Pulse oximeters, a central tool in monitoring oxygen levels of those stricken with Covid-19, can be three times as likely to provide a misreading in Black patients. Patricia Dillon wants to do something about that.
Dillon, a New Haven State Rep., has introduced a bill titled “An Act Concerning Pulse Oximeters, Individuals Of Color And Health Insurance.” The bill seeks to require a warning label attached to pulse oximeters indicating that the reading might be inaccurate for people of color, provide education to health care providers on erroneous readings, and “prohibit health insurers from reimbursing health care providers for certain health care, including, but not limited to, home health care, provided to an individual of color for a low blood oxygen saturation level.”
Fellow New Haven State Reps. Robyn Porter, Juan Candelaria and Toni Walker as well as New Haven State Sen. Martin Looney are cosponsors of the bill.
Dillon discussed the bill Wednesday during an appearance on WNHH FM’s “Love Babz Love Talk” program, during which host Babz Rawls-Ivy framed the conversation in the context of medical hesitancy within the Black community due to a history of racist experimentation. (Click on the video at the top of the story to watch the conversation, which begins at the 3:45 mark.)
Dillon called the pulse ox reader a “brilliant invention” that “provided tremendous comfort to my family.” She also acknowledged that the comfort it can provide is contingent on one’s skin color.
Since the device works by analyzing the amount of red and infrared light absorbed by the skin, darker skin might lead to inaccurate measurements because of how the skin absorbs light differently. Plus, Dillon added, the initial studies were conducted on majority white men.
A 94 reading for a Black patient, for example, can mean dangerously low levels, while a white person might consider that on the border of needing to be checked by a healthcare professional.
That’s why the bill’s final stipulation regarding reimbursements tells insurers that they can’t deny coverage to someone based on their pulse ox reading. State legislators are unable to regulate Medicare but, according to Dillon, they’re “starting the conversation.”
Rawls-Ivy noted that Black people “already have stress from” the medical profession, stemming from a history of experimentation. She specifically mentioned the Tuskegee Syphilis Study, in which Black men with syphilis were unknowingly observed for 40 years and not given treatment despite it being widely available, as well as gynecological experimentation on Black women who were deemed “subhuman.” She worried aloud about how emerging evidence regarding pulse oximeters might contribute to even more hesitancy for Black people to seek medical treatment. Especially in the midst of a pandemic, that hesitancy can be fatal.
Rawls-Ivy called the lack of knowledge on how the pulse ox reacts to Black skin “the insidiousness of racism.”
Dillon agreed. She noted that women were not included in initial studies of the pulse oximeters, either.
It is unlikely that the bill will pass as a stand-alone law, Dillon said. She is hoping the proposal will be folded into a broader equity bill that the Insurance Committee is currently drafting.
When Rawls-Ivy asked Dillon if she was in talks with the committee, Dillon laughed. “They’ve been hearing from me, yes,” she said.
The bill is still in the proposal stage and has yet to go to public hearing, at which case Dillon and the other representatives will be able to better understand public opinion regarding the issue.
So even medical machines are racist and sexist. Seriously, the scientists and the medical community and the AI/computer programmers need to take into account gender differences, body differences, racial differences and ethic differences to root out technological bias and to account for and accommodate for different bodies using the technology and medicine. Using typical height and body weight of the average adult in the prime of life white males as the "standard reference" for technology and medicine can't be used anymore as the only standard for the safety and effectiveness of health and safety equipment, medicine and technology. We need a wide variety of height, weight, color of skin, ethnicity, races, genders and ages to make sure technology and medicine works for almost everyone before science, technology and medicine can approve something for general use.