1) Are you planning to write a capstone paper or a Master’s essay?⃝ I am planning on writing a capstone paper on Maternal Mortality in Black American Women and their reproduction outcome. This paper will take the form of a systematic literature review.2) What are the specific research questions that your capstone will address?This research proposal seeks to address the following:A. What is the racial difference in the maternal mortality of African American women in comparison to White American females?B. How does the current health care system in the US contribute to the current racial disparities in maternal health as it relates to African American women and White American females?C. As a result of the COVID-19 pandemic, what are the contributing factors that results in the fatality of pregnant African American women in comparison to pregnant women of other ethnic group?D. What have been facilitators to providing quality maternal care among African American women that have improved health outcomes to this population?3) What is the relevance of your question to public health and what is already known about the topic? Consider the scope of the problem, prevalence of the exposure, and/or vulnerability of the population you plan to examine as well as what we already know about the relationships you are planning to evaluate for your project.In the United States each year about 700 women die during pregnancy or in the year after post-partum. Another 50,000 women each year experience severe pregnancy complication that can cause serious health issues for women’s health. Every pregnancy related death is tragic, especially because two to three are preventable. American Indian/Alaska Native and Black women are 2 to 3 times more likely to die from a pregnancy- related cause than white women.State Pregnancy Related Mortality Ratios (PRMR) was placed in three group’s high, medium and calculate by race/ethnicity for each group and even in states with the lowest PRMR the PRMR for black women was about 3 times as high as the PRMR for white women. Inequities increase by age, with the disparity for black and AI/AN women older than 30 years are 4 to 5 times than that of their white counterparts. The disparity ratio for black women compare to white ranged from 1.5 among the 20 years group to 4.3 for the 30-34 years age group.2007-2016 there hasn’t been any significant changes in the national data on pregnancy related mortality when it comes to eliminating racial disparities.Key Findings:• Overall PRMRs increased from 15.0 to 17.0 pregnancy- related deaths per 100, 000 births.• Non-Hispanic Black and non- Hispanic American Indian Alaska Native (AI/AN) women experienced higher PRMRs (40.8 and 29.7, respectively) than all other racial/ ethnic populations (White PRMR was 12.7, Asian/ Pacific Islander PRMR was 13.5 and Hispanic PRMR was 11.5). This was 3.2 and 2.3 times higher for White women and the gap widened among older age groups.• Women over the age of 30, PRMR for black abd AI/AN women was four to five times higher than it was for White women.• The PRMR for black women with at least a college degree was 5.2 times that of their white counterparts.Disparities were persistent and did not change significantly between 2007-2008 and 2015-2016.There are various factors of racial disparities that factors into health but first it has to be acknowledge racism is a critical public health concern. The health consequences of living in a racially stratified society are illustrated by a myriad of health outcomes that systematically occur along racial line such as disproportionately higher rates of infant mortality, shorter life expectancy for Blacks in comparison to white and death cost by heart disease and stroke.Black women are three times more likely to die from pregnancy related causes than white woman multiple factors contribute to these disparities, such as variation in quality healthcare, structural racism an implicit bias.Nine domain of structural racism that emerged were: negative societal view, housing, medical care, law enforcement, hidden resources, employment, education, community infrastructure and policing black families.Finding have shown that there is an interplay among structural racism and social determinants of health which negative impacts on black woman’s reproductive health.4) What are the gaps in the literature that your analysis will address?The numbers shown no real changes has been made in recent years. The multiple literature hasn’t shown any significant researches done on the issues, any policies been implemented that is sustainable. Or any significant training of healthcare/public health professionals with handling reproductive black women since they suffer from so much medical complication such a hypertension. There is not enough community based training been done in the community due to the limited resources, time, infrastructures and communication between reproductive women and their healthcare provider because often their complains go unheard or any major changes to correct this.5) How does your proposal address this gap?This review will survey existing literature on maternal mortality in black womanEnough is not been done to eliminate racial disparities in black maternal mortality.Enough training are not done to educate medical provider on dealing with black pregnant woman.Enough community engagement is not done with black reproductive women.This issue is not getting enough attention from the appropriate people.There are not enough policy changes been made in the human right framework that address black maternal and improving its outcome.Enough redirect and reframe of the conversation on black maternal is not been done.Enough researches are not been done on this issues.6) What data will you use to answer your question? Where/how are you going to obtain that data?The systematic literature review search will be completed over the spring 2022 semester focusing on maternal mortality in geographical locations in the United States. The data will be collected over online platform such as:CDCPubMedCuny One SearchGoogle ScholarNIH8) Do you have IRB approval and/or was your project deemed not human subjects research (HSR) by the SPH IRB?⃝ IRB deemed the project not HSR (please attach documentation)⃝ IRB approved the project (please attach IRB approval letter)⃝ IRB HSR determination form or application submitted but decision not yet made⃝ IRB HSR determination form or application not yet submitted (you must submit ASAP because you cannot register for capstone until you have done so)7) What variables will you use from the data?From the systematic review variables I will be using are: author, title, recommendations, measured used, main findings, ethnicity, settings- state, regions8) Who are the other people involved in the project (i.e. Investigators who obtained funding, others involved in data collection or cleaning and who might be involved in manuscript editing) who you will include as co-authors on any conference abstracts or journal publication that results from this capstone paper or Master’s essay?Answer: Jhenelle Duval-EditorCheryl Scott-Data collection11) If this study was grant funded, what is the funding statement you need to include at the end of the paper (you should ask the study PI for this statement). If you are using data not collected for a research project [e.g. publicly available data from CDC or DOH websites] this statement is not needed unless you or other co-authors have funding (e.g. salary support) you need to report.This systematic review is not funded.EPIDEMIOLOGY & BIOSTATISTCS MPH STUDENTS (Please complete the below additional questions):12) What are the specific hypotheses that you will be testing?13) For causal inference questions, what confounders will you address in your analysis?14) For causal inference questions, Please provide a Directed Acyclic Graph (DAG), theoretical model or other appropriate diagram depicting the hypothesized causal linkages among the variables you plan to include in your analysis. If a diagram is not appropriate, explain why.15) What statistical analyses are you going to conduct? Be specific. For example, describe the descriptive (e.g. frequencies and percents, means and SDs, chi-square test or t-test or Mann Whitney U test) and analytic statistics (e.g. crude and multivariable logistic, linear or negative binomial regression, meta-analysis or Mendelian randomization) you plan to conduct and how (e.g. put all hypothesized confounders in the final model, add interaction terms to the final model, etc.).
