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Published on: January 12, 2018
Racial disparities in infant mortality: a quality of care perspective
1Department of Health Policy and Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. elizabeth.howell@msnyuhealth.org
Insights
Black infants face a higher mortality risk than White infants. This study suggests that improving the quality of care may help reduce these racial disparities in infant mortality.
Area of Science:
- Public Health
- Neonatal Care
- Health Disparities Research
Background:
- Black infants experience more than double the mortality rate of White infants within the first year of life in the U.S.
- Despite extensive research, efforts to reduce preterm births have yielded limited success.
- Significant advancements in obstetrical and neonatal care have improved outcomes for premature infants.
Purpose of the Study:
- To investigate the impact of improved neonatal care on racial disparities in infant mortality.
- To propose a novel framework for addressing racial disparities in infant mortality.
- To explore the potential role of quality of care in explaining these disparities.
Main Methods:
- Literature review on infant mortality trends and interventions.
- Analysis of existing data on obstetrical and neonatal care quality.
- Framework development for addressing health disparities.
Main Results:
- Improvements in neonatal care have not demonstrably reduced racial disparities in infant mortality.
- A quality of care deficit is hypothesized as a partial contributor to racial disparities in infant mortality.
Conclusions:
- Existing strategies focused solely on reducing preterm birth have been insufficient to close the racial gap in infant mortality.
- A quality of care framework is recommended to address and reduce racial disparities in infant mortality.
- Further research is needed to identify and rectify quality of care issues impacting Black infants.
Abstract:
Black infants in the United States are more than twice as likely to die as White infants in the first year of life. Reducing the existing racial disparity in infant mortality rates is a major health policy focus. Despite decades of research aimed at reducing preterm births, our efforts have been largely unsuccessful. Much greater success has been achieved in reducing the morbidity and mortality of premature infants, largely through improvements in obstetrical and neonatal care. However, it is an open question whether such improvements have reduced racial disparities in infant mortality. In this article, we recommend a new framework for addressing infant mortality disparities. We suggest that a quality of care problem may partially underlie racial disparities in infant mortality rates.
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