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September 18, 2024 - 8:00pm
A study published this week in a prestigious journal, Proceedings of the National Academy of Sciences, makes a claim that’s almost unheard of on the pages of leading medical journals: systemic racism and implicit bias are not the self-evident explanations for a pervasive racial disparity. To be precise: black newborns aren’t dying at higher rates when they’re treated by white doctors.
The study, conducted by a Harvard economist and a Manhattan Institute researcher, purports to debunk a widely circulated 2020 study, also published in PNAS, which concluded that black newborns attended by a white physician suffer a “mortality penalty” and are twice as likely to die. That study garnered incriminating headlines in USA Today, CNN, Science News, NPR, and The Washington Post. It was also so influential that it was cited by Supreme Court Justice Brown Jackson in the high court’s 2023 affirmative action case, in which the American Medical Association and 44 other parties declared in their amicus brief: “For high-risk Black newborns, having a Black physician is tantamount to a miracle drug.”
How could two teams of researchers look at the same data — 1.8 million childbirths in Florida between 1992 and 2015 — and reach diametrically opposite conclusions?
This time around, the researchers added one key variable that the 2020 researchers had overlooked — low birth weights — and the whole thing collapsed. The research design contained a fatal flaw, overlooking the fact that severely underweight babies, who have very high mortality rates to start with, tend to be treated by white doctors. Physicians who handle the most serious medical cases tend to see higher death rates.
It’s no exaggeration to say that this level of scholarly error raises serious questions about the hundreds of peer-reviewed studies published in the past five years that documented the prevalence of systemic racism in the medical profession and implicit bias among white doctors. Could the research design of those papers, some of which have been cited hundreds of times in subsequent papers, also have been flawed, so as to advance a progressive political agenda cloaked in the authority of objective science?
At the peak of the nation’s racial reckoning, between the years 2019 and 2021, the leading journals of the Anglosphere rushed to put out special issues and contrite reflections on anti-black racism and their journals’ institutional complicity in the brutal oppression of African Americans. Scientific American, Science, Nature, Health Affairs, and others assumed that systemic racism and implicit bias operate as natural laws which give researchers carte blanche to interpret all racial disparities as being governed by those laws.
Medical schools added lessons on critical race theory, intersectionality, identity, oppression, allyship, colonialism, patriarchy, fatphobia, power and privilege to their curricula, taking up time and space previously allotted to cell biology and anatomy. To date, more than 250 governmental bodies and private institutions have declared racism to be a public healthcare crisis, an escalation in urgency that morally justifies the prioritisation of non-whites for medical treatment, from Covid vaccinations to organ transplants, as a means to close the racial disparities gap in healthcare outcomes.
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SubscribeJournalists are the least suitable people to comment on the efficacy of any study or report.
And people wonder why there is a mass loss of faith in institutions……
Just trust the “Science”, and shut up
Indeed. These teams of leading researchers might have made a freshmen error on the black babies, but for sure their studies into the Covid vaxxines are gold-plated, 100% accurate.
After all, what possible interest might they have in not getting at the truth? 🙂
It’s contracting the woke mind virus in higher education – many of them don’t even realise they are doing it any more.
“Medical schools added lessons on critical race theory, intersectionality, identity, oppression, allyship, colonialism, patriarchy, fatphobia, power and privilege to their curricula, taking up time and space previously allotted to cell biology and anatomy.”
A lie gets halfway around the world before the truth has a chance to get its pants on. Winston Churchill
Indeed. I take it that the purveyors of the original “misinformation” will be dealt with accordingly?
doubt it – not enough prison places left
There is nothing new under the sun. It’s the appropriateness of comment at the time that counts,
Ironic you should use a misattributed quote to make that point.
This all comes back to the fact that observational studies can only show correlation, not causation, but journalists imply causation thus ignoring any confounding factor.
That the death of black babies is highly correlated with the attendance of white physicians is explained by a confounding factor that the white physicians deal with the sickest babies.
Honestly, this is year 1 statistics, but ordinary journalists are either ignorant or deliberately seek to obscure the truth.
From the paper linked in the article –
‘We posit that these differences may be ameliorated by racial concordance between the physician and newborn patient.’
Journalists often are at fault for misinterpreting correlation, but here it appears to come from the authors of the paper.
Though it’s not really a case of the statistics being wrong, just that a variable was not included originally. It is quite easy to miss a potential factor in a complicated set of data such as this.
“Though it’s not really a case of the statistics being wrong, just that a variable was not included originally. It is quite easy to miss a potential factor in a complicated set of data such as this.”
Lol . . That’s hilarious.
