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Getting to health equity in NICU care in the USA and beyond
  1. Jochen Profit1,2,
  2. Erika M Edwards3,4,5,
  3. DeWayne Pursley6,7
  1. 1 Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, School of Medicine, Stanford University, Stanford, California, USA
  2. 2 California Perinatal Quality Care Collaborative, Lucile Packard Children's Hospital, Palo Alto, California, USA
  3. 3 Vermont Oxford Network, Burlington, Vermont, USA
  4. 4 Department of Pediatrics, Robert Larner MD College of Medicine, University of Vermont, Burlington, Vermont, USA
  5. 5 Department of Mathematics and Statistics, College of Engineering and Mathematical Sciences, University of Vermont, Burlington, Vermont, USA
  6. 6 Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
  7. 7 Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Jochen Profit, Pediatrics, Stanford University, Stanford, CA 94304, USA; profit{at}


Differences in race/ethnicity, gender, income and other social factors have long been associated with disparities in health, illness and premature death. Although the terms ‘health differences’ and ‘health disparities’ are often used interchangeably, health disparities has recently been reserved to describe worse health in socially disadvantaged populations, particularly members of disadvantaged racial/ethnic groups and the poor within a racial/ethnic group. Infants receiving disparate care based on race/ethnicity, immigration status, language proficiency, or social class may be discomforting to healthcare workers who dedicate their lives to care for these patients. Recent literature, however, has documented differences in neonatal intensive care unit (NICU) care quality that have contributed to racial and ethnic differences in mortality and significant morbidity. We examine the within-NICU and between-NICU mechanisms of disparate care and recommend approaches to address these disparities.

  • Healthcare Disparities
  • Health services research

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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  • Contributors JP, EME and DP conceptualised, reviewed and revised the manuscript.

  • Funding Dr. Profit's effort was in part funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) R01 - HD094847 (Co-PIs: J Profit, E Main)

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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