Health

Structural Racism is so prevalent and hidden in algorithms and software that physicians and patients are rarely aware of its effect on the health score and thus treatment of multiple organs. A large issue in Health is Race-Adjustment. You may have heard that the National Football League was sued because they were providing less benefits to Black players than to Whites. That suit uncovered the standard practice of adjusting Traumatic Brain Disorder scores downward for Black race players. Since then many other conditions have been found to have built-in race adjustments. Medical schools have taught since before the Civil War that Black people normally have smaller brains, smaller lungs, poorer liver and kidney function, less pain, etc. Most race adjustments are automatically calculated by the computer program  and are not seen by the patient and family. An exception may be that lab reports of blood tests until the last 3 years listed the eGFR (kidney) normal cut-off being different by race. As a result, many Black and mixed race patients have not been eligible for transplants. The consequences of those unintended racist practices are that some White patients who are less ill but have spent years waiting on the transplant list are much closer to getting a new organ.

Science Magazine analyzed why only 18% of Blacks were approved for treatment procedures that 82% of Whites got. In that study they found that the database used historical insurance payment data as a baseline. So if there was racism in the past, that just continued because current treatment decisions were based on historical treatment. With that kind of system, nothing will change.