Babies are weighed at birth and regularly through early infancy because their weight (and subsequent weight gain) is one of the most important indicators of their health.
Suggesting it was easy to miss is roughly the equivalent of saying that research on road traffic accidents missed data on how fast the vehicles were travelling.
I agree that intentional exclusion is much more likely than accidental oversight. There would be some consolation if this turned out to be a case of researchers (and their peer reviewers and publishers) conspiring to pervert science, but I fear it is worse.
This is likely yet another instance of the scourge of systemic anti-racism infecting the world of science. The deep faith of the devotees of this cult blinds them to their motivated reasoning and the more intelligent they are the more obdurate.
Systemic anti-racism is an established fact, and it is doing real-world damage. We have seen how the anti-racist George Floyd murder conviction and defund police campaign led to less policing and increased African American gang related violent deaths. In this instance maybe we now have more high-risk babies dying because highly experienced white doctors shied away from dealing them to avoid being accused by anti-racists of racist malpractice.
The researchers are on a mission to right perceived historical wrongs, not advance the body of scientific knowledge. A conclusion this inflammatory virtually guarantees publication, too. Where were peer reviewers in this scenario? Surely someone reviewing this paper’s conclusion should have asked about birth weight, a very basic marker for overall newborn health and vigor. Maybe the reviewers were afraid of the blowback that would result from questioning.
Result: Luxury beliefs kill infants.
It’s not that they’ve missed weight being an important factor (for the very obvious reasons you thought it necessary to point out), it’s because they’ve missed that lower weight babies were more likely to be seen by a white doctor.
Perhaps that is obvious to you, though as you’ve just demonstrated that you hadn’t realised that was what happened, I don’t think so. Even after you’ve just read an article pointing it out.
That’s just the same thing but re-stated to make it look more like it was a reasonable omission on the part of the researchers. What lawyers call a distinction without a difference.
Considering the impact of the low birth weight variable would, when placed with the variable of doctor ethnicity, inevitably have shown them that lower birth weight babies were more likely to be seen by a white doctor.
My PhD isn’t in medicine, but I did all the required ESRC research training. If you think there is a causal effect between two variables, you create and test the null hypothesis. If the data appears to disprove the null hypothesis (ie. it appears to show a correlation or possible causal effect) you look for any confounding variables.
Just to be clear, considering confounding variables is not a “nice to have”, it is fundamental to the scientific method.
Low birth weight is such a fundamental indicator of neonatal health that it very tough to avoid one of two obvious conclusions:
The researchers chose not to look at birth weight as a possible confounding variable, in which case they are incompetent.
The researchers did consider low birth weight as a possible confounding variable and chose to ignore it because it didn’t fit with their preferred conclusions. In which case they are unethical.
You are right in everything you say, so I am confused as to why you are being voted down.
The key point the article makes is that a flawed study design leads to flawed study results (not exactly rocket science!). The key question is why do we get so many flawed study designs these days? I believe the teaching of Critical Race Theory, which basically says racism has occurred, it is the job of the theorist to work out how it has occurred that is a big part of the problem. A subconscious bias towards creating flawed study designs? Or is it a confirmation bias thing when you get a result CRT predicts that you and your peer reviewed don’t critically analyse it and ask obvious questions like could there be another explanation? It would appear to be a combination of both.
It seems that the original study set out to prove racism, not investigate whether racism was a factor.
Sort of the opposite of “science”.
The motivations of the authors aren’t nearly as important as their methods. Did these people ever actually study science? Are they still being funded?
It’s confirmation bias- only use data that supports your opinions.
But road safety statistics generally DO miss exactly this variable! How can anyone easily and reliably price what speeds vehicles were travelling before they crashed (heavy vehicles equipped with tachometers excepted?
Subjective estimates of speed are woefully inaccurate, with the speed of two wheel vehicles being often estimated (small narrow vehicles).
A fairly accurate estimate of speed can be obtained by the length of skid marks and the extent and nature of damage. The engine doesn’t get torn out of a car by a thirty-mile-an-hour collision.
And once you get the result you are looking for you don’t look any further.
A bit like many of the people commenting on this thread…
Yes, it’s called ‘confirmation bias’.
It is very widespread. Almost nobody is immune to confirmation bias and researchers are trained to try to avoid it.
Or are they…..
Because of inherent bias. Inherent bias prevents proper observation. You could call the failure to include a variable incompetence or you could point out that it was completely accurate interpretation once you start from a biased premise. So why is if biased from the jump? Its an institution injecting politics into science.
“It is quite easy to miss a potential factor in a complicated set of data such as this.”
