(HealthDay News) — Racial and ethnic disparities persist in postoperative mortality among children, according to a study published online July 29 in Pediatrics.
Olubukola O. Nafiu, M.D., from Nationwide Children’s Hospital in Columbus, Ohio, and colleagues conducted a population-based study involving 673,677 children from U.S. hospitals undergoing intermediate- to high-risk surgery between 2000 and 2019 to estimate the excess deaths that could be avoided if Black and Hispanic children had mortality rates comparable to those of White children. The mortality reduction required to eliminate disparities within the next decade was estimated.
The researchers found that risk-adjusted postoperative mortality trended higher for Black and Hispanic versus White children during 2000 to 2019 (adjusted relative risks, 1.42 and 1.22, respectively). The gaps were driven by higher mortality among children receiving surgery in nonteaching hospitals (Black and Hispanic versus White: adjusted relative risks, 1.63 and 1.50, respectively). Overall, 4,700 and 5,500 excess deaths were seen among Black and Hispanic children, respectively. Approximately 1,100 deaths would be prevented among Black children in the next decade with policy changes achieving an annual 2.5 percent reduction in postoperative mortality.
“Despite steady decline in pediatric postsurgical mortality, persistent racial and ethnic disparities exist and are projected to continue unless robust, targeted actions are implemented to ensure equitable pediatric surgical outcomes,” the authors write.
What is postoperative mortality?
Postoperative mortality refers to the death of a patient following a surgical procedure. While advancements in medical technology and surgical techniques have significantly reduced overall mortality rates, disparities persist in postoperative outcomes based on race and ethnicity.
Why are Black children among the most affected?
The factors contributing to these disparities are complex and multifaceted. Systemic racism, socioeconomic inequalities, and implicit biases within the healthcare system play significant roles. Black children are more likely to live in poverty, have limited access to quality healthcare, and experience higher rates of chronic conditions, all of which increase their risk of adverse postoperative outcomes. Additionally, implicit biases among healthcare providers can lead to disparities in pain management, treatment decisions, and overall care quality.
Black and Hispanic children were at a significantly higher risk of postoperative mortality when undergoing surgery in non-teaching hospitals compared to white children. This finding underscores the importance of access to high-quality, specialized care, which is often concentrated in teaching hospitals.
To address this critical issue, comprehensive and multifaceted interventions are necessary. Efforts must focus on reducing socioeconomic disparities, improving access to quality healthcare, and addressing implicit bias within the medical profession. Investing in community-based programs that promote health equity, increasing the diversity of healthcare providers, and implementing standardized protocols for postoperative care are essential steps toward eliminating racial disparities in pediatric surgical outcomes.
The persistent racial disparities in postoperative mortality among Black children serve as a stark reminder of the deep-rooted inequities within the healthcare system. Urgent action is required to dismantle these barriers and ensure that all children have an equal opportunity to survive and thrive after surgery.