TiTi San
Fairbanks School of Public Health
PBHL-E330: Evidence - Based Writing for Public Health
Evidence-Based Writing Issue Brief
PBHL-E330, Evidence-Based Writing for Public Health, focuses on using credible evidence to develop public health interventions and communicate effectively with diverse audiences. The course emphasizes locating, generating, adapting, implementing, and evaluating public health messages. Students practice professional, technical, and persuasive writing for stakeholders and create literature reviews on public health topics.
The following work focuses on maternal and child health in Marion County, Indiana, with an emphasis on disparities in prenatal care, infant mortality, and birth outcomes across racial, ethnic, and socioeconomic groups. The study uses secondary data sources, including the Indiana Department of Health, Marion County Public Health Department, and hospital records, to provide a snapshot of health inequities and potential intervention points.
Evidence-Based Writing for Public Health
Maternal And Child Health in Marion County, Indiana
Key Findings
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Infant Mortality & Preterm Birth: Non-Hispanic Black infants in Marion County had an infant mortality rate of 11.2 per 1,000 live births—more than double that of White infants. Preterm births contribute heavily to these deaths.
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Prenatal Care Access: 37% of mothers did not receive early prenatal care, with the highest rates among Hispanic (54%) and non-Hispanic Black (47%) mothers.
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Socioeconomic & Geographic Disparities: Medicaid recipients, low-income mothers, and residents of zip codes 46241 and 46219 had higher infant mortality rates.
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Evidence-Based Interventions: Access to doulas, midwives, extended postpartum Medicaid, and coordinated prenatal care improves outcomes and reduces disparities.
Barriers to Early Prenatal Care and Health Inequities in Marion County
Access to prenatal care is a critical component of supporting healthy pregnancies. In Marion County, in 2023, 37% of mothers did not receive prenatal care in the first trimester, (Indiana Department of Health, 2024b). Among these, Hispanic mothers were the most affected, with 54% not receiving early care, followed by non-Hispanic Black mothers at 47%, (IDOH, 2024b). Lack of early prenatal care increases the risk of preterm birth, low birth weight, and infant mortality. Preterm birth alone accounts for nearly 70% of neonatal deaths in Marion County, (Marion County Public Health Department, 2014). These statistics highlight that a significant portion of mothers are not receiving the care necessary for healthy pregnancies, creating disparities in birth outcomes based on race, ethnicity, and socioeconomic status.
Premature births and low birth weight remain a significant challenge in Marion County. In 2022, preterm births accounted for 12.3% of all deliveries, with rates highest among non-Hispanic Black infants, (IDOH, 2024b). Babies born prematurely often require intensive medical care, including extended hospital stays in neonatal intensive care units (NICUs), which can be both emotionally and financially stressful for families. The cost of caring for a preterm infant in the first year can exceed $50,000, (March of Dimes, 2023).
Families with lower socioeconomic status are disproportionately affected. Limited resources, lack of nearby specialized care, and reliance on Medicaid increase the burden on already vulnerable households. Additionally, disparities in access to early interventions and follow-up care mean that some infants may face long-term health and developmental challenges, (Marion County Public Health Department, 2014). Without targeted support and community-based programs, these inequities are likely to persist, placing both infants and families at higher risk for adverse outcomes.
Postpartum care and home visiting services are essential for supporting both mothers and infants after birth. In Marion County, many mothers do not receive adequate postpartum follow-up, as standard Medicaid coverage ends just 60 days after delivery, (Katon et al., 2021). Limited access to postpartum care increases the risk of postpartum depression, uncontrolled chronic conditions, and poor infant growth and development. Home visiting programs, like Healthy Start, can improve outcomes by providing guidance on infant care, nutrition, and connecting families to resources, but not all eligible families are able to access these services, (MCPHD, 2023).
In Marion County, low-income families and communities of color face disproportionate challenges in accessing adequate prenatal and postpartum care. For example, 47% of non-Hispanic Black mothers and 54% of Hispanic mothers did not receive prenatal care in the first trimester in 2023, (IDOH, 2024b). Limited access to care can lead to preterm birth, low birth weight, and complications during delivery. Babies born preterm or with low birth weight often require extended hospital stays and specialized care, which can cost families thousands of dollars in medical bills, (March of Dimes, 2023).
Limited access to early prenatal care in Marion County has serious and lasting consequences for both mothers and infants. Mothers who do not receive prenatal care in the first trimester are more likely to experience pregnancy complications, while infants face increased risks of preterm birth and low birth weight, which often require costly medical interventions and extended hospital stays (March of Dimes, 2023).
What I learned
I chose this assignment because it represents one of the most meaningful and challenging projects I completed in this course. It required me to spend a significant amount of time researching credible, evidence-based sources and analyzing local data to understand how access to prenatal care affects maternal and infant health outcomes in Marion County. This project pushed me to move beyond simply summarizing information and instead critically connect social determinants of health, health equity, and real-world consequences for families in my community.
This assignment allowed me to strengthen my professional writing skills by translating complex public health evidence into clear, accessible language for a general audience. It helped me build confidence in my ability to communicate important health issues in a way that is both informative and engaging. I am particularly proud of this work because it reflects my growth as a public health student and highlights skills—such as evidence-based analysis, clear communication, and community-focused thinking—that will be valuable in my future career.