It certainly is if you have an agenda…
That does not excuse reviewers missing such an obvious confounding factor.
Unless they also had agendas…
‘We posit that these differences may be ameliorated by racial concordance between the physician and newborn patient.’’
If you are a white person and you go to an NHS hospital and ask for racial concordance between the physician and you, you could be refused treatment.
That post would get you a fail in a statistics exam.
It’s obvious some are using fake accounts to hit you with negative feedback—classic brigading. I hope the mods step in to fix this. Keep posting; your voice matters.
The process of falsification is a hallmark of White Supremacy as is your post which uses words like “observation” and implies “correlation is not causation.”
You need to reflect on your Whiteness and donate a significant chunk of your life savings to a political organization committed to eradicating barriers to Democracy.
Ho ho! Also don’t forget that, according to the most progressive ‘thinkers’, the use of mathematics and logic is a “male way of thinking” which is therefore obviously oppressive.
If it was so easy to spot the mistake, why did it take these authors 4 years (the article doesn’t answer the question in its own headline)? Why didn’t the reviewers spot the mistake? A more cynical interpretation might be that the authors (employed by a thinktank with a particular set of goals) spent 4 years trawling all the variables they could possibly find until they found a combination that supported their case.
Why did it take so long for Hillary Cass to be asked to do her review and then so long to do her review?
The answer is the same there as it is here – if you are going up against these sick and twisted woke ideologies, then you need extreme courage and extreme diligence to make sure you are on unassailably solid ground. The woke can make all the “mistakes” they like in the name of their “greater good” but those of us who speak out against their evil will be crucified for the slightest error, including past errors that have nothing to do with the situation being exposed.
Well, it is a basic mistake. There’s a class problem involving Simpson’s paradox (I think) in which death rates in kidney stone removal operations are compared for different treatments. One treatment apparently being noticeably less effective. However the treatment is the most sophisticated one, only used by the most skilled surgeons on the most difficult cases.
I don’t think they were trawling but they missed something that they probably shouldn’t have. Mind, given the atmosphere at the time, fools rush in where angels fear to tread.
Or there was another agenda at work.
Either, or?
I’d say many are both.
So, to summarise, White doctors (who also invented most of the medicine and medical technology that improves health outcomes for black people) take on the most difficult and risky cases and do their best to ensure black babies survive while the “diversity ” doctors take thr easy cases…..and a bunch of white liberal “researchers” decide to use bogus stats to malign those White doctors and paint them as racist.
I suppose, as a brown skinned person (and marginally more immune from being shut down by being labelled as racist), I am allowed to point out how utterly vile and disgusting this whole affair is? When and why did the West, or at least it’s academia and media, swap buzzwords and anti racism for common decency?
It’s been going on since the 70s, gathered pace in the 90s but has now spread like a virus though every institution.
Only marginally “more immune.” The utterly vile racist cartoon of Priti Patel (as a sacred cow with ring through nose) that appeared in the Guardian, along with relentless media abuse of Braverman, shows that leftist media can de-victimise at will any public figure who refuses to tow their political line – whatever their colour or ethnic origin. Lampooning of Abbott or Lammy, however, is strictly off limits.
True but they do get lampooned
But why do “severely underweight babies […] tend to be treated by white doctors”? That is left unexplained. Is it really – as you suggest – that white doctors are keener to take on more difficult cases? Even if it is so, that itself needs explanation.
No good deed goes unpunished?
Because, due to low everage IQ, they will never be enough highly skilled black doctors?
What about sending black babies to Africa to be treated if race is such critical factor in medical outcomes?
They may or may not be keener, but there are certainly more of them. At Massachusetts General Hospital, site of residency programs for Harvard Medical School, there are 3 black pediatricians out of 273. At Childrens’ Hospital of Atlanta, affiliated with Emory Medical School, there are no black neonatologists out of 56. Looks to me like the black baby attended by a black doctor is fortunate indeed.
In the US at least South Asians have lost immunity and are classified as “white adjacent”. See the vicious attacks on Usha Vance for example. Or any other brown Republican
We are witnessing the evisceration of the Enlightenment in real time. It’s not edifying.
Looking for racism everywhere is like looking for equidistant letter codes in the Bible (or any text for that matter). If you keep looking and looking, and looking, by golly, you will eventually find it.
Sadly this is the tip of an iceberg, in the UK at least. A whole structure has been created with the specific purpose of creating “evidence” that BAME people are discriminated against.
