Explaining Racial Difference in Neonatal Mortality
Reported November 28, 2005
(Ivanhoe Newswire) — The hospital where a very low-birth-weight (VLBW) baby is born could mean the difference between life and death. A new study explains minority-serving hospitals have a higher infant mortality rate than other hospitals.
Between 1940 and 2000, the infant mortality rate improved from 28.8 deaths per live birth to 4.6 deaths per live birth. Despite these drastic improvements, ethnic and racial disparities remain. Black infants have a two and a half-times higher risk of neonatal death than white infants. This fact, among others, caused President George W. Bush to declare infant mortality one of six areas to be targeted to reduce racial disparities in health.
Researchers, from the University of California, Los Angeles, set out to discover whether there is a connection between the hospital where an infant is treated and the mortality of VLBW infants.
Leo Morales, M.D., Ph.D., and colleagues, analyzed the medical records of more than 74,000 VLBW infants over five years. For the sake of the study, researchers defined minority-serving hospitals as those where more than 35 percent of the VLBW infants were black.
After analyzing the data, Dr. Morales and colleagues learned that minority-serving hospitals had significantly higher risk of neonatal mortality than other hospitals.
They examined how factors such as patient volume, level of care, and differences in use of effective treatments affected neonatal mortality rate. In the end, they found these other factors did not explain higher odds of death.
Based on their findings, researchers report that minority-serving hospitals may provide lower quality of care to these tiny infants when compared with other hospitals. They write, “Because VLBW black infants are disproportionately treated by minority-serving hospitals, higher neonatal mortality in minority-serving hospitals may be contributing to racial disparities in infant mortality overall.”
They conclude by saying, “Interventions to improve quality of care and reduce neonatal mortality at minority-serving hospitals may result in reduced racial disparities in infant mortality in the United States.”
SOURCE: Research and Practice,2005;95:12