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Study: Black babies are less likely to die when cared for by a Black doctor
Why do Black newborns have a relatively high mortality rate in the U.S. — and how does the race of the doctor factor in?
- A new study examined nearly 2 million births in Florida from 1992 to 2015.
- The results showed that, when cared more by a white doctor, Black newborns are 3 times more likely to die than white newborns.
- The researchers said several "disturbing" factors are likely at play.
The U.S. infant mortality rate has overall been dropping for decades, but there remain significant racial disparities. Black newborns are about 2.3 times more likely to die than white newborns, according to the U.S. Department of Health and Human Services' Office of Minority Health. Still, the precise causes have been unclear.
A new study offers insight into one little-understood factor: the race of the physician. The results showed that when the physician is white, Black newborns are three more times likely to die than white newborns. But when the physician is Black, that rate drops by roughly half.
Our study provides the First evidence that the Black-white newborn mortality gap is smaller when Black MDs provide… https://t.co/JjlbFMOBct— Rachel Hardeman, PhD, MPH (@Rachel Hardeman, PhD, MPH)1597703531.0
The study was published Monday in the journal Proceedings of the National Academy of Sciences of the United States of America. For the study, researchers examined the birth records of about 2 million babies born in Florida between 1992 to 2015. To collect data on race, they obtained photographs of the attending physician for each birth record.
The results showed that Black newborns experienced 430 more fatalities per 100,000 births than white newborns. Under the care of Black physicians, that "mortality penalty" for Black newborns dropped to 173.
The study listed several other key findings:
- In complicated medical situations, Black newborns are even more likely to survive when the physician is Black.
- Black newborns are also especially likely to survive when cared for by Black physicians at hospitals that deliver more Black babies.
- The race of the physician didn't impact the mortality rate of mothers.
Why might the race of the attending physician matter? Although the researchers didn't examine the root causes of the disparity, they did mention that factors like eclampsia and preeclampsia (dangerous conditions that afflict Black women at disproportionate rates), socioeconomic inequality, racial biases, and institutional racism may play a part.
Brad Greenwood, study co-author and an associate professor of Information Systems & Operations Management Sciences at George Mason University, told USA Today that a mix of "disturbing" structural influences could be contributing to the problem.
"I don't think any of us would suggest as co-authors that these results are manifesting as a result of malicious bias on the part of physicians," Greenwood said. "I also think that underscores how insidious something like this is. Children are dying as a result of just structural problems."
The infant mortality rate in the US declined 2.3% from 579.3 infant deaths/100,000 live births in 2017 to 566.2 in… https://t.co/N1JdWTuejI— NCHS (@NCHS)1580428856.0
One part of the problem, potentially, is that only 5 percent of doctors in the U.S. are Black, even though Black Americans represent 13 percent of the population. Still, representation is only one part of this complex issue, according to study co-author Rachel Hardeman, a reproductive health equity researcher and associate professor at the University of Minnesota.
"It could go a long ways to helping with this, but also we don't know that the answer is necessarily that we just need more Black doctors," she told USA Today. "We have to be thinking about the health care institutions themselves and how physicians are being trained ... to think about the role of race and racism in the clinical encounter but also in people's lives outside of health care settings."
- Women are more likely to survive a crisis than men - Big Think ›
- Working to Combat Infant Mortality in the Third World, North America ... ›
What is human dignity? Here's a primer, told through 200 years of great essays, lectures, and novels.
- Human dignity means that each of our lives have an unimpeachable value simply because we are human, and therefore we are deserving of a baseline level of respect.
- That baseline requires more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose.
- We look at incredible writings from the last 200 years that illustrate the push for human dignity in regards to slavery, equality, communism, free speech and education.
The inherent worth of all human beings<p>Human dignity is the inherent worth of each individual human being. Recognizing human dignity means respecting human beings' special value—value that sets us apart from other animals; value that is intrinsic and cannot be lost.</p> <p>Liberalism—the broad political philosophy that organizes society around liberty, justice, and equality—is rooted in the idea of human dignity. Liberalism assumes each of our lives, plans, and preferences have some unimpeachable value, not because of any objective evaluation or contribution to a greater good, but simply because they belong to a human being. We are human, and therefore deserving of a baseline level of respect. </p> <p>Because so many of us take human dignity for granted—just a fact of our humanness—it's usually only when someone's dignity is ignored or violated that we feel compelled to talk about it. </p> <p>But human dignity means more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose—a freedom that can be hampered by restrictive social institutions or the tyranny of the majority. The liberal ideal of the good society is not just peaceful but also pluralistic: It is a society in which we respect others' right to think and live differently than we do.</p>
From the 19th century to today<p>With <a href="https://books.google.com/ngrams/graph?year_start=1800&year_end=2019&content=human+dignity&corpus=26&smoothing=3&direct_url=t1%3B%2Chuman%20dignity%3B%2Cc0" target="_blank" rel="noopener noreferrer">Google Books Ngram Viewer</a>, we can chart mentions of human dignity from 1800-2019.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg0ODU0My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY1MTUwMzE4MX0.bu0D_0uQuyNLyJjfRESNhu7twkJ5nxu8pQtfa1w3hZs/img.png?width=980" id="7ef38" class="rm-shortcode" data-rm-shortcode-id="9974c7bef3812fcb36858f325889e3c6" data-rm-shortcode-name="rebelmouse-image" />
American novelist, writer, playwright, poet, essayist and civil rights activist James Baldwin at his home in Saint-Paul-de-Vence, southern France, on November 6, 1979.
