In New York City, black babies with very low birth weights (less than 1,500 grams, or 3 pounds, 5 ounces) are more likely to be born in hospitals with high risk-adjusted neonatal death rates, according to a Commonwealth Fund-supported study in the March issue of Pediatrics.
White very low birth weight (VLBW) babies are less likely to be born in hospitals with high risk-adjusted neonatal death rates. In fact, only 11 percent of white VLBW babies were born at hospitals with high death rates while 21 percent of black VLBW babies were born at those hospitals.
The study, conducted by researchers at Mount Sinai School of Medicine, found that if black mothers having VLBW babies gave birth at the same hospitals as white mothers of VLBW babies, death rates for black VLBW babies would fall nearly 5 percent, to a rate of 132 deaths for every 1,000 VLBW births in New York City hospitals. This would reduce the disparity that currently exists between black and white VLBW deaths by 34%.
“It is important to understand why black very low birth weight infants in New York City are more likely to die in their first month of life than white infants. This study tells us that a big part of that difference can be attributed to the hospital where the baby is born,” says lead study author Elizabeth Howell, M.D., of the Department of Health Policy at Mount Sinai School of Medicine. “It further tells us that we have an opportunity to save the lives of babies and eliminate a significant portion of the black-white gap.”
In addition to the disparity in where black and white VLBW babies are born, the authors also found a striking variation in the neonatal death rates for VLBW babies in New York City hospitals. The death rates ranged from 9.6 to 27.2 deaths for every 1,000 births and standardized mortality rates (ratio of observed deaths to actual deaths) ranged from 0.70 to 1.97.