The Downstream Effects of Fixing a Racist Lung Test (Felice J. Freyer, Harvard Public Health, 09.24.2024, UnDark)
Before, the computer program that assessed lung function sorted patients into one of four categories: Caucasian, Black, Asian, or Hispanic. It automatically lowered the threshold for what is “normal” for Black and Asian patients. It’s a startling example of how racial bias has literally been written into the machinery of 21st-century health care and how formulas based on supposed racial differences have skewed decision-making in many corners of medicine. Boston Medical Center is among the institutions working to address this problem, after an April 2023 recommendation by the American Thoracic Society that laboratories adopt a race-neutral algorithm, or set of rules, for assessments. But with thousands of lung-function laboratories and clinics scattered across the country, the movement for change faces manifold obstacles and thorny consequences.
Applying the race-neutral algorithm means broadly that Black patients will be deemed sicker and White ones healthier than before. A higher proportion of Black people (and, to a lesser extent, Asians) will be designated impaired — which could make them ineligible for certain occupations but increase their access to disability benefits, additional testing, and referral for lung transplants. White people will experience the opposite, with some potentially seeing their disability benefits reduced or eliminated.