The purpose of this assignment is to describe and explore what is known about your selected public health challenge (i.e., “wicked problem”) and the system of focus. The title of the document is your system statement, “The System to Reduce African-American Maternal Mortality Rates in Harris County, TX” .The document should be no more than 1000 words (four pages doubled spaced) and include the items listed below. Students should use and appropriately cite evidence (from the popular press and/or research literature) to support and explain the elements of your issue brief. As a reminder, use the inverted triangle approach to link the broad description of the public health issue to a more focused exploration of it in a specific geographic area and among a specific population of interest.  

1. A description of the health consequences of the public health “wicked problem”: 

– What are the short-term and long-term impacts of the issue on health outcomes, including health outcomes strongly associated with this public health issue? 

– What are the root causes (e.g., upstream social determinants of health factors) that play a causal role in the public health issue in your area of concern? 

2. A comparative assessment of the public health magnitude of the health-related issue or system of concern within the last three years, as well as the geographic and sociodemographic patterns: 

– How do the measures of occurrence (e.g., increasing or decreasing disease incidence/prevalence, risk) of the public health-related issue compare across the local, state, and federal levels? 

– Which parts of the country, state, and area of focus are most impacted? Which populations/sub-populations are most impacted? 

3. A description of past approaches to the public health issue/system of focus: 

– How do different community partners view the public health issue? What underlying assumptions are prevalent? 

– How have organizations/key community partners attempted to solve this public health issue in the past? What systems thinking insights have emerged from past attempts to intervene (i.e., examples of worse before better behavior or “solutions” that address symptoms rather than the underlying problem)? 


– Given the evidence that is presented in this document, how would you characterize the public health concern and associated health outcomes within your area of concern today? 

– How could addressing the public health-related issue or system improve the area of concern or other systems? 

Expert Solution Preview


The public health challenge that will be addressed in this assignment is the high rates of African-American maternal mortality in Harris County, TX. This assignment aims to explore and describe the health consequences of this “wicked problem” and provide a comparative assessment of its magnitude within the last three years. Additionally, past approaches to addressing this issue and the potential for improvement will be discussed.

1. Description of the health consequences of the public health “wicked problem”:

The short-term impacts of African-American maternal mortality rates in Harris County are alarming. Pregnant women and new mothers within this population face an increased risk of severe complications, such as postpartum hemorrhage, preeclampsia, and infection. These complications can lead to poor health outcomes not only for the mother but also for their newborns. In extreme cases, maternal mortality occurs, leading to the loss of life.

On a long-term basis, the consequences extend beyond individual health outcomes and have profound effects on the community. The loss of a mother not only impacts the immediate family but also has significant implications for the emotional and social well-being of the child. Furthermore, maternal mortality rates contribute to the widening health disparities among different racial and ethnic groups, perpetuating inequalities in healthcare access and outcomes.

The root causes of African-American maternal mortality rates in Harris County can be traced back to upstream social determinants of health. Factors such as socioeconomic status, limited access to quality healthcare, racial bias and discrimination in healthcare settings, and inadequate prenatal care contribute to these disparities. Structural racism also plays a significant role in perpetuating these inequities, as African American individuals often face systemic barriers that prevent them from receiving adequate healthcare.

2. Comparative assessment of the public health magnitude of the health-related issue:

When comparing the occurrence of African-American maternal mortality rates across different levels, it is crucial to analyze local, state, and federal data. In Harris County, within the last three years, there has been a concerning increase in maternal mortality rates among African American women. This trend is also observed at the state and national level, indicating a systemic problem that requires urgent attention.

Geographically, Harris County stands out as one of the areas most impacted by high rates of African-American maternal mortality. Within the state of Texas, there are significant disparities, with Harris County having one of the highest rates. Nationally, African American women face disproportionately higher rates compared to their counterparts from other racial and ethnic groups.

When examining sociodemographic patterns, it becomes apparent that African American women are the most impacted population group. This disparity is further exacerbated when considering sub-populations within this group, such as those with lower socioeconomic status or residing in disadvantaged neighborhoods.

3. Description of past approaches to the public health issue/system of focus:

The public health issue of African-American maternal mortality has been viewed differently by community partners. Some partners may view it as a consequence of individual choices and behaviors, while others recognize the influence of broader social determinants. The prevalent assumption is that adequate prenatal care and individual health behaviors alone can address this issue, disregarding the systemic factors and structural racism that underlie these disparities.

In the past, organizations and key community partners have attempted to solve this issue through interventions focused on improving access to prenatal care and maternal health education. However, these approaches often fall short of addressing the root causes and fail to address the systemic issues contributing to the problem. Systems thinking insights have emerged from past attempts, highlighting the need for comprehensive interventions that address the underlying social determinants of health and challenge structural inequities.

4. Conclusion:

The evidence presented in this assignment characterizes the African-American maternal mortality rates in Harris County as a critical public health concern. The issue is deeply rooted in upstream social determinants of health, perpetuated by systemic barriers and structural racism. Addressing this public health-related issue has the potential to significantly improve both the specific area of concern, Harris County, and other systems. By implementing comprehensive interventions that tackle the social determinants of health, ensure equitable access to quality healthcare, and challenge structural racism, positive outcomes can be achieved, leading to a decrease in African-American maternal mortality rates and improvements in overall health outcomes.