A painful but pioneering infant mortality study is a challenge we "can't walk away from," as Minnesota DFL Rep. Kelly Morrison, who's also a physician, aptly put it during a recent legislative briefing.
Black babies in the U.S. have long been at much higher risk of dying than white newborns. But a study from a team that included two University of Minnesota researchers yielded a stunning finding: The hospital death rate for Black infants drops by a third when a Black doctor cared for them during the critical period after delivery. The study garnered national headlines last year and appeared in one of the world's most prestigious scientific journals — and rightfully so. The distressing differences in infant mortality have long been a shameful public health crisis. The findings provide a groundbreaking perspective on the roots of this racial gap and should drive innovation to close it.
The work to do this is just beginning, but a timely $5 million donation will ensure that it will continue. Blue Cross Blue Shield of Minnesota has commendably provided a sizable gift to establish the Center for Antiracism Research for Health Equity at the U's School for Public Health.
Rachel Hardeman, an associate U professor renowned for her research on reproductive health equity, will lead this new center. Along with the U's Aaron Sojourner, she was one of four authors on the study linking Black infants' health to having a Black doctor. The study yielded critical questions that still need to be answered about why the provider's race matters.
The center will be one of the first of its kind. The work that will happen there will lead to health improvements across the nation. It will also address a grim reality behind rankings over the years that have declared Minnesota one of the healthiest states in the nation.
"When we dive deeper into the data, it is clear that Minnesota has some of the greatest health disparities in the country between whites and people of color and American Indians. This has been the case for decades," state Health Commissioner Jan Malcolm wrote in a 2019 letter to lawmakers.
The new center will investigate health gaps differently. As a fact sheet for the new center said, it will move beyond asking, "What's wrong with people of color that makes them die younger ... and suffer more illnesses?" Instead, researchers will take a systemic approach, asking, "How do systems, policies and social structures combine to create the conditions for poor health?"
The study documenting "concordance" between Black infants' clinical outcomes and their doctor's race is an example of the value of looking through this lens. Policy solutions could include efforts to encourage more people of color to become medical providers.
A worthy bill in the Minnesota Legislature is an early example of how research like this can inspire other solutions. DFL Rep. Ruth Richardson is the chief author of HF 660, the Dignity in Pregnancy and Childbirth Act. It would require continuing education for obstetric care providers on racism and implicit bias. In addition, it would expand the state's maternal health research, gathering data not just about maternal mortality but health problems mothers experience after birth.
The investment in the new center "will go a long way to helping policymakers and clinicians alike recognize and dismantle structural racism and the harm it perpetuates," said Dr. Nathan Chomilo, a board member for Minnesota Doctors for Health Equity.
The center will put Minnesota at the forefront of addressing racial health gaps. Blue Cross merits praise for recognizing Hardeman's vision for the center and then funding it. We hope the insurer continues its support beyond the generous one-time donation and that others will join the effort.