Poor maternal and infant health outcomes are long-standing public health problems particularly in rural, low-income communities of color. Sustainable improvements are needed 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, multisectoral 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.