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Disparities/Minority Health

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Very low-birthweight babies treated at minority-serving hospitals have higher death rates

Despite tremendous gains in the survival of very low-birthweight (VLBW) babies (1.1 to 3.3 pounds) in the United States, racial and ethnic disparities in mortality among these infants persist. A new study supported in part by the Agency for Healthcare Research and Quality (HS13280 and HS10858) reveals that neonatal mortality rates among black VLBW infants are 2.5 times higher than those of white VLBW infants.

Researchers analyzed the medical records of 74,050 black and white VLBW infants treated at 332 hospitals participating in the Vermont Oxford Network of hospitals. They defined hospitals where more than 35 percent of VLBW infants were black as minority-serving. Far more black infants were treated by minority-serving hospitals than at hospitals where less than 15 percent of infants were black (57 vs. 8 percent). Both black and white VLBW babies were 28 percent more likely to die at minority-serving hospitals than at hospitals where less than 15 percent of VLBW infants were black, even though the hospitals treated similarly ill infants.

The higher death rate at minority-serving hospitals was not explained by either hospital or treatment variables. The findings suggest that racial disparity in neonatal mortality could be reduced by improving mortality outcomes for VLBW infants treated at minority-serving hospitals. If neonatal mortality in minority-serving hospitals were reduced to the level observed in hospitals where less than 15 percent of VLBW infants were black, overall neonatal mortality would be reduced by about 10 percent for white VLBW infants and 22 percent for VLBW black infants.

More details are in "Mortality among very low-birthweight infants in hospitals serving minority populations," by Leo S. Morales, M.D., Ph.D., Douglas Staiger, Ph.D., Jeffrey D. Horbar, M.D., and others, in the December 2005 American Journal of Public Health 95(12), pp. 2206-2212.

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