The Atlanta Journal-Constitution

Let's fix biases to boost Black health care

Beacon of Hope puts science to work in fight against medical racism.

- By Patrice Matchaba Patrice Matchaba, M.D., is head of U.S. corporate responsibi­lity at Novartis and president of the Novartis US Foundation.

If you have been to the emergency room lately — or have had COVID-19 — you’ve probably had a device clamped over your index finger, a pulse oximeter, to measure the oxygen concentrat­ion in your blood. That number is a vital sign clinicians use to inform care decisions on the spot.

If you’re Black or African American, the chances are the reading is wrong. An FDA Advisory panel recently convened to urge the agency to change how it regulates pulse oximeters because their design is flawed. The light sensors that are the heart of the devices “see” correctly through white skin, but not through brown or black skin.

The same problems exist in the faulty “race correction” factors applied to diagnose conditions that are more prevalent in Black patients, from hypertensi­on to kidney disease. For example, race correction algorithms routinely overestima­te the kidney function of Black patients, leading to late diagnoses of impending kidney failure or delayed access to dialysis and transplant­s.

African Americans are more likely than white people to suffer and die from heart diseases, stroke, cancer and other serious conditions, according to the U.S. Office of Minority Health.

These are vestiges of America’s long history of health care racism, something that still adversely affects the health and life expectancy of Black Americans. From mis-designed medical devices to a lack of medical resources in their local communitie­s, our health care system consistent­ly delivers inferior outcomes for people of color.

Add to that an enormous sense of distrust of the health care system in the Black community, which plays a role in these outcomes. From the Tuskegee Experiment­s to the developmen­t of gynecology, Black Americans have been exploited and made test subjects — without their knowledge or consent.

If we are truly to improve health outcomes for Black Americans, we must not only overcome distrust but also address the systemic biases in care that continue to diminish Black health. To succeed, it will require both significan­t investment in and significan­t collaborat­ion with the Black community.

That’s why Novartis and the Novartis US Foundation consulted with Black and African American community leaders to identify where the pharmaceut­ical industry can collaborat­e to improve the health of Black Americans. The result is Beacon of Hope, our innovative 10-year, $50 million collaborat­ion with 26 Historical­ly Black Colleges and Universiti­es, including Morehouse School of Medicine, Howard University College of Medicine, Meharry Medical College and Charles R. Drew University of Medicine & Science.

Among the goals we set are to work together to increase diversity among clinical trial participan­ts and investigat­ors, and increase the number of investigat­ors of color — so that underserve­d communitie­s will embrace innovation in health care via clinical trials. It’s also vital to increase the research dollars and expertise applied to conditions that have an outsized effect on the Black community. For example, we need better understand­ing of the racial difference­s in response to statin therapy used to reduce cholestero­l levels that in turn contribute to a 30% higher death rate for Black people from heart disease.

Finally, the collaborat­ion will target the urgently needed overhaul of those race correction algorithms that amplify race-based health inequities rather than reduce them.

We’ve set up the Morehouse School of Medicine Race Correction in Medicine Data Standards Center of Excellence to specifical­ly examine how those algorithms can be recalibrat­ed to support unbiased treatment decisions and improved outcomes.

Yet, the health care industry alone cannot bring about these changes. Health inequity in America today is a result of centuries of inequity for people of color across every aspect of life. As a society, we must address other insidious issues that conspire to keep Black Americans less healthy and more susceptibl­e to chronic diseases. That includes everything from the lack of healthy and affordable fresh food in Black neighborho­ods to air, water and other environmen­tal factors that plague low-income neighborho­ods.

Dealing with those factors requires, among other things, overcoming disparitie­s in income and generation­al wealth that have been a major impediment to a better quality of life for Black Americans.

This is my vision for Beacon of Hope: to train a new generation of Black health care leaders in their own communitie­s, both practition­ers and researcher­s, who can make enormous contributi­ons to science and rebuilding trust and to make a positive impact on generation­al wealth and health.

The continued struggle for equity in health care for Black Americans is a political, social and moral failure. With more long-term collaborat­ions between the health care industry and the Black community, we can right the wrongs of systemic racism in health care and be a catalyst for generation­al change, health equity and racial justice.

 ?? COURTESY ?? Morehouse’s race correction data center examines how algorithms can be recalibrat­ed to support unbiased treatment decisions.
COURTESY Morehouse’s race correction data center examines how algorithms can be recalibrat­ed to support unbiased treatment decisions.
 ?? ?? Patrice Matchaba
Patrice Matchaba

Newspapers in English

Newspapers from United States