A new study published in the Proceedings of the National Academy of Sciences
has found that newborn Black babies are more likely to survive if delivered by Black doctors.
Researchers from George Mason University, the University of Minnesota and Harvard University used data from Florida’s Agency for Health Care Administration that included anonymized patient information on 1.8 million births between 1992 and 2015.
"Findings suggest that when Black newborns are cared for by Black physicians, the mortality penalty they suffer, as compared with White infants, is halved," the groundbreaking study said.
From the data, researchers found that Black newborns died at three times the rate of white newborns overall and that the numbers change significantly based on the race of the doctor delivering the child.
"Empirically, this study provides evidence that the Black-White newborn mortality gap is smaller when Black doctors provide care for Black newborns than when White doctors do—lending support to research that examines the importance of racial concordance in addressing health care disparities," the study said.
"Under the care of White physicians, Black newborns experience triple the in-hospital mortality rate of White infants. Under the care of White physicians, the White newborn mortality rate is 290 per 100,000 births. … Black newborn mortality is estimated at 894 per 100,000 births," the report continued. "The Physician Black coefficient implies no significant difference in mortality among White newborns cared for by Black vs. White physicians. In contrast, we observe a robust racial concordance benefit for Black newborns."
The findings from the study acknowledged that there is a large body of work dedicated to highlighting the survival rates between Black and white newborns during childbirth. But the study sought to, and ultimately did, prove that the rate of survival for Black infants relies heavily on the race of the doctor delivering them.
There is a 58% reduction in the racial mortality difference when comparing Black doctors to white doctors.
"Consistent with extant research, we see a large mortality penalty for Black newborns. In the sample, the raw mortality rate is 289 per 100,000 births among the 1.35 million white newborns and is 784 per 100,000 births among the 0.46 million Black newborns," the study said.
"Applying the sample mortality rate to the current number of Black newborns born in the United States implies ∼ 4,400 Black newborn deaths annually. If these newborns experienced the same mortality rate as White newborns, this number would fall by roughly 2,800 deaths annually," the study added.
For white infants, the race of the doctor made no difference, but having a Black doctor more than halved the likelihood of death for Black newborns. The mortality penalty for Black newborns, according to the study, is 39% when they are cared for by Black physicians rather than white physicians.
The researchers suggested that it was more likely that white physicians were "underperforming" during their treatment of Black infants as opposed to Black doctors "overperforming" specifically for Black infants. The data set showed that in hospital wards with many Black newborns, the children delivered by white doctors saw especially high mortality penalties.
The study goes on to offer some reasons as to why the numbers look the way they do. Doctors, researchers, activists and politicians have spent years decrying the mortality rate for Black mothers.
The CDC has reported that Black mothers in the United States die at three to four times the rate of white mothers. A Black woman is 243% more likely to die from pregnancy-related or childbirth-related causes than a white woman, NPR reported.
The report states that other studies have suggested inherent bias, even against children, is real. But what throws a wrench in that theory is that the mortality rates between white and Black children who are treated by Black doctors are not significantly different. It was only for white doctors that there was a noticeable difference in mortality rates.
"Extant research indicates that mortality across White and Black newborns is starkly different, suggesting Black newborns may have different needs and be more medically challenging to treat due to social risk factors and cumulative racial and socioeconomic disadvantages of Black pregnant women," the study posits as an explanation for the data.
"To the extent that physicians of a social outgroup are more likely to be aware of the challenges and issues that arise when treating their group, it stands to reason that these physicians may be more equipped to treat patients with complex needs," it added, noting that Black infants experience inferior health outcomes no matter who treats them.
According to the study, Black infants nationally are more than twice as likely to die within their first year compared to white newborns due mostly to higher rates of eclampsia and preeclampsia in Black mothers.
To deal with these disparities, the researchers suggest hospitals and other care organizations invest in racial bias training and examine how they may be participating in institutionalized racism.
"Reducing racial disparities in newborn mortality will also require raising awareness among physicians, nurses, and hospital administrators about the prevalence of racial and ethnic disparities, their effects, furthering diversity initiatives, and revisiting organizational routines in low performing hospitals. It is clear that patient-physician racial concordance provides benefits, particularly because of the inequities in clinical care outcomes experienced by Black patients," the study concludes.
"For families giving birth to a Black baby, the desire to minimize risk and seek care from a Black physician would be understandable. However, the disproportionately White physician workforce makes this untenable because there are too few Black physicians to service the entire population," the study said.
