Abstract
Unintended pregnancies and poor maternal and infant health outcomes are long-standing public
health problems particularly in rural, low-income communities of color. The recent SCOTUS
decision to reverse Roe v. Wade is expected to significantly exacerbate this issue unless
meaningful, sustainable improvements can be made to address structural barriers and policies
which have trapped marginalized populations in generational cycles of insufficient access to care
and high rates of maternal and infant mortality and morbidity. This community-led, multi-
sectoral partnership seeks to jointly conduct a community assessment in five rural impoverished
counties of the Mississippi Delta, to identify the structural factors that contribute to these
negative outcomes, Subsequently we will then develop, implement and evaluate a structural
intervention research strategy that will support sustainable health equity improvements in these
marginalized communities. Delta Health Alliance, the largest community-based non-profit in
Mississippi, has developed this study in partnership with the Center for Community Research
and Evaluation, building upon our eight years of experience working together on large and small
health and community-engaged research encompassing the full spectrum of qualitative and
quantitative methods on projects pertaining to behavioral health, chronic disease, maternal and
infant home visitation, nutrition, COVID-19 vaccinations, and teenage pregnancy. This effort is
joined by a wide range of partners including local practitioners, social service providers, business
leaders, policy advocates, members of faith-based communities, and members of a regional
advisory group consisting of representatives of our target population – to capture and directly
address the concerns of all parties of interest.