Semester

Spring

Date of Graduation

2022

Document Type

Thesis

Degree Type

MA

College

Eberly College of Arts and Sciences

Department

Geology and Geography

Committee Chair

Jamison Conley

Committee Co-Chair

Aaron Maxwell

Committee Member

Aaron Maxwell

Committee Member

Brian Hendricks

Abstract

Maternal-related morbidity rates in the United States have risen almost three fold since the early 1990’s. Issues related to rurality, socioeconomic disparities, and pre-existing health conditions increase the risk of poor pregnancy outcomes and introduce barriers to accessing advanced maternal health care. West Virginia (WV) has higher maternal morbidity rates than many other states in the United States (US), and is considered to be driven by all 55 counties being classified as Appalachian, possessing the highest prenatal smoking rate in the US, and having disparities in access to health care. Despite this, no previous studies have evaluated maternal morbidity in West Virginia. In this analysis, severe maternal morbidity (SMM) rates and its relationship with county-level covariates, including socioeconomic, demographic, and maternal behavior characteristics, and spatial access to health care sites are explored using morbidity cases in WV from 2014 to 2018. Moran’s I, Local Moran’s I, and drive time to maternal health care sites are in the analysis to explore spatial patterns of SMM and access to maternal care. Exploratory spatial data analysis (ESDA) revealed counties in the southern and eastern parts of the state experience higher maternal morbidity rates compared to the rest of the counties. OLS modelling identified the percent of pregnant African American women and the percent of women with more than 14 prenatal visits as the only two variables with a significant relationship to SMM. This suggests an increase in SMM in counties with a higher percent of pregnant African American women and women who attend fewer than 14 visits. Maternal health care sites were found to not be spatially accessible by everyone in the state and many areas in WV had no maternal sites within 30 minutes. Highlighting counties in West Virginia that have higher rates of SMM and lowered access to health care can support efforts on increasing access to maternal-related health care by identifying where maternal health care is needed.

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