Sources of Racial Disparities in Critical Care Outcomes: A Single Center Analysis

There has been substantial documentation of racial and ethnic disparities in health outcomes, and a growing body of research on critical care outcomes specifically. In this paper, we seek to quantify the sources of racial disparities in a single urban intensive care unit (ICU), at Johns Hopkins Hospital in Baltimore, Maryland. Between 2014 and 2021, we document significant disparities in in-unit mortality, and length of ICU stay between racial and ethnic minority group patients versus White patients. Using the ZIP-Code and sociodemographic information collected on patients, we quantify the extent to which the disparities can be attributed to the observable socioeconomic and physiological factors. We find that socioeconomic factors and the Sequential Organ Failure Assessment (SOFA) score—a measure of ICU acuity—explain the Black-White, Hispanic-White, and Asian-White gaps in length of stay, and the Hispanic-White and Asian-White gaps in mortality. The SOFA score fully explains the Black-White gap in mortality outcomes, and socioeconomic factors surprisingly offset these gaps.