July 6th 2023.
The Doris Duke Foundation has a mission to promote the well-being of people and the planet for a more equitable, creative, and sustainable future. To put this mission into action, they are currently investing $10 million into five health organizations to reevaluate the role of race in medical algorithms. As Joseph Wright, the foundation’s incoming Chief Health Equity Officer explains, “Race is not a biological proxy. Race is a social construct and has no place being embedded in a clinical guideline like this.”
Sindy Escobar Alvarez, Program Director for Medical Research at the Doris Duke Foundation, says that the decision to invest is a result of the limited research done to examine the impact and composition of “race-aware” algorithms. This funding will include grants ranging from $1.36 million to $3.4 million to research the use of medical algorithms in hospitals, with the goal of reforming and creating guidelines that take into account race.
Medical assessment tools have been influencing patient care decisions since the 1970s. Research has shown that algorithms can lead to worse outcomes and biased assessments for patients of color, even denying treatment for some. It wasn’t until 2016 that medical students began to raise questions about the use of race in clinical calculations, leading hospitals such as Beth Israel Deaconess Medical Center and Zuckerberg San Francisco General to stop using calculators that factor in race.
Nwamaka Eneanya, a nephrologist and assistant professor at the University of Pennsylvania, believes that the inequities of the pandemic and the murder of George Floyd really served as a catalyst for change. Some organizations, such as the American Academy of Pediatrics, have already begun to update their guidelines. However, there is still disagreement among medical-society members about whether it is better to keep race in clinical equations or to find an alternative to medical algorithms.
The Doris Duke Foundation is making a bold move in the effort to promote health equity and create more just medical algorithms. It remains to be seen what the ultimate outcome of this research will be, but it is clear that this is an important step in the right direction.
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