A new study by Virginia Tangel and researchers from the Center for Perioperative Outcomes (CPO) finds that race alone is a factor that predicts maternal mortality and cesarean delivery in most categories of insurance payer and socioeconomic status, with black women experiencing poorer outcomes than white women.
In the study, published in the American Journal of Perinatology, researchers reviewed data from nearly 7 million delivery records obtained from the State Inpatient Databases, Healthcare Cost and Utilization Project (HCUP) from five states: California, Florida, Kentucky, Maryland, and New York from 2007 to 2014. Compared to white women, researchers found black women are more likely to die in-hospital, experience a longer average length of stay, and undergo a cesarean delivery.
The study, titled "Racial and Ethnic Disparities in Maternal Outcomes and the Disadvantage of Peripartum Black Women: A Multistate Analysis, 2007–2014," replicated findings from previous studies on racial disparities in maternal outcomes, and additionally examined outcomes by insurance payer and socioeconomic status.
“Though racial disparities in obstetric care and delivery outcomes are known, we were surprised by the magnitude of these disparities," Tangel said. "Even in patient populations where we would otherwise see better outcomes – namely in patients who have private insurance and who live in wealthier areas – black women still experience disadvantages. Our analyses also accounted for pre-existing conditions, which made our findings even more alarming,” she continued.
Co-authors of the study include Dr. Robert White, Dr. Jeremy Pick and Anna Nachamie.
Tangel’s research is part of a multi-project effort by the CPO designed to investigate the relationship between sociodemographic factors and healthcare disparities in surgical and anesthesia patients. These projects are supervised by Dr. Robert White, an obstetric anesthesiology fellow at Weill Cornell Medicine; Dr. Zachary Turnbull, director of the CPO and medical director of performance improvement, and Anna Nachamie, operations administrator for the CPO.
Dr. Kane Pryor, director of clinical research for the Department of Anesthesiology, served as a faculty mentor.