The racial gap in infant mortality is a pressing public health concern … [However, we] find that the magnitude of the concordance effect is substantially reduced after controlling for diagnoses indicating very low birth weight (<1,500 g), which are a strong predictor of neonatal mortality … In fact, the estimated effect is near zero and statistically insignificant in the expanded specifications that control for very low birth weight and include hospital and physician fixed effects.
In other words, the newborns attended by White and Black physicians are not random samples. Black newborns with a very low birth weight are disproportionately more likely to be attended by White doctors than by Black doctors. Those newborns are also more likely to have a low chance of survival. The exclusion of the very-low-birth-weight variable from the regressions then suggests that, on average, Black babies attended by White doctors will have poorer outcomes than Black babies attended by Black doctors. But this effect may have little to do with racial concordance.