Study: Race Affects The Quality Of Care Babies Receive In The NICU

by Wendy Wisner
Originally Published: 
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In case you were wondering: Yep, racism is alive and well in the U.S., and it affects even our tiniest, most vulnerable citizens.

A new report, issued by researchers at Stanford University School of Medicine and published by the Academy of American Pediatrics, highlights the ways that quality of care for very low-birth-weight babies in the NICU is heavily impacted by racial inequities. In a nutshell, the whiter a baby is, the better quality of care that baby gets.

This is totally unacceptable, but it’s a harsh truth we all need to be aware of, and that all health care workers and health institutions need to consider as we move forward toward a (hopefully) brighter future for our children.

The researchers from Stanford University looked at a very large pool of babies — almost 19,000 babies across 134 NICU units in California (that’s 90% of all California units). The babies they looked at were all born between 2010 and 2014, and the researchers specifically examined the quality of care these infants got based on their race.

They analyzed this using something called the Baby-Monitor index, which measures nine aspects of quality of care for babies, including maternal steroid administration during pregnancy, hypothermia, bacterial or fungal infections, lung disease, collapsed lungs, whether the babies received an eye exam, mortality during hospitalization, and whether the babies received breast milk before leaving the hospital.

Here’s what they found: Asian-American and white babies received the highest quality of care, with African-American babies lagging slightly, but noticeably behind. That’s bad enough, but here comes the most glaring part: Hispanic babies, and babies classified as “other” (which includes Native American and Alaskan Native babies) had significantly lower quality of care scores than any other races.

As the researchers put it: “Significant racial and/or ethnic differences in quality between and within NICUs are a troubling finding.”

Hmmm…ya think?

It should be noted that these findings were not evident in all of the NICUs studied. As SFGate points out, in certain NICUs African-American and Hispanic babies actually got better care. But the trend, overall, was that the highest quality of care was provided to white babies.

“On a population basis there are general trends — the higher proportion of African-American or Hispanic infants in an NICU, the lower the overall quality scores tend to be,” Dr. Jochen Profit, one of the study’s authors, tells SFGate.

According to the study, African-American and Hispanic mothers were less likely than white mothers to receive the steroids during pregnancy that protect a preemie’s lungs once they are born. The babies were also less likely to receive an eye exam at the hospital, and were disproportionately less likely to be receive breast milk upon leaving the hospital.

Finally, these babies were more likely to get an infection associated with the care they received at the hospital.

This is unconscionable and should make us all sick to our stomachs. How can it possibly be okay for the race of a baby to affect the kind of life-or-death care they get? There is just no way to get around how unacceptable this is. And remember, these are low-birth-weight, teenie, fragile preemies we are talking about here — babies whose livelihoods hang in the balance every day.

So what’s the answer here? Here’s what conclusions the researchers come to at the end of their report: “Providing feedback of disparity scores to NICUs could serve as an important starting point for promoting improvement and reducing disparities,” they write.

This is their very cut-and-dry, college professor-y way of saying, “Health care providers, educate yourselves about how rampant racism is in our country, and how it may be affecting your youngest patients. Then, fucking do something about it, starting right now.”

And I think the rest of us could use a gentle reminder about this as well. Even if we don’t work with babies or young children of various races, we all need to become enlightened about what a huge problem racial disparities are in our country.

We can’t just keep letting this stuff slide, even if it doesn’t affect us directly. We are all part of this beautiful, diverse nation, and we better start treating one another with the respect and care we all deserve — starting with our smallest, most vulnerable citizens.

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