The Optics of Health: Race Skin Tone Minority Health and Health Disparities in the U.S.

项目摘要 1980年，据估计，纽约市哈莱姆区的黑人男性青年不太可能 在孟加拉国，活到65岁的男性比年轻的男性多。1980年的死亡率为 据估计，哈莱姆黑人男性和女性的比例大约是白人男性的6倍 以及同年龄段的女性。研究表明，这些巨大的差距-- 通常被理解为是社会压力和其他导致发病较早的因素的结果 更多的疾病，更严重的疾病，以及更差的医疗质量来应对发病率- 仍然相当可观。新冠肺炎大流行不仅抹去了任何前进的进展 在这些差异中，但实际上似乎造成了更大的民族健康差异。 估计显示，2020年新冠肺炎将使美国白人的预期寿命减少整整一年 而非洲裔美国人的减少量将是这个数字的3-4倍。此外，这种寿命的减少 预期可能会持续到2020年以后，因为持续的新冠肺炎死亡率和长期的 大流行对健康、社会和经济的长期影响。了解少数群体的健康和 长期以来，健康差距一直是美国国立卫生研究院的核心优先事项。在以下关键战略中 推进少数民族健康与健康差距的科学化是：1)全面 测量通过导致下丘脑失调而影响健康的社会压力-- 垂体-肾上腺皮质轴(HPA轴)，2)严格的方法学方法，使 因果推断方法(例如纵向分析)，以及3)改善患者-临床医生 跨民族类别的平等护理的关系和诊断程序。 因此，这个项目考虑了两个可能影响少数族裔的肤色的途径 健康：与算法偏差相关的社会压力和医疗保健的差异化质量 医疗技术.脉搏血氧测定法尤其是脉搏血氧饱和度测定，在 高估少数民族血氧饱和度可能导致COVID的年龄 即使他们需要医疗干预，也没有接受治疗。前一条途径将 通过对非裔美国人进行具有全国代表性的纵向调查进行调查 (包括白人的亚样本)和迄今为止未经检查的来源的一系列衡量标准 社交压力。后一种途径将与光学专家合作进行研究，这些专家 将与一起评估脉搏血氧仪中的算法偏差，并最终设计解决方案 确保脉搏血氧测定仪在整个肤色范围内同样有效。

Project Summary In 1980 Black male youths in Harlem, New York City were estimated to being less likely to survive to the age of 65 than male youths in Bangladesh. Mortality rates in 1980 were estimated to be roughly 6 times greater among Black Harlem men and women than White men and women in the same age groups. Research has shown that these profound disparities – often understood to the be result of social stress and other factors that produce earlier onset of disease, greater disease severity, and poorer quality healthcare to deal with morbidity – remain considerable. The COVID-19 pandemic has not only wiped away any forward progress in these disparities but has actually seemed to cause larger ethnoracial health disparities. Estimates show that COVID-19 will reduce US life expectancy in 2020 by a full year for Whites and the reductions for African Americans will be 3-4 times this. Additionally, this reduction in life expectancy will likely persist beyond 2020 because of continued COVID-19 mortality and long- term health, social, and economic impacts of the pandemic. Understanding minority health and health disparities has long been a core priority of the NIH. Among the key strategies for advancing the science of minority health and health disparities are: 1) comprehensively measuring how social stress, which affects health by causing dysregulation of the Hypothalamo- Pituitary-Adrenocortical axis (HPA axis), 2) rigorous methodological approaches that enable causal inference approaches (e.g. longitudinal analyses), and 3) improving patient-clinician relations and diagnostic procedures for equitable care across ethnoracial categories. Accordingly, this project considers two pathways through which skin tone may affect minority health: social stress and differential quality of healthcare related to algorithmic biases built into medical technology – pulse oximetry. Pulse oximetry, in particular, is especially critical during the age of COVID where overestimating the oxygen saturation of minorities may lead to them not receiving treatment even though they need medical intervention. The former pathway will be investigated through a longitudinal, nationally representative survey of African Americans (with sub-sample of Whites) with a host of measures of heretofore unexamined sources of social stress. The latter pathway will be investigated in collaboration with experts in optics who I will work with to assess algorithmic biases in pulse oximetry and, ultimately, design solutions to ensure that pulse oximetry works equally well across the skin color continuum.