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Simple Answers for Simple People
So, I’ve been trying to cut back on my political input/output lately, so I’m trying to return to my old lurking ways. But a CNN article title I saw on Parler gave me pause. So yes, I’m doing a bad job of cutting back.
Black newborns 3 times more likely to die when looked after by White doctors
It’s a pretty short article but basically says that in looking at 1.8 million hospital births in Florida from 1992 through 2015, that when cared for by White (hey we got our ‘W’!) doctors, Black newborns were three times more likely to die than if cared for by Black physicians.
The effect also appeared to be stronger in more complicated cases, and when hospitals deliver more Black newborns.
It says the authors did not speculate about the reasons behind this (until they did) but decided that it means hospitals should work to reduce it and explore a connection to institutional racism.
Has ‘institutional racism’ become the new answer to life, the universe, and everything?
I mean, this is a huge difference that BEGS for further investigation. And I can’t believe that the data they were using was something like this where more analysis couldn’t be done:
| Newborns | Births | Deaths |
| White | 900,000 | 1 |
| Black | 900,000 | 3 |
I admit, I haven’t read the underlying paper because 1) it requires a subscription, and 2) my brain is small. But I did read a bit of the summary, and it states that other research has shown that patient-physician concordance for underrepresented minorities can “ameliorate outgroup biases, boost communication, and increase trust” (is part of academic training finding bigger words to replace smaller words with?). I can even buy the last two to an extent.
So maybe babies have a problem with communication and trust because they see someone of a different skin color? Holy carp! Black babies are racist!
No, I don’t believe that. Please interwebs don’t copy and paste to make it seem like I believe that. You aren’t better than that, but don’t do it anyway.
My point is that even if the underlying academic article might have some value, the CNN article does not, except to lead one to believe that White (which would be better – a white shirt with a big black capital W on it, or a black shirt with a white W?) doctors are somehow letting black babies die where they would have saved the white baby because whether consciously or unconsciously they or the system are biased. If I was a white doctor (I only play one on TV) then I would be a bit frosted. And I’d also want to find out what the hell IS behind those numbers.
It’s just so frustrating when we look at numbers and then attach them to a solution without doing the investigatory steps in between.
I know this was linked on another Ricochet story, but if you haven’t read it, read The Challenge of Marxism on Quillette. I think this is another example of side effects of that process.
If you’ve made it thus far through my less than stellar writing, two points to Hufflepuff because I heard they are the most inclusive of the four schools. And a thank you to my dear reader.
Published in Healthcare
CNN actively sowing racial division.
Which is evil.
Perhaps the most complicated/difficult deliveries are more likely to be in hospitals where there are more white doctors?
It would be nice if a Ricochet member with medical & statistical training..and an appropriate subscription…would read this and let the rest of us know what you think.
After being transferred from hospitals with fewer resources, etc.etc. Or another situation where co-morbidities of the mother affect birth outcome.
We (our company) were recently asked to work on a campaign that highlighted the inequity of outcomes in the healthcare system. One of the firms we do contract work for was apparently working directly with the BLM organization.
The conclusion was presented without any sort of effort to provide context with the numbers. We refused to help, and frankly would refuse any political work done in the name of our company.
They’re in a full court press while they can be, no doubt about it. But companies are starting to resist the shakedown. How many times did Peter cry ‘wolf?’
Yeah, there could be more to that story . . .
@phcheese
Can you respond to this damning evidence of the calamitous side effects of the consumption of processed dairy products?
Just the process of finding the “white” vs “black” doctors in any state, exactly how is that data organized? Did they go off of licensed OBGYN directories and then somehow get photos? Did they contact all hospitals in Florida and somehow get their personnel departments to compile those doctors with admitting privileges, cross referenced with doctors that delivered babies and kept track of “W” & “L” (lived/died) somehow by race of patient and doctor. Its Florida, how are Hispanic Doctors counted? What about partial birth abortions? Any correction or reference made for birth weight? Prenatal or drug addicted mothers?
I’m calling B.S. on this entire streaming pile of a story.
It has been noted that, in general, people who go see oncologists are much more likely to die from cancer. That’s because if you’re going to see an oncologist, you’re probably pretty sick already.
I met an oncologist once who was well-known for having something like a 20% survival rate. He was incredibly well-respected, and busy as hell… because the cases they sent him were the ones who were going to die anyway. Any survival at all was near enough to a miracle.
Average-skill doctors have average-type results. Not-very-good doctors can have surprisingly good survival rates (because they hand off the troublesome cases very quickly).
Really good doctors? They inherit sadness and the weight of the world.
That is a rather important inquiry. And what steps did the study authors control for possible racial differences in complicated/difficult deliveries?
How did they define “care for”? Would any/all doctors (anesthesiologist, General Practitioner, Obstetrician) that were involved in birth that baby did not survive inflate those numbers? Say “three white doctors” noted in parentheses?
This just sounds fabricated to further inflame racial tensions.
“What does he win, Johnny?”
Without doubt.
That CNN article is a case study in whipping up outrage by pretending to cite statistics while providing absolutely no useful information. I am too lazy to go dig up the actual study or even its executive summary, but “news reporting” is supposed to give us actual information, not agitprop. Oops – it is CNN.
