EXCLUSIVE: Researchers Axed Data Point Undermining ‘Narrative’ That White Doctors Are Biased Against Black Babies
A researcher who argued that infant mortality is higher for black newborns with white doctors because of racial bias omitted a variable from the paper that “undermines the narrative,” according to the researcher’s internal notes.
The study forms a keystone of the racial concordance field, which hypothesizes patients are better served by medical providers of the same race, and has served as a rationale for affirmative action. It faces new questions just as universities move to defund their Diversity, Equity and Inclusion programs or face legal action.
The August 2020 study in the prestigious Proceedings of the National Academy of Sciences (PNAS) concluded that the gap in mortality rates between black newborns and white newborns declines by 58% if the black newborns are under the care of black physicians. A possible driver of the phenomenon could include a “spontaneous bias” by white physicians toward the babies, the researchers wrote.
The paper’s most high-profile booster was Supreme Court Justice Ketanji Brown Jackson, who cited it as evidence for the benefits of affirmative action in her dissent in the 2023 Supreme Court ruling Students for Fair Admissions v. Harvard, which found that universities that considered the race of college applicants had violated the equal protection clause of the Fourteenth Amendment.
“For high-risk Black newborns, having a Black physician is tantamount to a miracle drug: it more than doubles the likelihood that the baby will live,” reads an amicus brief filed by the Association of American Medical Colleges. “Yet due to the enduring and significant underrepresentation of minorities in the health professions, many minority patients will not receive care from a racially diverse team or from providers who were trained in a diverse environment.”
Black newborn babies in the US are more likely to survive childbirth if they are cared for by Black doctors, but three times more likely to die when looked after by White doctors, a study finds. https://t.co/cwZ3BZmlL2— CNN (@CNN) August 18, 2020
Now, evidence has emerged that the paper’s lead author buried information in order to tell a tidier story than the one his methods and data originally illustrated.
A key data point was edited out of the body of the paper, apparently because it muddled the downstream policy implications of the study, according to documents obtained through the Freedom of Information Act by the nonprofit Do No Harm, which opposes identity politics in medical research and clinical practice.
The study originally asserted that white babies died less frequently with white doctors.
“White newborns experience 80 deaths per 100,000 births more with a black physician than a white physician, implying a 22% fatality reduction from racial concordance,” an unpublished draft reads.
But the study’s lead author Brad N. Greenwood wrote in the margin: “I’d rather not focus on this. If we’re telling the story from the perspective of saving black infants this undermines the narrative.”
“That’s not how scientists speak,” Ian Kingsbury, director of research at Do No Harm, told the Daily Caller News Foundation. “It’s not a smoking gun, but it’s certainly suggestive they were pushing one narrative or another.”
The data point was axed.
“Concordance appears to bring little benefit for White newborns,” the paper reads.
While omitted in the paper’s body, the data point can be found in the appendix as part of a logistic model. Unlike the linear regression highlighted in the paper, a logistic model is more appropriate for binary questions like whether a newborn survives or dies, according to Ted Frank, a senior attorney with the Hamilton Lincoln Law Institute, which filed an amicus brief in favor of Students for Fair Admissions.
Saw this in @SCOTUSblog. Wait, what? Affirmative action doctors *double* the chances of black infant survival?!? pic.twitter.com/mMKB58vJey
— tedfrank (@tedfrank) October 30, 2022
Greenwood, the Maximus Corporate Partner Professor of Business at George Mason University, wrote another note to his coauthors that may indicate he had a predetermined desired conclusion, a strong correlation between physician race and clinical outcomes, the FOIA documents suggest. Greenwood wrote in a February 2019 email that the correlation between variables had decreased after a coding fix, which he described as “bad news.”
“Good news – I caught my obligatory coding error, updated results are attached. Bad news- results are not as strong. We lose the effect when a physician fixed effect is included for newborns,” Greenwood said in an email to his coauthors on February 16, 2019. “I think there is enough to tell a story here.”
Greenwood did not reply to a request for comment. Publisher PNAS also did not respond to a request for comment.
Kingsbury said that because of the study’s apparent methodological flaws he doubts the paper’s claims on both the purported benefits of racial concordance for both white newborns and black newborns.
“Not only is this offensive to the doctors who don’t care at all what color their patients are but it’s self-defeating,” Kingsbury said. “You want the highest quality of care from the highest quality of candidates who get into and go through medical school.”
The study has been cited 507 times in the scientific literature. But the study has made a big impact outside of academia too.
Published in August 2020 amid the Black Lives Matter protests, the study has generated more public discussion in the laypress and on social media than 99% of scientific studies published in the last five years, according to Altmetric. The study has received coverage in 340 outlets including CNN, USA Today, and the Washington Post.
Time Magazine named one of the study’s coauthors, University of Minnesota Center for Antiracism Research for Health Equity Director Rachel Hardeman, as one of the country’s 100 most influential people in 2024. Prior investigations by the Daily Caller News Foundation found that the University of Minnesota questioned applicants to its medical school about George Floyd and that the medical school spent $200,000 on racial bias training.
Hardeman did not respond to a request for comment.
The PNAS paper illustrates that health equity research is often politically motivated, which is used to justify DEI policies, which are used to incentivize more of the same types of research questions, John Sailer, director of higher education policy at the Manhattan Institute, told the DCNF.
“A lot of researchers will openly declare their political agenda, espousing methodologies like public health critical race praxis. To state the obvious, it politicizes science,” he said. “It’s no surprise universities are now facing a serious reckoning.”
AUTHOR
Emily Kopp
Contributor.
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