Black and Hispanic children have significantly higher rates of death after surgery than white children, according to a new study.
“A continuous, targeted national focus on implementing effective, equitable prevention strategies in all communities and healthcare settings (especially those serving areas with predominant minoritized populations) will be necessary to bend post-surgical mortality curves downward for children of all races and to eliminate disparities,” authors wrote in “Race, Ethnicity, and Pediatric Postsurgical Mortality: Current Trends and Future Projections” (Nafiu OO, et al. Pediatrics. July 29, 2024).
Researchers examined data on 673,677 children under 18 years undergoing intermediate- to high-risk surgery in U.S. hospitals between 2000 and 2019.
Deaths in the hospital after surgery declined for Black, white and Hispanic children, but there were significant disparities among the three groups.
Compared to white children, Black children were 42% more likely to die after surgery and Hispanic children were 22% more likely to die. Authors calculated there were 4,700 excess deaths for Black children after surgery and 5,500 for Hispanic children, averaging more than 500 per year when combined.
Disparities were especially significant in the Northeast and in non-teaching hospitals. They also were high for Black children in the West.
Authors said socioeconomic status, comorbidities, implicit bias, suboptimal care before surgery and timeliness of referral for surgical consultation may contribute to disparities.
The team said its findings call for “urgent interventions” such as incentivizing hospitals to address these disparities and increasing universal access to high-quality health care.
Reducing postoperative deaths among Black children by 2.5% each year would prevent about 1,100 deaths in the next decade, according to the study.
“As children are vulnerable members of the society who depend on adults to mitigate external determinants of health and health outcomes, disparities in pediatric postoperative mortality rates are a riveting social mirror underscoring societal inequities that must be addressed,” authors wrote. “We must move beyond resolute complacency to comprehensive, solution-focused efforts to reduce, and ultimately eliminate, inequities in pediatric surgical health.”
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