Mortality rate for Black babies is cut dramatically when they're delivered by Black doctors

[WhiskeyGrinder]

https://www.washingtonpost.com/health/black-baby-death-rate-cut-by-black-doctors/2021/01/08/e9f0f850-238a-11eb-952e-0c475972cfc0_story.html

In an effort to find some of the reasons behind the high death rates, Hardeman, an associate professor at the University of Minnesota School of Public Health, and three other researchers combed through the records of 1.8 million Florida hospital births between 1992 and 2015 looking for clues.

They found a tantalizing statistic. Although Black newborns are three times as likely to die as White newborns, when Black babies are delivered by Black doctors, their mortality rate is cut in half.

"Strikingly, these effects appear to manifest more strongly in more complicated cases," the researchers wrote, "and when hospitals deliver more Black newborns." They found no similar relationship between White doctors and White births. Nor did they find a difference in maternal death rates when the doctor's race was the same as the patient's.

(snip)

“Key open questions include the following: 1) whether physician race proxies for differences in physician practice behavior, 2) if so, which practices, and 3) what actions can be taken by policymakers, administrators, and physicians to ensure that all newborns receive optimal care,” they wrote. “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.”

[txwhitedove]

1. OMG...

[Demovictory9]

2. k&r

[Phoenix61]

3. Wonder if it has to do with pre-natal care?

Maybe AA Ob/Gyns are better at listening and communicating to their AA mothers than white doctors.

[pat_k]

5. Perhaps. However...

... the fact the effect is more pronounced in more complex deliveries seems to speak to the idea that white doctors are just more willing to go the "extra mile" when the patient is white.

Racial bias is deeply ingrained in the American mind -- all American minds. Like it or not, we have all been steeped in racial stereotypes that add up to some degree of "black lives don't matter."

Highly recommend:

White Fragility

How to Be an Anti-Racist

[Phoenix61]

7. I was thinking about the AA female doctor who

died from covid. She wasn’t taken seriously when she told her health care providers how she was feeling. If a doctor can’t get other doctors to listen that doesn’t bode well for a birthing mom. If the doctor who is delivering her baby won’t listen to her I can see how things could go south quickly.

[pat_k]

8. Makes perfect sense.

[pat_k]

4. Wow

Racial bias is incredibly insidious and deeply ingrained in the American mind. White doctors -- probably even very well-meaning white doctors -- are just more willing to go the "extra mile" when the patient is white. White lives do "matter" more. The fact the effect is more pronounced in complex cases seems to speak to that.

Addressing educational inequality requires programs to recruit and train more black teachers. (Outcomes for black kids are likewise far better with black teachers.) In addition to universal health care, addressing health care inequality will require programs to train and recruit more black doctors.

Basically, if we want to improve outcomes for black students, employees, communities policed, whatever, we need A LOT need more black people in charge.

I guess it really isn't rocket science.

Creating the political will to implement well-funded programs to get there, that's our collective challenge.

How to be an Anti-Racist. Ibram X. Kendi

[mopinko]

6. possible explanation

w newborns, the tone of the skin is very important. any tint of blue calls for urgent intervention.
if you arent used to looking at black babies, and you dont have perfect color vision, you could miss a vital clue.
the bit about- 'or delivered a lot of black babies' jumped out at me.

[electric_blue68]

15. Woah...

scary but a sensible observation. Wow.

[angstlessk]

16. Does that mean black doctors have better visual acuity?

Maybe white docs aren't taught the correct way to see distress in black babies/

[mopinko]

17. not necessarily. they're just used to it. apgar scores are super important.

i'm a tetrachrome. i can tell 2 colors apart that are almost indistinguishable to most ppl.
that's why it jumped out at me.

[ismnotwasm]

9. Jesus

Terrifying

[uponit7771]

10. omfg

[no_hypocrisy]

11. Meaning White Privilege starts at Day One (or less)

[Tom Rinaldo]

12. This is DEEPLY disturbing n/t

[Hortensis]

13. I'm questioning what those raw numbers seem to suggest,

that twice as many babies die when delivered by white doctors. Because the babies are black and the care white.

What is the correlation between this and numbers of black women who establish early good prenatal care with obstetricians and those who do not? The stats likely did not allow that analysis. In general I would assume those who do would choose a good OB recommended by friends and family and that black women would have some preference for black OBs.

Those who are able to choose and have good care tend to fall on the "privileged" side of the divide between privileged and underprivileged. No need to assume, we know.

We also know underprivileged people tend to be underprivileged in many ways and are more likely to have health problems in general, such as being unable to afford meds and to have more, and more inadequately controlled, medical conditions during the childbearing years.

I'm further assuming there are far more white OBs than black. And that black women who did not establish with an OB of their choice and sought care later, often at delivery, are far more likely to be delivered by white OBs because of that.

I'm also assuming that better, earlier prenatal care is more likely to be established for higher risk pregnancies, i.e., those "more complicated cases."

Anything else? Oh, poverty. Keep everything else the same but change these women to white, and I'm guessing the raw stats would be relatively similar, if not the same (as they should be). Poverty is not just a leading cause of premature death, it also correlates extremely strongly with institutionalized discrimination. I.e., what we all know exists -- lower standards of care for its designated victims.

[WhiskeyGrinder]

14. From the article:

Historically, Black maternal health has always been concerning, with Black women four to five times more likely to die during pregnancy and childbirth than White women, regardless of income, education or lifestyle. A Black woman does not have to be poor for her life or her baby’s life to be at stake.

[Hortensis]

19. 4-5 times more regardless of income, education or lifestyle?

Doesn't that raise a "wait a second" alarm right there?

Are we talking only American women here? If this is a planetwide phenomenon, shouldn't that be stated up top?

The implication taken is that no matter how wealthy a family she might be born into and be, how highly educated, or how healthy her lifestyle, a black AMERICAN woman is still 4-5 times more likely to die than the average white AMERICAN woman, including all the poor white women, uninsured white women, stupid white women, obese white women, drug-addicted white women.

And remember, the average white woman didn't have $400 stashed away for emergency expenses, like an uninsured pregnancy, before the pandemic.

I'm prepared to believe that black women die in higher numbers because of both institutional discrimination and what would seemingly have to be biologic-genetic factors or ? if income, education, and lifestyle are all irrelevant (!), but not in these numbers.

I'm just saying, don't swallow without chewing first. =

[WhiskeyGrinder]

20. "Don't just swallow this stuff."

What stuff? The actual fact that our healthcare system is racist, because we live in a white supremacy?

[angstlessk]

23. I will tell you what, my experience as a white woman...

who had gall stones from age 17, misdiagnosed by every white doctor, was finally relieved because of a black doctor.

You will never tell me black doctors do not care MORE for women than white doctors.

White doctors are focused on white men!

[mopinko]

18. color vision.

not being used to seeing the hues in black skin.
even pulse ox meters dont work as well on black skin.

i'm a tetrachrome. i can see color better than most ppl. this jumps put at me.
esp newborns. apgar scores rule newborn assessment. if your eyes arent tuned to it, most ppl just, physically, cant see it.

[tonedevil]

21. What about the idea...

that white doctors don't think black people experience pain to the same degree as white people? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/
Maybe those doctors don't understand their patient adequately enough for them to competently practice medicine in those cases?

[Hortensis]

22. That's the institutional problem no one denies exists.

And we all know it kills.