A new study calls into question the high-profile conclusion of the first major study that a doctor’s race influences health outcomes.
In August 2020, study Published in the Proceedings of the National Academy of Sciences I made a headline It was found that black infants were half as likely to survive to their first birthday if they were cared for by a white doctor instead of a black person.
But new analysis This result was reversed in the same journal, showing that the difference in survival seen in the original study was almost entirely due to infants with very low birth weights. Physician race did not have a statistically significant effect on infant mortality.
Other studies have shown that black patients are more likely to experience: Follow medication guidelines and Get cancer screenings and vaccinations When asked to do so by Black doctors, and a 2023 study showed people of all races lived longer in counties with at least one Black doctor, a 2020 paper received widespread attention. Ta.
The study, published shortly after George Floyd’s death, attracted the attention of many organizations, which claimed to show that: Diversification is an urgent need The country’s physician workforce. just 5.2% A higher percentage of physicians in the United States are black. The study was the subject of a 2023 challenge by Supreme Court Justice Ketanji Brown in the high-profile Students for Fair Admissions v. Harvard University case, which severely limited the use of affirmative action in college admissions.・Quoted by Judge Jackson.
Robert Verbruggen, a co-author of the new study and a fellow at the Manhattan Institute, a right-wing think tank, said he was initially skeptical of the study when he read the paper. CNN article about it. But when he saw how comprehensive the paper was and how many variables it included, he was “at a loss as to how to explain the findings.”
The 2020 study included 65 of the most common causes of infant mortality, as well as factors such as insurance status and the number of seriously ill infants hospitals treat, making it a “daunting” and “thorough” study. It has even been described as “. by critics.
Verbruggen said he decided to take a closer look at the study after it resurfaced after the Supreme Court ruling. The new analysis includes one variable that was not included in the original study. It has a very low birth weight (baby weighs less than 3.3 pounds). Such babies are rare, but only 1.2% of white babies and 3.3% of black babies are born very small, which is very small. Vulnerable and least likely to survive.
“That’s where the mortality rate really starts to spike,” Verbruggen said. “This is a very strong predictor.”
A new study finds that very low birth weight infants are more likely to be black and more likely to be cared for by white doctors, adding to the initial theory that the doctor’s race plays a role in infant survival. This explains many of the findings, he said in an interview with STAT. Verbruggen said it was easy to understand why this factor was not initially included, as birth weight is not easy to derive from the data. The original authors used several measures of low birth weight and prematurity, but did not focus on the lowest birth weight.
A new study found that the sickest babies are most likely to be treated in neonatal intensive care units (NICUs), where doctors are predominantly white. Only 3.8% of neonatologists in the United States are Black. The study also noted that it is unfair to blame a single doctor for outcomes for infants in the NICU. Because those infants are cared for by large (and likely multiracial) teams that ignore implicit or explicit bias that may exist in any one clinician. .
A new study finds that the doctor’s race still appears to play a role in infant survival, but it is not statistically significant. “We can’t say that the impact is zero, but the impact is much smaller than before,” Verbruggen said. He also praised the original study’s lead author for being willing to share the data and walk through the original analysis.
Its researcher, Ben Greenwood, said he would be happy to share the data. “I encouraged them to study this because it’s so important,” said Greenwood, a business professor at George Mason University’s Costello College of Business. “I don’t think there’s any point in being defensive about your job.”
Greenwood told STAT that he believes the new analysis shows that a doctor’s race plays some role in infant mortality, even if the effect is smaller than the one found in the study, which contradicts research. He said the results highlight the need for further research. Further research using different statistical models and including different variables could yield further conclusions about the complex role that a doctor’s race may play, he said. Ta.
“If the real goal is to reduce infant mortality, what we need to do is to ensure that people continue to achieve this goal,” he said.
Greenwood said he believes his work receives more scrutiny than other topics in health research because racial issues are politically polarized. He said he is not happy with how the research is being used on both the right and the left, including by those who have interpreted the findings to conclude that some white doctors are racist. added.
“The first thing we say in every interview is that you shouldn’t choose a doctor based on race. No matter what race you are, there are good doctors and there are bad doctors. ” he said. “We also said we shouldn’t have a policy on this.”
Verbruggen was very open about how the role that 2020 research could play in politics and policy-making was the driving force behind the new analysis. He described the Manhattan Institute as a “free market-oriented, right-leaning” think tank. Verbruggen was not a scholar. Although he is a journalist, he taught himself how to use statistical analysis software. For the new study, he collaborated with Harvard University economist George J. Borjas.
Borjas is a Cuban-American who focuses on immigration and has been involved in several research debates, including supervising a 2009 research paper. Harvard University Dissertation He argued that Latino immigrants in the United States are, and will continue to be, less intelligent than “native whites.” His research showing that Cuban immigration to Florida reduced wages in the state was regularly cited by President Trump and other politicians calling for immigration cuts. almost disproven by other economists.
Politics aside, Verbruggen said this new study shows that future research on infant mortality needs to include very low birth weight as a factor and also examine its impact on hospitals. He said there was. Some hospitals have more technology; save the life of a premature baby. “Racial disparity [in infant mortality] “It’s worth researching,” he said.
Black infants are twice as likely to die in the first year of life than white infants. Understanding which factors may and may not suppress these numbers is an important topic for future research, Baruch College economist Ted Joyce said in a paper. Ta. Explanation Attached to the new paper.
Black infants are also three times more likely to be born at very low birth weight than white infants, a figure that other studies show is clearly tied to socioeconomic status, with no noticeable change over the past 30 years. No, Joyce pointed out.
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