Borjas George J, VerBruggen Robert
Harvard Kennedy School, Harvard University, Cambridge, MA 02138.
Manhattan Institute, New York, NY 10017.
Proc Natl Acad Sci U S A. 2024 Sep 24;121(39):e2409264121. doi: 10.1073/pnas.2409264121. Epub 2024 Sep 16.
The racial gap in infant mortality is a pressing public-health concern, and [B. N. Greenwood et al., , 21194-21200 (2020), 10.1073/pnas.1913405117] suggest that Black newborns are more likely to survive if cared for by Black physicians after birth, even in models that control for numerous variables, including hospital and physician fixed effects, and the 65 most common comorbidities affecting newborns (as described by International Classification of Disease codes). We acquired the data used in the study, covering Florida hospital discharges from 1992 through the third quarter of 2015, to replicate and extend the analysis. We find that the magnitude of the concordance effect is substantially reduced after controlling for diagnoses indicating very low birth weight (<1,500 g), which are a strong predictor of neonatal mortality but not among the 65 most common comorbidities. In fact, the estimated effect is near zero and statistically insignificant in the expanded specifications that control for very low birth weight and include hospital and physician fixed effects.
婴儿死亡率方面的种族差距是一个紧迫的公共卫生问题，[B. N. 格林伍德等人，《美国国家科学院院刊》，第21194 - 21200页（2020年），doi:10.1073/pnas.1913405117]表明，黑人新生儿如果在出生后由黑人医生照料，存活的可能性更大，即使在控制了众多变量的模型中也是如此，这些变量包括医院和医生固定效应，以及影响新生儿的65种最常见的合并症（如国际疾病分类代码所描述）。我们获取了该研究中使用的数据，涵盖1992年至2015年第三季度佛罗里达州的医院出院情况，以复制并扩展该分析。我们发现，在控制了表明极低出生体重（<1500克）的诊断后，一致性效应的幅度大幅降低，极低出生体重是新生儿死亡率的一个强有力预测指标，但不在65种最常见的合并症之列。事实上，在控制了极低出生体重并纳入医院和医生固定效应的扩展规格中，估计效应接近零且在统计上不显著。
