Physician-patient racial concordance and newborn mortality

Area of Science:

• Public Health
• Neonatal Medicine
• Health Disparities

Background:

• The racial disparity in infant mortality is a significant public health issue.
• Prior research suggested Black newborns had improved survival rates when treated by Black physicians, even after controlling for various factors.

Purpose of the Study:

• To replicate and extend previous findings on the association between physician race and Black infant mortality.
• To investigate the role of very low birth weight in this association.

Main Methods:

• Analysis of Florida hospital discharge data from 1992 to 2015.
• Replication of a previous study controlling for hospital and physician fixed effects and common comorbidities.
• Expansion of models to include diagnoses of very low birth weight (<1,500 g).

Main Results:

• The previously observed survival concordance effect between Black newborns and Black physicians was substantially reduced when controlling for very low birth weight.
• The effect became near zero and statistically insignificant in models that included very low birth weight, hospital, and physician fixed effects.

Conclusions:

• Very low birth weight is a critical factor influencing neonatal mortality and may confound the apparent effect of physician race.
• The association between physician race and Black infant survival is not robust when accounting for key clinical factors like very low birth weight.