Date of Award

Spring 2022

Degree Type


Director of Thesis

Dr. Myriam Torres

First Reader

Dr. Edena Guimaraes

Second Reader

Dr. Edena Guimaraes


The United States maintains disproportionately high infant mortality rates compared to other developed countries globally (Arima et al., 2009). High barriers to accessing affordable reproductive health care are key drivers behind this phenomenon, with minority ethnic and racial populations in the Deep South region of the United States facing these barriers at much higher rates than their white counterparts (Davis et al., 2020). Factors such as low levels of education, low use of private health insurance, and low participation in prenatal care generally correlate with adverse birth outcomes. Both Hispanic and Black mothers experience these factors at similarly low levels, and while this correlates with high infant mortality rates within the Black population, Hispanic mothers in South Carolina achieve positive birth outcomes at rates equal to that of their white counterparts, mothers who have higher rates of private insurance use, participate in more prenatal care visits, and have higher education levels. This is a manifestation of the Hispanic Health Paradox, wherein limited access to quality resources is paired with positive health outcomes (Roy et al., 2020). Strong familial and community-based support systems that discourage unhealthy behaviors and lifestyles that exist within Hispanic cultures and supplement formal medicine can begin to explain this paradox (Scribner, 1996). However, the positive health outcomes of this paradox diminish over time as Hispanic populations become assimilated to United States cultures and behaviors (Scribner, 1996). This creates a need within the country’s health care system to implement community-based health care programs that decrease social and cultural distance between doctors and their patients of color and are tailored to the circumstances of minority populations. This study provides evidence that supports the existence of the Hispanic Health Paradox in maternal and infant health, and overall aims to understand the relationships between education, payment method for deliveries, adequacy of prenatal care, tobacco use, and obesity during pregnancy and the discrepancies within these factors and birth outcomes that exist between racial and ethnic groups in South Carolina, with a specific focus on the Hispanic populations.

First Page


Last Page



© 2022, Reilly Leaver