If you were asked if you thought racial and ethnic disparities played a role in influencing NICU outcomes, you would likely say yes and unfortunately be correct. But what is the scope of the problem? Sigurdson et al. (10.1542/peds.2018-3114) opted to do a systematic review on this topic and identified 40 relevant articles. The studies indicated that black infants are most disadvantaged and that non-white infants are more likely to receive care in lower quality NICUs or get inferior care in NICUs overall regardless of the overall quality of the NICU.
So what needs to change? We asked Drs. Wanda Barfield, Shanna Cox, and Zsakeba Henderson to share with us their thoughts in an accompanying commentary. (10.1542/peds.2019-1688) The commentary authors point out that this study indicates that NICUs are not the great equalizers we think they are for treating all babies similarly. They remind us how implicit biases can creep in without our realizing it and influence the course of not just infant care but maternal care as well in the perinatal and even prenatal period. They do however also suggest that through quality-improvement initiatives, these disparities can be overcome. The authors of this commentary even provide five actions we can take to change the disappointing findings in this systematic review. To find out what the five action steps are and how they relate to the studies in the systematic review, take special care to read both and then see which of the five actions can be improved in your local NICU to close the racial/ethnic disparity gap that should not be as wide as it is today in the NICUs described in the Sigurdson et al. review article.