Study: Black kids more likely to die after surgery
Black children are more than three times as likely to die within a month of surgery as white children, according to a study published in the journal Pediatrics on Monday.
Disparities in surgical outcomes between Black and white patients have been well established, with researchers attributing some of the difference to higher rates of chronic conditions among Black people. But this study, which looked at data on 172,549 children, highlights the racial disparities in health outcomes even when comparing healthy children.
Researchers found that Black children were 3.4 times as likely to die within a month after surgery and were 1.2 times as likely to develop postoperative complications. The authors performed a retrospective study based on data on children who underwent surgery from 2012 through 2017.
Olubukola Nafiu, the lead author of the study and a pediatric anesthesiologist at Nationwide Children’s Hospital in Columbus, said the authors were not surprised to find that healthy children, across the board, had extremely low rates of mortality and rates of complications after surgery. But what surprised them was the magnitude of the difference in mortality and complication rates by race.
“The hypothesis we had when we started was that if you studied a relatively healthy cohort of patients, there shouldn’t be any difference in outcomes,” Nafiu said.
The authors, in their paper, acknowledged limitations of the study: They did not explore the site of care where patients received their treatments or the insurance status of patients, which can be used as a proxy for socioeconomic status. This meant they could not account for differences in the quality of care that patients received or the economic backgrounds of the patients.
Another limitation was that because mortality and postoperative complications are so uncommon among healthy children, it is possible that most of the cases came from a few hospitals, Nafiu said.
But while Black people are more likely to receive care in low-performing hospitals, that may not be the main factor driving the gap this study found, Nafiu said. The hospitals examined in the study were all part of the National Surgical Quality Improvement Program, a voluntary program, meaning they had resources to be part of the program and belief that quality improvement is important.
Adil Haider, dean of the medical college at Aga Khan University, who was not involved with the study, said that it told an important piece of the story about racial disparities in surgical outcomes, but that there were still many questions about what drives disparities.
“The real take-home is that we just need to start reporting data within hospitals and when we aggregate hospitals — by race and by insurance status — so that we know that, at a given hospital, people from different backgrounds are all receiving the same outcomes,” said Haider, the former director of the Center for Surgery and Public Health, a joint initiative of Brigham and Women’s Hospital, Harvard Medical School and the Harvard T.H. Chan School of Public Health.
Many studies have shown that people of color receive less and often worse care than white Americans because of reasons including lower rates of health coverage and racial stereotyping.
But one study, published in June by JAMA, suggested some signs of improvement. That research paper, which looked at more than 20,000 extremely preterm infants, suggested that racial disparities in mortality rates had shrunk from 2002 to 2016. The results were significant because the racial disparities around maternal mortality, premature birth and infant mortality have been persistent.
Business: Midway Trailer Sales LLC
Locations: 5135 Wadsworth Road in Dayton, and 14275 Glynwood New Knoxville Road in St. Marys
Owners: Roger and Deb Miller
Years in operation: Rodoc Leasing Sales and Service in Delphos — the parent company to Midway — has been in business for 46 years. The Dayton Midway for 2½ years, the St. Marys Midway for 25 years.
Describe what your business does: Midway Trailers and
Rodoc has set up shop as a dealer for over 15 trailer manufacturers, offering a full line of utility, enclosed, equipment, dump, livestock, fuel and grain hopper trailers. We also offer service repair and a complete stock of trailer parts and accessories. We are Ohio’s only authorized Timpte grain hopper dealer and are the premier dealers for Thunder Creek fuel trailers.
What inspired you to start this business? The Midway store in St. Marys was originally opened in 1995 by Barb Sattler and her late husband, Larry. The store was opened to sell parts and service during the
spring and summer, while doubling as a shop to work on their hot rods and other projects during the winter. As business grew, they started filling their lot with more and more types of trailers to better meet the needs of farmers, construction crews and landscapers alike. Fast forward 20 years and the new owners, Roger and Deb Miller, brought the new store front to the Dayton market. The Miami Valley area has offered a wide range in consumers — commercial businesses, consumers looking for a way to move motorcycles and other toys, and everything in between.
How has your business embraced innovation? Like many others, Midway Trailers has found a certain shift in how information is spread to the consumer base. Technology has offered a whole new realm of convenience to everyone on both ends, in how information is received and also how it is disseminated. While the industry itself is always growing and changing, bringing more cost effective and efficient features and upgrades to the product, the dealers really have no choice but to keep up. We embrace innovation differently every day. Whether it’s a new regulation on road safety and towing capacities or a new feature designed to extend trailer life and ease the maintenance down the road, it seems the business is always reinventing itself.
What’s your biggest challenge right now? It’s been tough to keep trailers on the lot. While most commercial crews were still running jobs, there never really was a lull in sales. The Dayton area has been good to us in that sense. However, with manufacturers shutting down to help slow the spread of COVID-19, orders have been backlogged. But they are slowly trickling back onto the lots. Our manufacturers have been amazing, working with us at all hours of the day to get forms and pricing. Though they may have been at home in their PJs, they have been more than accommodating in getting us quotes and updates on orders.
What’s your biggest opportunity right now? The people who have been working still need trailers, which has been a huge opportunity for us, especially with most consumer-based customers actually having time to make it on the lot. Though they have been met with some limitations to the showroom and physical procedures once in, we are very glad to see a steady flow of traffic through the doors.
We have a huge opportunity for new growth this year. Especially in the agricultural market, as we have just recently become Timpte’s only authorized grain hopper dealer in Ohio. Also, we are thrilled to be Ohio’s premiere dealer for Thunder Creek fuel trailers, offering a safe, clean, and convenient solution to crews working with bulk diesel, DEF, and
other oils and fuels.
What do you want readers to know about your business today? We are continually looking to explore and expand what we can offer to customers. We have recently taken on numerous new brands and product lines, both local and national, to provide the best products at the best price. From dipping our toes into the boat trailer world to trying out new preventative maintenance product lines, we work hard to find what works best for the customer.
We are in the business of getting people what they need and nothing less. We have worked with countless companies and noncommercial haulers to keep them moving smoothly from point A to point B, safely and efficiently.
We want to thank the Dayton community for welcoming us with open arms, and we are excited to see what we can continue to bring to the storefront to meet the hauling needs of the Miami Valley.