Hospital costs for Black children were also higher, according to a peer-reviewed study published Thursday in the journal Pediatrics, which is put out by the American Academy of Pediatrics.

“Our study demonstrates the economic impact on our health care system of persisting inequalities in pediatric surgical outcomes,” the authors wrote.The study looked at more than 100,000 children who had appendectomies between 2001 and 2018. A little more than 10% of those children were non-Hispanic Black; the rest were non-Hispanic white.

Researchers said the rates of surgical complications, when adjusting for factors like differences in income, were always higher for Black children, even while the overall rates for Black and white children fell.

“Surgical complications were consistently higher for Black children compared with white children, with no evidence of narrowing of the racial disparity gap over time,” they wrote. This was true regardless of whether the appendix had ruptured when the child was admitted.

Black children’s hospital costs during the study period totaled $518.7 million, with more than 11% of that stemming from higher rupture rates, the researchers found. Between 2015 and 2016 alone, almost $12 million in healthcare spending would have been avoidable had Black and white children had comparable rates of appendix ruptures, also known as perforations.

“The excess risk of perforation in Black patients was associated with a significant financial burden to the health care system because of consistently higher costs incurred by Black children,” the article said.

Racial disparities have arisen during the Covid-19 pandemic as well, where more minorities have been disproportionately impacted by the virus.