Scoping Review of Black Maternal Morbidity and Mortality in the United States: The Role of Social Determinants of Health, Systemic Racism, and Implicit Bias

Background Evidence suggests that social determinants of health (SDoH), systemic racism, implicit biases in healthcare, and environmental factors are major contributors to the disproportionately high rates of maternal morbidity and mortality among Black women in the United States. In order to find themes, forms of evidence, and gaps in the research, this scoping review maps the literature. Methods Following PRISMA-ScR criteria and Arksey and O'Malley's methodology, we searched EBSCOhost, ProQuest, Google Scholar, and CDC databases for papers published between 2017 and 2024. The inclusion criteria were based on quantitative (e.g., vital statistics, cross-sectional) and qualitative (e.g., focus groups) evidence of Black maternal health inequalities in the US. The data were organized into themes such as SDoH, racism, segregation, and intersectionality, with narrative synthesis. Results Fifteen sources were included out of 150 initial records. Primary concerns include the intersectional effects of race and gender, systematic racism through redlining and segregation, implicit biases resulting in unequal care, and SDoH links to health issues including preeclampsia (59% of discrepancies). Longitudinal research on the long-term impacts of treatments has gaps. The results highlight the necessity of racial policies in order to correct injustices and enhance results. Bias training, legislative changes, and community-based interventions are among the recommendations and areas for future research. Potential publishing bias and restricted regional variety are among the limitations.