Leveraging CBSD to Advance Community Engaged Approaches to Identifying Structural Drivers of Racial Bias in Health Diagnostic Algorithms

Much attention and concern has been raised recently about bias and the use of machine learning algorithms in healthcare, especially as it relates to perpetuating racial discrimination and health disparities. Following an initial SD workshop at the Data for Black Lives II conference hosted at MIT in January of 2019, a group of conference participants interested in building capabilities to use SD to understand complex social issues convened monthly to explore issues related to racial bias in AI and implications for health disparities through qualitative and simulation modeling. Insights from the modeling process highlight the importance of centering the discussion of data and healthcare on people and their experiences with healthcare and science, and recognizing the social context where the algorithm is operating. Collective memory of community trauma, through deaths attributed to poor medical care, and negative experiences with healthcare are endogenous drivers of seeking treatment and experiencing effective care, which impact the availability and quality of data for algorithms. These drivers have drastically disparate initial conditions for different racial groups and point to limited impact of focusing solely on improving diagnostic algorithms on achieving better health outcomes for some groups.