Credit: Ralph Gatti/AFP via Getty Images
The future of dignity<p>Around the world, people are still working toward the full and equal recognition of human dignity. Every year, new speeches and writings help us understand what dignity is—not only what it looks like when dignity is violated but also what it looks like when dignity is honored. In his posthumous essay, Congressman Lewis wrote, "When historians pick up their pens to write the story of the 21st century, let them say that it was your generation who laid down the heavy burdens of hate at last and that peace finally triumphed over violence, aggression and war."</p> <p>The more we talk about human dignity, the better we understand it. And the sooner we can make progress toward a shared vision of peace, freedom, and mutual respect for all. </p>
With just a few strategical tweaks, the Nazis could have won one of World War II's most decisive battles.
- The Battle of Britain is widely recognized as one of the most significant battles that occurred during World War II. It marked the first major victory of the Allied forces and shifted the tide of the war.
- Historians, however, have long debated the deciding factor in the British victory and German defeat.
- A new mathematical model took into account numerous alternative tactics that the German's could have made and found that just two tweaks stood between them and victory over Britain.
Two strategic blunders<p>Now, historians and mathematicians from York St. John University have collaborated to produce <a href="http://www-users.york.ac.uk/~nm15/bootstrapBoB%20AAMS.docx" target="_blank">a statistical model (docx download)</a> capable of calculating what the likely outcomes of the Battle of Britain would have been had the circumstances been different. </p><p>Would the German war effort have fared better had they not bombed Britain at all? What if Hitler had begun his bombing campaign earlier, even by just a few weeks? What if they had focused their targets on RAF airfields for the entire course of the battle? Using a statistical technique called weighted bootstrapping, the researchers studied these and other alternatives.</p><p>"The weighted bootstrap technique allowed us to model alternative campaigns in which the Luftwaffe prolongs or contracts the different phases of the battle and varies its targets," said co-author Dr. Jaime Wood in a <a href="https://www.york.ac.uk/news-and-events/news/2020/research/mathematicians-battle-britain-what-if-scenarios/" target="_blank">statement</a>. Based on the different strategic decisions that the German forces could have made, the researchers' model enabled them to predict the likelihood that the events of a given day of fighting would or would not occur.</p><p>"The Luftwaffe would only have been able to make the necessary bases in France available to launch an air attack on Britain in June at the earliest, so our alternative campaign brings forward the air campaign by three weeks," continued Wood. "We tested the impact of this and the other counterfactuals by varying the probabilities with which we choose individual days."</p><p>Ultimately, two strategic tweaks shifted the odds significantly towards the Germans' favor. Had the German forces started their campaign earlier in the year and had they consistently targeted RAF airfields, an Allied victory would have been extremely unlikely.</p><p>Say the odds of a British victory in the real-world Battle of Britain stood at 50-50 (there's no real way of knowing what the actual odds are, so we'll just have to select an arbitrary figure). If this were the case, changing the start date of the campaign and focusing only on airfields would have reduced British chances at victory to just 10 percent. Even if a British victory stood at 98 percent, these changes would have cut them down to just 34 percent.</p>
A tool for understanding history<p>This technique, said co-author Niall Mackay, "demonstrates just how finely-balanced the outcomes of some of the biggest moments of history were. Even when we use the actual days' events of the battle, make a small change of timing or emphasis to the arrangement of those days and things might have turned out very differently."</p><p>The researchers also claimed that their technique could be applied to other uncertain historical events. "Weighted bootstrapping can provide a natural and intuitive tool for historians to investigate unrealized possibilities, informing historical controversies and debates," said Mackay.</p><p>Using this technique, researchers can evaluate other what-ifs and gain insight into how differently influential events could have turned out if only the slightest things had changed. For now, at least, we can all be thankful that Hitler underestimated Britain's grit.</p>
A new study shows our planet is much closer to the supermassive black hole at the galaxy's center than previously estimated.
Arrows on this map show position and velocity data for the 224 objects utilized to model the Milky Way Galaxy. The solid black lines point to the positions of the spiral arms of the Galaxy. Colors reflect groups of objects that are part of the same arm, while the background is a simulation image.
Apple sold its first iPod in 2001, and six years later it introduced the iPhone, which ushered in a new era of personal technology.