Diversity in STEM is a matter of life and death

Earlier this month, thought leaders in technology came together for a public event on “diversity in STEM”, emphasizing the importance of a talented and diverse workforce in science, technology, engineering and mathematics (STEM) fields. But they overlooked one essential element: STEM is literally a matter of life and death.

Indeed, on the same day, a panel of the American Food and Drug Administration met virtually and discussed how pulse oximeters, a fingertip device that estimates blood oxygen levels, need improvement due to ‘ongoing concerns that pulse oximeters may be less accurate in people with skin pigmentations darker”, as recognized by a statement published a few days later.

On the Medical Devices Advisory Committee’s Anesthesia and Respiratory Therapy Devices Expert Panel panel, Dr. Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, spoke of a “bias potential,” in pulse oximeters “due to skin pigmentation, potentially putting patients with darker skin pigmentation at risk for treatment delays and worse patient outcomes.

He called the concerns “an issue of great public health importance”.

In other words, some innovations work well for white people, but black and brown men, women, and children may actually be put at risk by inaccurate readings.

Take for example the growing recognition that racism runs deep in clinical algorithms that clinicians use to assess everything from kidney function to determining pain thresholds. One of the main drivers of reform is a black doctor, Dr. Michelle Morse, who is now deputy commissioner and chief medical officer at the New York City Department of Health, and leads a Coalition to End Racism in the Clinical Algorithm.

It is clear that racism in medicine contributes to the larger problem of inequalities in communities of color and social determinants of health, which affect the quality of life for many black families, sending men, women and children to premature deaths.

“The travesty of life expectancies varying from 20 to 30 years based on ZIP codes a few miles apart is inexcusable,” says Dr. Eric Griggs, assistant vice president of community medicine for Access Health Louisiana. “The equitable health umbrella includes access to health care, digital literacy, food security, safety, health education, health literacy, and the overall health stability of the communities in which we live. live…all communities have the right to live their healthiest lives…ALL communities. ..everywhere. “

With medical technology and innovations, the issues go beyond race. Not so long ago, because women were historically excluded from the design and testing processes of automobile manufacturing, female drivers wearing seatbelts had a 47% more risk of injury than male drivers wearing seat belts in similar crashes. This sobering statistic is the result of the exclusion of women from the design and test processes of automotive manufacturing. In 2014, Apple’s iOS team released a health app that excluded women’s menstrual cycles.

I’ve watched the pulse oximeter debate unfold over the past two years, as an educator, former professor of mechanical engineering, and founder of Global STEM Action, a non-profit organization based in New Orleans, LA., dedicated to advancing youth from low-income, low-resource communities in STEM. In December 2020, amid the Covid pandemic, doctors at the University of Michigan Medical School first raised concerns about oximeters with a letter to the editor at The New England Journal of Medicine, titled, “Racial Bias in Pulse Oximetry Measurement.”

“Oxygen is one of the most frequently administered medical treatments, with a level that is usually adjusted based on the reading on a pulse oximeter that measures patients’ oxygen saturation,” the Michigan doctors wrote. “Questions about pulse oximeter technology have been raised, given its original development in populations that were not racially diverse…in two large cohorts, black patients had nearly three times the frequency of occult hypoxemia that was not detected by pulse oximetry than white patients.Given the widespread use of pulse oximetry for medical decision-making, these findings have major implications, particularly during current coronavirus disease (Covid-19) pandemic.Our findings suggest that the use of pulse oximetry to triage patients and adjust supplemental oxygen levels may put black patients at increased risk of hypoxemia.

Two years later, experts are still talking about, and not doing enough about, this issue and other apps, which are biased against black and brown people.

At SGA, we have an answer.

Along with hands-on activities, SGA affiliates bring STEM activities to communities across Ne

w Orleans and throughout the country. Our K-12 students learn coding, Newton’s Laws, higher-level math, robotics, and other STEM fundamentals. There is a clear path to eliminating racial inequities across all of medicine and science: bringing more students of color into the jobs and careers that design and evaluate healthcare devices, practices and standards.

Our formula works. With SGA partners from the private sector and academia, we organize “STEM Saturday” events across the country that engage black and brown children in a wide range of STEM activities, building their interest in STEM, creating a pipeline towards STEM careers and using young professionals and university interns to serve as mentors. It is so important that our children see people like them as doctors, scientists and engineers.

For the past three weeks alone, we’ve hosted a STEM Saturday in New Orleans where, in partnership with Ochsner Health System, our event helped children learn more about their heart and circulatory system. Over 150 K-12 students dissected sheep hearts, were exposed to technology with model hearts printed on a 3D printer, learned about the inside of the heart and circulatory system through virtual reality and walked away with their own mechanical heart that they built. Ochsner professionals worked with students as well as more than 75 medical students from Tulane University and LSU, as well as undergraduate students from local colleges. The same Heart STEM Saturday event was hosted in Gulfport, MS, engaging over 150 K-12 students, parents, and volunteers.

But our initiatives, and others like them, face a growing problem. There is an urgent need to scale them, but a shocking “lack of diversity” and inclusion exists in funding the innovations that will shape the future.

Over the past two years, CARES Act funding has enabled thousands of young students to participate in STEM programs. But our concern is that not enough of this funding goes to organizations such as our SGA affiliates and community-based nonprofits, which have developed effective ways to engage children from disadvantaged communities in STEM. You have to feel the joy and wonder at our STEM events to understand their impact. Instead, the bulk of the funding goes to white-led entities that may have good intentions but lack the experience to shape programs that work.

Why is improving representation in STEM important? This is important because women and people of color can help find solutions to the inequalities and biases expressed – and hopefully eliminate them in scientific research and health care.

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