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Black children are almost 3.5 times more likely to die after common surgeries as white children, according to the latest study to show clear disparities in medical care between Black and white patients.
Reported in the journal Pediatrics, researchers at Nationwide Children’s Hospital in Ohio looked at data on over 172,000 children who underwent surgery between 2012 and 2017 across the US, around 14 percent of who experienced some complications after the surgery.
Being an apparently healthy Black child, however, meant there was a 27 percent relative greater risk of developing postoperative complications. By their workings, seemingly healthy Black children were 3.4 times more likely to die within a month after surgery and were 1.2 times more likely to develop complications than white children.
While the proportion of total deaths after surgery was reassuringly low — 0.07 percent mortality rate for Black children, 0.02 percent for white children — the statistics highlight a clear racial disparity, the study authors say.
“Generally, we expect that healthier patients should do well with surgeries. Healthy kids have low complication rates,” lead study author Dr Olubukola Nafiu, pediatric anesthesiologist and vice-chair for Academic Affairs and Research at Nationwide Children’s Hospital, said in a statement. “The expectation should be that complication rates and/or mortality among healthy children won’t vary based on racial category – what we found is that they do.”
Researchers have noted this kind of disparity before, but it was previously put down to a “higher preoperative comorbidity burden among African American patients.” In other words, Black people were more likely to have other underlying health conditions that cause complications. However, this new study argues this isn’t the problem.
What could explain this disparity? While the research did not specifically look to find a causal link, it argues the problem likely encompasses a whole range of interwoven factors, including family dynamics, wider social inequality, factors involving insurance and health care providers, and differences in hospitals. As one example, Black people are perhaps more likely to receive care in overstretched and low-performing hospitals.
“Importantly, we want to highlight that these findings are from observational data. Race doesn’t cause these outcomes, but it is strongly associated with them,” explained Dr Nafiu. “Our next job is to look at what postoperative complications are driving the observed morbidity and mortality pattern in order to identify modifiable outcomes.”
Nevertheless, the study does not stand alone. Over the past few decades, a number of other pieces of research have highlighted racial disparities in the US medical system. A study in 2012 found that Black patients were 22 percent less likely than white patients to receive any pain medication in a range of hospital settings. Another study from 2019 concluded that algorithms were less likely to refer black people than white people (who were equally sick) for extended care. As per the study, the reason for this was that Black people face disproportionate levels of poverty and, therefore, tend to spend less on health care than white people.
Other studies have shown signs of progress in some respects, but there is evidently still a long way to go.