Take a look at the “WRES”, which claims, for example, that BAME people are under represented at senior levels in the NHS. In fact, the official stats published by the department of health tell a different story. Amongst doctors there are 3 times more south Asians than in the general population; it’s white people who are under represented. WRES systematically distorts the evidence to reach its preconceived conclusions, and this is then used as a pretext to discriminate against white people in recruitment and promotion.
The GMC and medical royal colleges are no better. Last year the GMC published a review of performance at postgraduate exams broken down by various criteria, and claimed the data demonstrated racial bias (BAME junior doctors do not perform as well). Even a cursory review of the original data shows this conclusion is flawed. BAME students are hugely over represented at medical schools, so that the groups are not directly comparable. It’s clear that the criteria used to select entrants results in the whites who do get in being more highly selected. The largest single disparity is the proportion of students from lower socioeconomic groups ie working class white students are almost absent; the report passes over this in silence. One glaring example of the authors’ prejudices is the statement in the summary that Christian juniors do better than Muslims. In fact it’s atheists who do best and Buddhists who do worst, but that’s not the headline the authors want.
I could give many more examples, but I think this is enough for now!
I’d like to believe that a reckoning is coming, and that these dishonest bodies will be exposed, but I’m not holding my breath.
You are out of date. BAME (a senseless acronym for saying non white) has been replaced by Global Majority – an even more senseless way of saying non white. There is so much variation between all the non white groups (and withing white groups for that matter) it makes no sense to group them together. The colour of someones skin is totally irrelevant, what is relevant is the environment they were brought up in and in particular their culture. Cultures that prize and reward learning and hard work are going to do far better than cultures that don’t.
I was informed by a social justice advocate with an Oxbridge degree, that differentiating people by “culture” is dog whistle racism. Leftist doctrine teaches that cultural differences are the product of power differentials, and so even to argue that they exist is reinforcement of “white supremacy.”
That would entail that the idea that power differentials exist is itself part of “white supremacy”, and so – presumably – is an idea that should be spurned. And if power differentials do not exist, then obviously white supremacy does not exist either. So everyone’s happy.
It is one of the charms of this sort of social constructionist claptrap that it so swiftly and effectively puts cancels itself, like a suicide bomber who blows himself up before he has got within a mile of his intended target.
Whole concept of Bame is dishonest.
It was invented to hide the basic fact that it is blacks and Muslims who underperformed due to low IQ and culture.
Indians, Chinese, Koreans are doing better than whites.
Just look at brainboxes like Lamy and Abbott.
How these morons ever got to their positions?
Obviously because of overpromotion of useless minorities.
To what ever extent such things are/ were factual or not is unfortunately irrelevant. It was, is, and will be political.
People want it to be political no matter what “it” is. Going with one’s gut and preferred narrative just feels good and right and often is a means to a self interested end…
Gosh! Expect any different! University standards in the gutter. No education of self bias. Science what science
Well there goes the myth of objectivity. Does it or can it exist? The idea that extensive peer review removes self bias is central to the scientific method as it is practised, but is the opposite actually true: a coterie of people continually confirming an initial bias of an initial hypothesis? Trust the science? Really?
“If you torture the data long enough, it will confess to anything”.
Such a stupid comment. It’s simply not true.
Yeah, cause ‘data’ has no nerve endings and cannot feel pain.
What do we call someone who does not recognize a metaphor when he sees one?
‘The research design contained a fatal flaw, overlooking the fact that severely underweight babies, who have very high mortality rates to start with, tend to be treated by white doctors.’
I said exactly this in the comments section to another article, a few months back.
Simpson’s Paradox reared its head again.
The question is – why do hospitals know that if there is a difficult case, then give it to the white guy?
That’s where the racism/white supremacy bit gets in – the senior doctors are all ‘white guys’, eh? Alternatively, ‘the hospital’ (=admitting staff) is racist and makes the assumption that the white guys are best even if they’re not the senior doctors. You have to account for all this sort of thing as well as the LBW before you can rule out any element of the original claims.
There are more questions than that if we want to rule out racism in medical institutions. Such as access to and availability of services across social, economic and geographic demographics for starters. What is the percentage of babies in need who ended up in intensive care in the first place, and is that affected by race?
Yes, that is an interesting question that the article doesn’t deal with.
Some well known medical schools are now admitting students based on race!!! DEI (which means Didn’t Earn It). So, tell me, ten years from now will you be suspicious when you choose a black doctor to look after you?
In the US, I suspect all patients will be nervous that their Black doctor was a DEI graduate. Which is why it is so pernicious and means that all the highly qualified Black doctors get smeared with the DEI brush.
