How diverse is NC's obstetric delivery workforce?

By Julie Spero

Feb 5, 2020

In 2018, 21% of NC’s population identified as black or African American, compared to 13% of the state’s obstetric delivery providers.
Similarly, 10% of NC’s population identified as Hispanic or Latino in 2018, compared to 3% of NC’s obstetric delivery providers.
Additionally, only five black family medicine physicians reported providing routine obstetric delivery services in 2018.
In North Carolina, infant mortality rates are higher for non-Hispanic black babies than for non-Hispanic white babies, and this gap has persisted for nearly 20 years. [1] In 2018, black infants were almost two and a half times more likely to die than white infants. [2, 3]
Relative to white patients, black patients report worse communication and lower shared decision-making with physicians. [4] Racial concordance, when patients and physicians identify as the same race, is associated with better patient-physician communication. Training can help improve communication between non-racially concordant providers and patients.

Row chart comparing the racial composition in North Carolina of Family Medicine Physicians who Deliver Babies, Certified Nurse Midwives, Ob Gyns who deliver, and the NC population.

[1] Di Bona, V. Jones-Vessey K, Cobb SM. Running the numbers: disparities in infant mortality: examining perinatal periods of risk.NCMJ 2020; 81: 70-74.

[2] NC Department of Health and Human Services State Center for Health Statistics, 24 Sept 2019. 2018 NC Infant Mortality Report, Table 3b: Infant Mortality Racial Disparities Between White Non-Hispanics & African American Non-Hispanics: 2014-2018.Accessed 2/5/20 at: https://schs.dph.ncdhhs.gov/data/vital/ims/2018/table3b.html.

[3] Bonner L. Urban or rural, black lives in NC are being cut short almost before they begin.News & Observer, 1/29/20.Accessed 2/5/20 at: https://www.newsobserver.com/news/politics-government/article239388203.html

[4] Shen MJ, Peterson EB, Costas-Muniz R, Hernandez MH, Jewell ST, Matsoukas K, Bylund CL. The effects of race and racial concordance on patient-physician communication: a systematic review of the literature. J Racial Ethn Health Disparities, 2018; 5(1):117-140.

Funding & Acknowledgements

The HPDS is maintained by the Program on Health Workforce Research and Policy at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, in collaboration with the North Carolina Area Health Education Centers Program (AHEC), and the state’s independent health professional licensing boards. Ongoing financial support is provided by the NC AHEC Program Office. Although the NC HPDS maintains the data system, the data remain the property of their respective licensing board. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by NC AHEC. To learn more about NC AHEC please visit: https://www.ncahec.net.

How diverse is NC's obstetric delivery workforce?

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