In the United States, health disparities related to race and ethnicity start early. A study published March 25 in JAMA Pediatrics has found very-low-birth weight and very-preterm infants are segregated by race and ethnicity in neonatal intensive care units (NICUs). Black babies tend to be treated in NICUs that offer lower-quality care. Infants of Asian and Hispanic ethnicity receive care at NICUs known for best-quality care, and white infants fall in between these extremes.
The authors, from several U.S. universities and hospitals, say that the segregation in the NICU reflects broader social patterns in the United States. Indeed, NICU quality varies by geography and well as by populations treated in them. Continue reading
Courtesy of Neel Shah, M.D.Health reformers are grappling with how to bring down the high rate of cesarean section deliveries in the United States. The U.S. isn’t the only country in the world overusing the procedure, but it does have one of the highest rates.
I recently heard Neel Shah, M.D., an obstetrician at Beth Israel Deaconess Medical Center, the founder of Costs of Care, and associate faculty at Ariadne Labs (more about all of that here) speak about health care quality and delivering babies.
We’ve all heard about unnecessary cesarean sections (and elective induced early births, although that’s a related but not identical set of challenges). Many of us tend to think of it as a doctor-centered issue. Some doctors perform more C-sections than others and there are a host of reasons, ranging from how and where they were trained to how they assess and tolerate maternal risk to time management and financial considerations.
But Shah challenged me to think of unnecessary C-sections as a hospital management or system engineering problem – not just a problem created by individual doctors. Continue reading
While beauticians and tattoo artists are regulated in the state of Oregon, midwife certification is voluntary and, even then, the hurdles for certification are rather minimal.
But with midwives largely operating outside of the established health care system, there was little more than anecdotal evidence about the safety of home births to go on. That changed last year.
Markian Hawryluk, a health reporter with The Bend (Ore.) Bulletin and an AHCJ Regional Health Journalism Fellow, describes how he took advantage of new data collected by the state of Oregon to shape an article that revealed high mortality rates for home births in his state.
“If home birth were a drug,” he wrote, “it would be taken off the market.”
Read more about how he reported the story and get links to resources he used.
Births in the United States went down nearly 2 percent in 2008, according to new figures [PDF] from the CDC’s National Center for Health Statistics.
Among the report’s highlights:
- The birth rate for U.S. teenagers fell 2 percent, reversing a two-year increase.
- The birth rate for Hispanic teenagers declined to an historic low.
- The cesarean delivery rate rose for the 12th straight year, to 32.3 percent of all births.
- The percentage of births born preterm declined 3 percent.
Health Journalism 2010
Learn more about “Pregnancy and childbirth trends: Issues of safety and choice,” a panel featuring Mark R. Chassin, M.D., president of The Joint Commission; Julie Deardorff, health and fitness reporter at the Chicago Tribune; Alan M. Peaceman, M.D., professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine and chief of the Division of Maternal-Fetal Medicine at Northwestern Memorial Hospital; and moderated by Deborah L. Shelton, a Chicago Tribune health reporter.