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JAMA Network Open

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Pediatrics -- health equity


The study from Sullivan et al1 is a valuable contribution to the literature that aims to improve health equity among very preterm infants (and their families). It is to be lauded for its attention to nonclinical factors such as area-level deprivation and racial disparities. By examining communitylevel factors such as area deprivation, this study engages both the medical and public health communities and places infant outcomes directly within the context of housing policy and lack of neighborhood investment. However, it is important that we articulate the connections between area deprivation and adverse outcomes for very preterm infants to even conceive of solutions outside the scope of more patient care. In this commentary, we add historical context to the conditions that predispose very preterm infants in the neonatal intensive care unit (NICU) to morbidity and mortality and look for solutions to the health disparities observed within the hospital by considering the disparate and disenfranchising geographies that produce its young patients.


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