Racial Disparities in the Measurement of APGAR Scores for Newborns

WHEREAS, The NAACP has long been dedicated to ensuring equal treatment and care for all individuals, regardless of race or ethnicity; the APGAR score, a critical measure used to assess the health of newborns immediately after birth, is essential for determining the need for medical intervention; this score (0 – 10) evaluates based on five criteria: Appearance (skin color), Pulse (heart rate), Grimace response (reflexes), Activity (muscle tone), and Respiration (breathing rate and effort); and

WHEREAS, In 2023, the National Center for Health Statistics and the Division of Vital Statistics found Black Newborns had a less than 50% chance of having a 5-minute APGAR score of 10 when compared to white newborns. White babies (non-Hispanic and Hispanic) had the highest proportion of APGAR scores of 10 across all races and ethnicities; and

WHEREAS, Based upon APGAR scores, medical providers disproportionally refer and admit Black neonatal infants to NICU units at a higher rate than non-Black people; and

WHEREAS, Research has indicated significant racial disparities in the measurement of APGAR scores, particularly in the criterion of skin color; the appearance criterion can be biased against babies with darker skin tones, making it challenging for healthcare providers to accurately assess symptoms such as cyanosis (blue or pale discoloration due to lack of oxygen); this bias results in potentially lower or inaccurate APGAR scores for these newborns; and

WHEREAS, Implicit biases among healthcare providers may also affect their assessment of other APGAR criteria, such as muscle tone and reflex response, leading to disparities in scoring; additionally, systemic inequalities in access to quality prenatal and postnatal care exacerbate these disparities, contributing to poorer health outcomes for minority populations; and

WHEREAS, Inaccurate APGAR scores can delay or prevent appropriate medical interventions, increasing the risk of adverse health outcomes and higher infant mortality rates among minority populations; moreover, early disparities in health assessments can contribute to long-term health inequities, affecting ongoing medical care and support for these infants.

THEREFORE, BE IT RESOLVED, that the NAACP urges healthcare institutions and entities to enhance training programs for medical professionals to accurately assess APGAR scores across different skin tones; that this training should include recognizing symptoms of distress in infants from diverse racial and ethnic backgrounds.

BE IT FURTHER RESOLVED, that the NAACP advocates for the development and implementation of standardized guidelines that account for racial differences in skin color and other physiological factors to reduce bias in APGAR scoring.

BE IT FURTHER RESOLVED, that the NAACP calls for researchers in epidemiology, obstetrics, and pediatrics to increase research to understand the extent of racial disparities in APGAR scores and to develop strategies to mitigate them. Raising awareness about these issues within the medical community and the broader society is essential to addressing these disparities.

BE IT FINALLY RESOLVED, that the NAACP demands policies that ensure equitable access to high-quality prenatal and postnatal care for all racial and ethnic groups. Addressing the root causes of these disparities is crucial for promoting health equity.