Physician–patient racial concordance and disparities in birthing mortality for newborns

/1913405117

  • @unagi
    unagi CC BY-NC
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    @arno
    @kassem
    2

    Black babies more likely to survive when cared for by black doctors – US study | World news | The Guardian
    ▻https://www.theguardian.com/world/2020/aug/17/black-babies-survival-black-doctors-study
    ▻https://i.guim.co.uk/img/media/b210cd886513b61c4ee3d5b623310de9b1bc4964/0_457_1412_846/master/1412.jpg?width=1200&height=630&quality=85&auto=format&fit=crop&overlay-ali

    Black babies have a greater chance of survival when the hospital doctor in charge of their care is also black, according to a new study.

    In the US, babies of colour face starkly worse clinical outcomes than white newborns.

    Earlier research from the Centers for Disease Control and Prevention (CDC) published last year shows that black babies are more than twice as likely to die before reaching their first birthday than white babies, regardless of the mother’s income or education level.

    While infant mortality has fallen overall in the past century thanks to improvements in hygiene, nutrition and healthcare, the black-white disparity has grown.

    Multiple interrelated factors which contribute to these disparities include structural and societal racism, toxic stress and cumulative socioeconomic disadvantages.

    The new study published in the Proceedings of the National Academy of Sciences suggests the race of the attending doctor also plays an important role.

    Researchers reviewed 1.8m hospital birth records in Florida from 1992 to 2015, and established the race of the doctor in charge of each newborn’s care.

    When cared for by white doctors, black babies are about three times more likely to die in the hospital than white newborns.

    This disparity halves when black babies are cared for by a black doctor.

    unagi CC BY-NC
    • @simplicissimus
      Simplicissimus

      article original #paywall

      Physician–patient racial concordance and disparities in birthing mortality for newborns | PNAS
      ▻https://www.pnas.org/content/early/2020/08/12/1913405117

      Significance
      A large body of work highlights disparities in survival rates across Black and White newborns during childbirth. We posit that these differences may be ameliorated by racial concordance between the physician and newborn patient. Findings suggest that when Black newborns are cared for by Black physicians, the mortality penalty they suffer, as compared with White infants, is halved. Strikingly, these effects appear to manifest more strongly in more complicated cases, and when hospitals deliver more Black newborns. No such concordance effect is found among birthing mothers.

      Abstract
      Recent work has emphasized the benefits of patient–physician concordance on clinical care outcomes for underrepresented minorities, arguing it can ameliorate outgroup biases, boost communication, and increase trust. We explore concordance in a setting where racial disparities are particularly severe: childbirth. In the United States, Black newborns die at three times the rate of White newborns. Results examining 1.8 million hospital births in the state of Florida between 1992 and 2015 suggest that newborn–physician racial concordance is associated with a significant improvement in mortality for Black infants. Results further suggest that these benefits manifest during more challenging births and in hospitals that deliver more Black babies. We find no significant improvement in maternal mortality when birthing mothers share race with their physician.

      Simplicissimus
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