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Updated: Jul 21, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Racial and geographic disparities in neonatal brain care
Zachary A Vesoulis1, Stephanie Diggs1, Cherise Brackett2
1Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Insights
Racial disparities in neonatology disproportionately affect Black infants, leading to higher rates of brain injury and adverse neurodevelopmental outcomes. Addressing systemic racism is crucial for equitable neonatal care.
Area of Science:
- Neonatology
- Neurodevelopmental Outcomes
- Health Disparities
Background:
- Historical healthcare discrimination and segregation created lasting inequities.
- Significant disparities exist in infant mortality rates between Black and White infants.
- Prenatal factors like metabolic syndrome and toxic stress negatively impact neonatal health.
Purpose of the Study:
- To review race-based disparities in neonatology.
- To examine the impact of these disparities on brain injury and neurodevelopmental outcomes.
- To highlight the need for systemic change in healthcare access and equity.
Main Methods:
- Literature review exploring historical and geographic factors.
- Analysis of data on infant mortality and neonatal brain injury.
- Examination of socioeconomic determinants of neonatal health.
Main Results:
- Black neonates experience a higher incidence of brain injuries.
- Disparities in adverse neurodevelopmental outcomes are evident in Black infants.
- Systemic factors like redlining contribute to unequal access to healthcare and nutrition.
Conclusions:
- Race-based disparities in neonatology persist, impacting infant brain health.
- Addressing systemic racism is essential for improving neonatal and neurodevelopmental outcomes.
- Equitable access to healthcare resources is critical for all neonates.
Abstract:
In this review, we explore race-based disparities in neonatology and their impact on brain injury and neurodevelopmental outcomes. We discuss the historical context of healthcare discrimination, focusing on the post-Civil War era and the segregation of healthcare facilities. We highlight the increasing disparity in infant mortality rates between Black and White infants, with premature birth being a major contributing factor, and emphasize the role of prenatal factors such as metabolic syndrome and toxic stress in affecting neonatal health. Furthermore, we examine the geographic and historical aspects of racial disparities, including the consequences of redlining and limited access to healthcare facilities or nutritious food options in Black communities. Finally, we delve into the higher incidence of brain injuries in Black neonates, as well as disparities in adverse neurodevelopmental outcome. This evidence underscores the need for comprehensive efforts to address systemic racism and provide equitable access to healthcare resources.
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