Antiracism in the Field of Neonatology: A Foundation and Concrete Approaches

Abstract

Neonatal patients and families from historically marginalized and discriminated communities have long been documented to have differential access to health care, disparate health care, and as a result, inequitable health outcomes. Fundamental to these processes is an understanding of what race and ethnicity represent for patients and how different levels of racism act as social determinants of health. The NICU presents a unique opportunity to intervene with regard to the detrimental ways in which structural, institutional, interpersonal, and internalized racism affect the health of newborn infants. The aim of this article is to provide neonatal clinicians with a foundational understanding of race, racism, and antiracism within medicine, as well as concrete ways in which health care professionals in the field of neonatology can contribute to antiracism and health equity in their professional careers.

Structural racism is associated with adverse postnatal outcomes among Black preterm infants

“…Medical institutions can evaluate and address current culture and practice differences, strengthen ties to community resources, and reduce additional financial burdens. 38 , 47 Both the federal government and medical institutions must both examine how structural racism is operationalized within their spaces and redistribute and equitably share power for all by revising their laws, practices, policies, and culture to become actively antiracist. 47 – 49 …”

“… 38 , 47 Both the federal government and medical institutions must both examine how structural racism is operationalized within their spaces and redistribute and equitably share power for all by revising their laws, practices, policies, and culture to become actively antiracist. 47 – 49 …”

“…Medical institutions can evaluate and address current culture and practice differences, strengthen ties to community resources, and reduce additional financial burdens. 38,47 Both the federal government and medical institutions must both examine how structural racism is operationalized within their spaces and redistribute and equitably share power for all by revising laws, practices, policies, and culture to become actively antiracist. [47][48][49] CONCLUSION In our study, structural racism, measured by racial and economic segregation, was associated with adverse postnatal outcomes for preterm infants born to Black birthing people, including frequent acute care visits, readmissions, and post-discharge mortality.…”

Impact of COVID-19 on Infants followed after Discharge from the Neonatal Intensive Care Unit Using a Telemedicine Model

“…Neonatal providers are optimally suited to address the social needs of NICU families as they transition to life at home with their infant. 43 These findings can be used by NICUs locally, but also across the country to explore regional needs and develop programs and policies to better prepare NICU families for the challenges they may face after discharge from the NICU. Here are some statements that people have made about their food situation.…”

Consensus on an implicit bias and health disparities curriculum in neonatal medicine: a Delphi study

“…These biases are ubiquitous, observed even among health professions education (HPE) learners 12 and professionals, 13 and they often exist in stark opposition to self-reported perceptions of and behaviors towards Black people. 14 IBs have been linked to health disparities 15,16 but are potentially modi able, 17,18 leading to a longstanding call for effective IB education of health professionals and HPE learners, 9,[19][20][21] including within pediatrics 8 and its subspecialties such as neonatology 22 . Though many have attempted to study IB education in healthcare, empirical studies of IB education within HPE commonly assess only lowerlevel learning outcomes such as self-assessed awareness or knowledge, [23][24][25] and few assess for lasting changes in knowledge, skill or behavior.…”