Does limited access to NICU services account for higher neonatal mortality rates among blacks?

During a 2-year period in the Finger Lakes region of upstate New York, black infants were admitted to the NICU 2.6 times as often as white infants. The relative risk of NICU admission among black low birthweight infants was 9.2 times that of normal birthweight black infants. The relative risk of NICU admission among white low birthweight infants was 16.4 times that of normal birthweight white infants. Thus, higher rates of low birthweight among blacks did not account for the increased utilization of NICU services by blacks. Within the NICU, 30% of the deaths among black normal birthweight infants could be attributed to complications of asphyxia, persistent fetal circulation, or meconium aspiration. Only 14.3% of the deaths among white normal birthweight infants were attributed to these cause. Higher black neonatal mortality rates did not appear to be due to limited access to NICU services, but more normal birthweight black babies may have died of potentially preventable causes.