Not Biological, But Built: Structural and Metabolic Pathways Driving Black Maternal Health Disparities in the United States
Year: 2026
Type: dissertation
Abstract: Black infants in the United States are more than twice as likely to die before their first birthday than white infants, a disparity often attributed to genetics, behavior, or individual health choices. However, this idea is challenged by a key contradiction: African immigrant women consistently experience better birth outcomes than U.S.-born Black women despite being similarly racialized. This thesis investigates the origins of this reproductive advantage and the factors contributing to its decline over time. By drawing on epidemiological data, metabolic health research, and literature on African diasporic healing traditions, it argues that the “healthy immigrant effect” is not biological, but structurally and culturally produced. Protective dietary practices and culturally grounded models of care initially support favorable outcomes, but these protections erode with prolonged exposure to U.S. systems of racialized medicine, nutritional inequity, and chronic stress. To address these disparities, this study proposes the Integrative Reproductive Justice Care Model (IRJCM), a community based intervention emphasizing early metabolic screening, culturally responsive nutrition, and the reintegration of community birthworkers into prenatal care. By reframing Black maternal health disparities as socially produced rather than biologically inevitable, this thesis advances a reproductive justice framework that centers metabolic health, nutrition justice, and cultural knowledge as essential to equitable maternal care.
Author: Umegboh, Alexandra I
Institution: Claremont McKenna College
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7162821206