Dissecting racial bias in an algorithm used to manage the health of populations

Author:

Obermeyer Ziad12ORCID,Powers Brian3,Vogeli Christine4,Mullainathan Sendhil5ORCID

Affiliation:

1. School of Public Health, University of California, Berkeley, Berkeley, CA, USA.

2. Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA.

3. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA.

4. Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, MA, USA.

5. Booth School of Business, University of Chicago, Chicago, IL, USA.

Abstract

Racial bias in health algorithms The U.S. health care system uses commercial algorithms to guide health decisions. Obermeyer et al. find evidence of racial bias in one widely used algorithm, such that Black patients assigned the same level of risk by the algorithm are sicker than White patients (see the Perspective by Benjamin). The authors estimated that this racial bias reduces the number of Black patients identified for extra care by more than half. Bias occurs because the algorithm uses health costs as a proxy for health needs. Less money is spent on Black patients who have the same level of need, and the algorithm thus falsely concludes that Black patients are healthier than equally sick White patients. Reformulating the algorithm so that it no longer uses costs as a proxy for needs eliminates the racial bias in predicting who needs extra care. Science , this issue p. 447 ; see also p. 421

Funder

National Institute for Health Care Management Foundation

Publisher

American Association for the Advancement of Science (AAAS)

Subject

Multidisciplinary

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3. A. Chouldechova A. Roth The frontiers of fairness in machine learning. arXiv:1810.08810 [cs.LG] (20 October 2018).

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