The capture of all formerly respected institutions and publications by critical race theory and gender theory means that the public can expect this agenda to be played for many years to come. Indocrination, combined with professional intimidation, insures the “allyship” demanded of all doctors and scientists. It will get worse before it gets better, because resistance means reputational suicide.
God forbid (the state) that people should take responsibility for their health and lifestyles……
Hear hear!!!
As a physicist, my understanding of the scientific method is to come up with a theory and then design an experiment that seeks to disprove it. Observational studies are highly prone to error as they can only deliver answers that were within the range of possible answers conceived of by the researchers. In other words, bias is almost guaranteed.
Do not expect any retractions. Do not hope for a more factual direction in future articles. The progressive media has no brain and no conscience. The issue of race is just too politically useful to be dealt with honestly.
Not to worry! These new conclusions will be disseminated with even more zeal than the original FALSE results.
Right, guys?
In recent years, the largest medical journals have all become “woke”, publishing articles that have nothing to do with credible basic science or clinical science. Hippocrates must be rolling over in his grave.
Statistics is a really difficult area of mathematics to master. While being able to run a few regressions and hypothesis tests through some software is relatively easy to learn, working out which model is most suitable, which variables to focus on and how to collect data is super difficult. More seriously, those who can work the tools are not necessarily impartial truth seekers.
It’s not all that difficult. I agree that the choice of variables is important. But in this case, omitting the categorical low birth weight indicator suggests a very deliberate analysis to gin up outrage. If birth weight is available (which it apparently is/was), under no circumstances would I (medical statistican for 35 years) have omitted it.
There is an outstanding question here of why is it that white physicians are more likely to take on babies with low birth weights?
I am instinctively anti-CRT and anti-affirmative action, but I keep waiting for someone to drop the shoe in the comment section: why are white doctors more likely to see the most serious cases? And is that piece of data not at risk of CRT criticism?
Further, and in the same vein, are low birth weights correlated to race in infants?
Are low birth weights correlated to race? Yes, but they’re much better correlated to income.
Great questions! I posted the same question above.
Obviously it’s less serious than the previous premise, but interesting that it was past by in the article.
look at the crime and prison statistics.. look at African and Carribean countries in world economic league tables, in industrial, financial and manufacturing output, civil war statistics, education…
…And conclude what? Black babies are weaker? How would that follow or even explain the misinterpretation?
Anyway, I’m pretty sure these studies were only looking at stats from few USA.
As a physician, it is abhorrent that the flawed study took this long to refute. I suspect in this case it was a result of the popular notion of being a race issue. This is not an uncommon problem, as many studies are flawed and must be carefully reviewed by experts to determine their validity. Personally, I assume every new study is flawed until convinced otherwise.
The implications here is the spread of false theory concerning racism and medical care. “Could the research design of those papers, some of which have been cited hundreds of times in subsequent papers, also have been flawed, so as to advance a progressive political agenda cloaked in the authority of objective science?”
The AMA should be shamed.
It’s incredibly challenging as a doctor to address the racial differences in medical outcomes without fear of serious repercussions. The study suggesting that Black doctors were more effective in ensuring the survival of Black babies than their White counterparts ignored a critical variable: the birth weight of the babies. Low birth weight infants, who are at higher risk, are typically assigned to the most senior and experienced doctors—often White. This oversight skews the data, attributing better outcomes to race rather than to the experience and expertise of the doctor.
When dealing with individuals who fail to recognize these differences in research quality, you’re likely encountering those who haven’t been educated to a high level—a demographic that often makes up the majority of lower-paid employees in hospitals and post-acute care facilities. Discussing complex issues like the role of race in a child’s survival requires also addressing economic independence, maternal nutrition during pregnancy, and follow-up care for Black mothers in the United States.
Comparisons with other nations such as Nigeria, Chad, Haiti, and the Dominican Republic might show that African-American women are less likely to have underweight babies than their counterparts in these countries. However, this won’t prevent the knee-jerk reactions toward systemic racism, especially among the less educated in medical environments. Doctors, who need to work collaboratively with these staff members, are not in a position to single-handedly tackle DEI, CRT, and systemic racism within their workplace.
The burden of proof must remain with the research establishment and those conducting peer reviews. Expecting a doctor in a hospital to navigate these complex social issues while providing patient care is unrealistic and unfair. The focus should be on ensuring that research is thorough, unbiased, and considers all relevant factors, rather than placing the onus on individual healthcare providers to address these broader societal issues in their daily practice.
It is hard to believe (ie disturbingly so) that any serious clinical research about the morbidity/mortality outcomes of newborns omitted birth weight as a fundamental variable.