be implemented to render this effect powerless. By conducting this study, this dissertation assesses the association between health insurance status and maternal morbidity among women in Mississippi. This research further addresses an acute knowledge gap on the influence and implications of health policy initiatives that critically impact health outcomes among women of childbearing age. This population, for over a century, has been negatively and severely affected by maternal morbidity and mortality, especially Black women. The findings will inform healthcare providers and policymakers about the dire need for inclusive and immediate health policy reforms that place the welfare of historically marginalized communities primarily to progress maternal health equity for women in Mississippi and the broader United States.Policy Implications: Precursory findings underscore the importance of health insurance as a critical health policy intervention in mitigating adverse maternal morbidity risks in Mississippi, where women without adequate insurance coverage were more likely to experience maternal morbidity. The findings of this study underline the need for policymakers in Mississippi to (1) expand Medicaid coverage postpartum and bolster prenatal and postnatal care funding, (2) strengthen presumptive eligibility measures for pregnant women, (3) invest in accessible healthcare infrastructure, especially in rural communities, that addresses social determinants of health, (4) mandate continuous cultural competency and anti-racism training for healthcare providers, and (5) implement targeted interventions for vulnerable populations including smoking cessation and alcohol use public health campaigns and community-based interventions for pregnant women. These policy implications are necessary measures for reducing racial disparities and improving the maternal health outcomes for women in Mississippi, especially those most severely impacted by the social determinants of health living in underserved, marginalized, and high-risk communities.
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