In her dissenting opinion to the Supreme Court’s decision to strike down racial preferences in university admissions, Justice Ketanji Brown Jackson managed to pull off a trifecta: She was factually incorrect in describing the results of a study that should not be believed, which wouldn’t provide practical support for her argument even if it were accurate and credible.
Jackson claimed that racial preferences were essential in admission to medical schools because more black doctors were needed to improve health outcomes for black patients.
Specifically, she wrote, “For high-risk black newborns, having a black physician more than doubles the likelihood that the baby will live, and not die.” That claim was taken from an amicus brief filed by the Association of American Medical Colleges, which in turn was referencing a study that appeared in the Proceedings of the National Academy of Sciences.
First, the study does not claim to find a doubling in survival rates for black newborns who have a black attending doctor. Instead, in its most fully specified model, it reports that 99.6839% of black babies born with a black attending physician survived compared with 99.5549% of black babies born with white attending physicians, a difference of 0.129%.
The survival rate of 99.6839% is not double 99.5549%.
The claim that survival rates for black newborns double when they have black physicians is just plain false. The fact that neither the Association of American Medical Colleges nor Jackson’s clerks could read and properly understand a medical study is an alarming indication for the current state of both medical and legal education.
Second, even if the results of the Proceedings of the National Academy of Sciences study were accurately described, they should not be believed. The study’s comparison of death rates for newborns who have doctors of different races does not take into account the fact that black newborns have a greater likelihood of serious medical complications and the attending physicians assigned to treat those more challenging cases are likely to be white.
For example, the study does control for whether newborns are low weight (less than 2,500 grams), but does not control for whether they are very low weight (less than 1,500 grams). Black newborns are almost three times as likely as white newborns to weigh less than 1,500 grams.
Doctors assigned to treat very low-weight babies are more likely to be specialists, rather than regular pediatricians or family practitioners. Black doctors are significantly less likely to be found in those specialized fields.
More than 5% of pediatricians or family practice physicians are black, compared with 3.8% of neonatologists and pediatric cardiologists, and 1.8% of pediatric surgeons.
Rather than demonstrating the protective benefits of black newborns having black doctors, the Proceedings of the National Academy of Sciences study only documents that black newborns are more likely to have severe issues that increase their risk of infant mortality, and those severe cases are more likely to have white attending physicians because white doctors are more prevalent in the specialized fields that treat those complications.
The study provides no convincing evidence on whether black newborns with identical conditions would fare better, worse, or no differently with a black or white doctor.
Third, even if Jackson could describe the results of the study accurately and even if those results were credible, the finding would not support the claim that we should employ racial preferences in medical school admissions.
As a practical matter, increasing the number of black doctors so that every black newborn could be ensured to have one would require significant dilution in the quality of doctors so that the modest benefit claimed in the study would likely be swamped by the harm of less capable physicians.
In addition, matching black newborns even to this larger number of black doctors would require racial segregation in health care that would run afoul of widely accepted legal and political opposition to such practices.
Misdescribing badly conducted research to advocate impractical policy solutions is not a winning combination, but somehow critics of the Supreme Court decision fail to notice these flaws.
Washington Post columnist Ruth Marcus repeated the false claim found in Jackson’s dissenting opinion and in the Association of American Medical Colleges brief, intoning that we should “consider this sobering point.”
A New York Times editorial avoids misdescribing the results, but still embraces the faulty study, declaring that “black infants, for example, are more likely to survive under the care of a black doctor.”
Because they pride themselves as people who “believe in science,” they feel it necessary to invoke research to justify their support of racial preferences, never minding whether they are reading the research correctly, whether the research is convincing, or whether the research actually supports their preferred policy.
This piece originally appeared in The Daily Signal on June 30, 2023.
