SCOTUS Turns a Blind Eye to Black Infant Mortality Rates - Replaces Affirmative Action with Affirmative Inaction

by Brian T. Lynch, MSW

"The United States has never been color blind."

 So wrote Justice Ketanji Jackson in her scathing dissent of the conservative majority decision to end Affirmative Action and the holistic methods universities use to overcome the systemic advantages of white students in college admissions. All evidence in the case point to the fact that affirmative actions taken to overcome racial disadvantages in college admission decisions are working, over time, to narrow the historical gaps in outcomes of Black Americans in areas of health, wealth, and well-being.

One of many examples that Justice Jackson cited struck me as particularly disturbing. It is also emblematic of the problem-solving abilities of affirmative action programs to close a real-life, race-based disparity. Black infant mortality rates, which are 2 to 3 times higher than for white infants, are reduced by half when their doctors are also African-American.

I couldn’t believe it. I had to check.

“Although Black newborns are three times as likely to die as White newborns, when the doctor of record for Black newborns — primarily pediatricians, neonatologists and family practitioners — was also Black, their mortality rate, as compared with White newborns, was cut in half.” - Washington Post.

For the record, the mortality rate for white newborn infants treated by black physicians is the same as it is for white doctors. An underlying study lays it out more starkly:

"In the simple model absent controls, the Patient Black coefficient indicates that, under the care of White physicians, Black newborns experience triple the in-hospital mortality rate of White infants (column 1 of Table 1). Under the care of White physicians, the White newborn mortality rate is 290 per 100,000 births, as implied by the constant term (0.290). Black newborn mortality is estimated at 894 per 100,000 births (0.290 + 0.604). The Physician Black coefficient implies no significant difference in mortality among White newborns cared for by Black vs. White physicians (columns 1 to 5 of Table 1). In contrast, we observe a robust racial concordance benefit for Black newborns, as captured by the Physician Black * Patient Black interaction. Under the care of White physicians, Black newborns experience 430 more fatalities per 100,000 births than White newborns (column 4). Under the care of Black physicians, the mortality penalty for Black newborns is only 173 fatalities per 100,000 births above White newborns, a difference of 257 deaths per 100,000 births, and a 58% reduction in the racial mortality difference." - Proceedings of the National Academy of Science (PNAS)

Here is a clear example of where an affirmative intent to locate and educate highly qualified African-American students to perhaps become doctors can directly solve a horrible and long-standing racial gap in health outcomes for infants who are born Black. The transformational powers of Affirmative Action programs made it a target for the opponents of change.  The colorblind admissions criteria mandated by the Supreme Court turn a blind eye to tens of thousands of avoidable deaths of Black babies every year. How does this square with the sanctity of life principle behind last year's Dobb decision overturning abortion? How will requiring institutions of learning to avert their attention from the social impacts of racial disparities ever solve problems like this?