The Disparity Machine
The COVID pandemic has revealed, again, the tremendous racially-based disparities in US health outcomes, with death rates among black and latinx populations much higher than those for whites. Here’s a thought-provoking piece from the New York Times, “Many Medical Decision Tools Disadvantage Black Patients,” that explains how disparities get baked into the system of medicine via tools, software and formulas that dictate care.
This is the nub of the Times‘ story: “Unbeknown to most patients, their race is incorporated into numerous medical decision-making tools and formulas that doctors consult to decide treatment for a range of conditions and services, including heart disease, cancer and maternity care, according to a new paper published Wednesday in the New England Journal of Medicine.
“The unintended result, the paper concludes, has been to direct medical resources away from black patients and to deny some black patients treatment options available to white patients.
“The tools are often digital calculators on websites of medical organizations or — in the case of assessing kidney function — actually built into the tools commercial labs use to calculate normal values of blood tests. They assess risk and potential outcomes based on formulas derived from population studies and modeling that looked for variables associated with different outcomes.
“’These tests are woven into the fabric of medicine,’ said Dr. David Jones, the paper’s senior author, a Harvard historian who also teaches ethics to medical students.”