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The Value of Social Science to Reducing Racial/ethnic Disparities in Maternal and Neonatal Quality of Care

Mon, August 13, 4:30 to 6:10pm, Philadelphia Marriott Downtown, Floor: Level 4, Franklin Hall 7

Abstract

Medical sociologists have long debated what it means to be a sociologist in or of medicine, and whether this distinction even matters. As two sociologists working within the School of Medicine at Stanford at quality collaboratives focusing on neonatal and maternal quality care respectively, we routinely grapple with the question of how we are both in and outside of medicine, and how we can maintain our relative “outsider” status while making real and unique contributions to improving healthcare. In this paper, we explore what insights we as medical sociologists, who are invested in maternal and child health, can add to quality improvement work at the hospital level. We draw specifically on our current areas of research – racial/ethnic disparities in quality of neonatal and maternal care – both of which are a national priority and have garnered much needed media attention. We argue that social science theories and methods are essential in quality improvement efforts to reduce clinically based racial/ethnic disparities. We begin with a brief review of quality improvement by looking at the historical context of this approach and its application in healthcare in general and our organizations in particular. We then review racial/ethnic disparities in maternal and neonatal quality of care in order to support our argument that sociological insights and tools can enhance health care quality improvement efforts. Overall, we ask: how can a model derived from industrial engineering (quality improvement) be applied to addressing complex racial/ethnic inequalities in care quality with roots in historical and contemporary systemic racism, and embodied within intergenerational life trajectories. We would suggest that any progress in this area is not possible without the insights of social science – on the effects of racism and stress, on the role of cultural health capital in health care interactions, on the imperative to use critical qualitative methods, on interrogating systemic racism, on the need to include communities as partners in research, and on the insights of critical race theory in interrogating the power relations in research and medicine.

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