How many newborn deliveries and deaths were in the study? Were there enough of each category (white baby, black doctor; black baby, black doctor; black baby, white doctor; white baby, black doctor) to provide statistically significant data? Condemning white doctors treating black newborns based on a data set of 5 deaths of black newborns treated by white doctors is different than doing so on the basis of 5,000 deaths.
What steps were taken to control for possible differences in maternal health (and thus newborn health) between black and white patients?
What steps were taken to control for possible differences in the amount of training, specialization, experience, etc. between the studied white doctors and black doctors? As @richardfinlay noted above (comment #2), are white doctors more likely to be treating the complicated or difficult deliveries?
Are there statistically significant differences in the amount of time that elapsed before different types of doctors saw the newborn? Could be affected by rural/urban, or whether one mother group or another is more likely to use people other than medical doctors for delivery (i.e., is the medical doctor the first professional to see the newborn, or have other people like midwives been involved first)?
Before people start screaming “racism,” they need to account for a whole bunch of other factors that might contribute to differential outcomes.
Probably started as a BLM press release, made the NY Times, then CNN followed suit.
Theodore Dalrymple has repeatedly pointed out that many medical studies are fatally flawed by bad statistical analysis and by poorly constructed methodology. I’ll wait until there are numerous studies checking on these claims (bearing in mind that with every year it becomes more difficult to question leftist claims without getting fired.)
I read it but quickly so it was basically skimming so I’m sorry to all if I make a mistake.
I try to be careful how I speak about studies because I don’t want to elevate differences in statistical evaluation or intuition into moral battles and I can’t know if someone was “sloppy” or not. Having read the study it seems very descriptive. The change in black deaths compared to whites is invariant to a variety of interesting controls! (You want to see that.) They do try and make a claim about omitted variable bias that I’m not familiar with but essentially they are saying OVB would have to be unrealistically large to account for the change in the outcome variable. Fair enough. I’m not familiar with it.
I think @cirby and @richardfinlay have it right that the major confounder is the selection effect. Looking at the paper, that wouldn’t actually be controlled for by doctor fixed effects. Another problem is that I think the authors subtly admit their data probably isn’t fit for the way they modeled it when they interpret the death rates on an increasing number of black babies with black doctors. It strikes me as them interpreting the non-normality in the data that does affect their model as being proof they are right!
If I were at my computer running this I wouldn’t get to the interpretations. I’d explore other ways of looking at the data. Wilfred Riley, on twitter (“@wil_da_beast630”, points out that this is an example of just interpreting small effect sizes as big percentage changes by basing it on different reference categories which is also something I wish I thought of when I first read it. As a descriptive paper, it has some merit. But I wouldn’t draw any strong conclusions from it.
See, another situation where more research is needed. Does dairy give flatulence, causing air currents that are uniquely designed to strangle you with your own sheet?
My wife has repeatedly stated that if there is more flatulence at night that I will die. I must ask her if she has already done this research.
From the appendix:
In general, I take all claims of “controlled for…” with large bags of salt pellets.
It doesn’t take a rocket scientist to figure out there are WAY MORE white doctors than black. Of the roughly 1,000,000 doctors in the US, only 5% are black. It’s absurd to leave out that very important statistic as it makes all the difference.
Clearly there are social pathology reasons why black babies die at a higher rate than white babies. Mothers are less likely to have had adequate prenatal care, more likely to be drug addicted, etc. Those are just the realities of the social world we happen to live in. And the fact that they die more in “complicated cases” than uncomplicated ones isn’t very interesting. It seems tautological. I assume the same is true of babies of all races. I’m having trouble though, thinking of an obvious reason why black babies would die more when treated by white doctors than by black doctors. There are probably plenty of variables to consider other than the race of the doctor, and perhaps they explain this. Perhaps the study even considers those variables its authors could come up with and attempts to adjust for them (I didn’t read it either). But on its face the disparity in outcome based on the race of the doctor IS a striking finding that cries out for more study.
Maybe because there are so many more white doctors than black doctors. The odds of dying are the same from white doctors or black doctors, and more of those dying have white doctors. Just guessing.
That doesn’t sound like it’s what they’re saying, but the CNN article is kind of undecipherable (and probably spun anyway) and the actual study is behind a paywall, so who knows?
An excellent point too.
It’s worth noting, though, that the “correct” share of black doctors would not be something like 50%. Since blacks make up about 13% of the population, the “fair share” would be 13%. So 5% is not “off” by 95%, or even by 45% (in order to achieve 50-50). It’s “off” by like 8%.
Race causes racism. Just as cops are giving up policing in predominantly black neighborhoods, if the Left keeps this up, white OB/GYNs will stop taking black mothers as patients. Why risk it? “Sorry, the practice is full.”
They have to be careful of stuff like that. If they say “we’re full” to a black mother, and then a white mother is accepted, they get put out of business by lawyers. Often lawyers from the DOJ.
Does anyone, in an emergency, make decisions on who will treat their newborn based on race? “No, doctor, please don’t clear his airway with your white fingers…” “No black doctor is saving my child’s life!”
This is just absurd.
Of course they do. But, they also have retirement as an option, which many took/are taking after Obamacare. Reduce the total number of police and total number of doctors and see what happens.
The Left ruins everything.
Were they referring to emergency situations? I thought it was more about doctors picked to monitor a pregnancy along the way, etc.
Sometimes referred to as “fouling their own nest.” And “refugees” from PRC (People’s Republic of California) and other lefty strongholds tend to do the same wherever they flee to.