Accessibility Compliance
1
Date of Award
5-15-2026
Degree Type
Open Access Capstone
Degree Name
Master of Science in Nursing (MSN)
Department
Nursing
Keywords
maternal morbidity, SMM, community health worker
Abstract
Racial disparities in severe maternal morbidity (SMM) represent a persistent and preventable public health crisis in Massachusetts. Black women experience SMM at two to three times the rate of White women, disparities driven primarily by structural racism, fragmented perinatal care, and unaddressed social determinants of health rather than individual clinical risk. This systematic review examines the evidence supporting Community Health Worker (CHW) home visiting programs as a targeted intervention to reduce racial disparities in SMM among Black MassHealth enrollees, and evaluates the policy mechanisms necessary to sustain this intervention at scale. For this systematic review, peer-reviewed literature published between 2020 and 2025 was searched across PubMed, CINAHL, and Google Scholar using PRISMA methodology, resulting in six studies selected for final synthesis alongside Massachusetts Department of Public Health surveillance data and federal policy documents. Findings consistently demonstrate that CHW-led interventions improve first-trimester prenatal care initiation, increase postpartum follow-up attendance, support chronic disease management, and address social determinants that clinical providers cannot adequately reach within standard visit constraints. Despite this evidence, Massachusetts lacks standardized MassHealth reimbursement for CHW perinatal services, limiting sustainability and access for the highest-risk populations. Minnesota's Medicaid CHW reimbursement model offers a proven and directly applicable implementation pathway. This review recommends that Massachusetts establish standardized MassHealth reimbursement for CHW perinatal services, prioritize deployment in high-burden counties, and ensure cultural and linguistic concordance in CHW recruitment. Together, these recommendations would position Massachusetts to put its existing CHW infrastructure to work and achieve meaningful reductions in preventable maternal morbidity statewide.
Recommended Citation
Thorat, Priya, "Reducing Maternal Morbidity in Black Women in Massachusetts" (2026). Capstones. 18.
https://scholarworks.umb.edu/capstones/18
Comments
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