Technology is failing women of color. How can we address its blind spot and reverse the rising maternal mortality?

Despite global efforts to improve health and wellbeing, the rates of maternal deaths among women of color continue to soar with over 810 women dying every day globally. In developed countries like the United States, COVID-19 pandemic has unveiled that women of color pay an unacceptably high price whereby the deaths of black women remain more than twice the national average. This reflects health equity gaps and the inability of the current public health interventions to address women’s needs. Technology-focused innovations such as the use of artificial intelligence (AI) were adopted as means to predict factors associated with poor maternal health outcomes. Although there have been significant developments in engineering technology such as Mobile Health (mHealth) and tele-medicine, these solutions are often limited in features and affordability. A number of blind spots of the current technology include the lack of language capabilities, the lack of offline options which require users to have high cost internet data plans, and lack or poor data privacy. Unless public health agencies introduce new ways to assess the readiness of current technology, it will be impossible to understand how tech solutions meet women’s health needs and the death toll will remain unacceptably high. Assessing tech readiness will require a three-fold process including the understanding that disparities in maternal health outcomes are not random, embracing the need and power of tech readiness data to address women’s health needs, and data privacy as a must. Disparities in maternal health outcomes are not random In the US, 861 maternal deaths were reported in 2020, signaling 14% increases from the previous year. The mortality rate for non-Hispanic Black women was 2.9 times the rate for non-Hispanic White women, and the rates for non-Hispanic Black women were significantly higher than rates for non-Hispanic White and Hispanic women. The disparity in maternal deaths is just the tip of the iceberg, systemic racism and implicit bias of social and technological solutions constitute the root causes. This is often fueled by power dynamics strictly defined by who has a voice in influencing design, deployment, and access. The medical and biotech field experience gender demographics congruent with the population, but disproportionate representation in regard to race, ethnicity, and sexual representation. As a result the nation maintains the highest maternal mortality rate among all developed countries. It is important to note that approximately 60 percent of pregnancy-related deaths are preventable, highlighting a critical opportunity to uncover the factors impeding more equitable health outcomes for the nation as a whole. With these factors in mind, tech solutions could be wisely deployed and be used as a panacea to the high maternal mortality rates observed. Embracing the need and power of tech readiness data to address women’s health needs The introduction of Mobile Health (mHealth) has generated much interest as a possible solution to overcoming many of the recognized barriers to maternal health care globally and has been well received in many developing countries. In fact, several tools have been employed in research to help reverse the consistently high maternal morbidity and mortality rates which constitute an important public health priority. It is critical to understand the current state of technology in addressing equitable access to and improved outcomes of women’s maternal health needs. Academic institutions and public health agencies should invest in innovative strategies to understand and address blindspots of modern technology to better meet women’s health needs. In line with this effort, the Heller School for Social Policy and Management and Institute for Economic and Racial Equity have partnered with the Kapor Center to launch an initiative to expand the focus into the next generation of policy challenges with a new Racial Justice x Tech Policy (RJxTP) Initiative. A team of students and faculty is developing a tech readiness index, an assessment and data visualization dashboard which will help to evaluate tech solutions and benchmark public health facilities by their level of tech readiness for addressing maternal health needs. This project emanated from the knowledge that the available technology is incomplete in addressing women’s health needs. Producing such data will enable public health institutions and agencies to make informed decisions and deploy bias-free solutions. Data privacy as a must Deploying tech solutions should go along with strengthening confidentiality and data governance policies to keep pace with these efforts. In fact, technology interventions are often accessed and used by those who are not disproportionately impacted by health inequities. As new technologies continue to emerge in the effort to eradicate or lessen reproductive health problems, unintended consequences of these innovations are having a significant impact on women and women’s reproductive health such as data privacy concerns. Notably, issues pertaining to trust, perceived risk, ease of use, subjective norms, access, and availability continue to hamper its progress. To be sure, the current technology has brought about remarkable improvements in women’s health; from knowledge and skills building to service delivery platform. Early in the pandemic, one of the studies in the US found that women preferred telemedicine. However, the preference was significantly associated with their ability to afford the internet and the hardware required to have a video visit. The assumption that the current technology addresses women’s health needs should be taken with caution. The blindspots of the current technology reflects an implicit bias which should be addressed during the design and implementation of tech solutions. As members of the Commonwealth Heads of Government discuss strategies to explore new opportunities and tackle common challenges for the well-being of future generations, access to life saving and biasfree technology should be on their agenda. An intentional effort to assess and benchmark tech readiness will raise the standard of tech equity and revise the rising rates of maternal deaths. Kumba Sennaar is a women’s health and tech policy scientist and PhD candidate in Social Policy at Brandeis University. Her research is focused on innovative strategies to reduce algorithmic bias and improve equitable use of Artificial Intelligence (AI) in healthcare. Vanessa Palomares is a women’s health activist and graduate of Brandeis University where she double majored in Anthropology and Health, Science, and Public Policy (HSSP). Idah Zvoushe is a women’s health activist with graduate degrees in Global Health Policy Management from Brandeis University and Demography and Population Studies from University of Zimbabwe. She also serves as Patient Navigator at Boston Medical Center

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Technology is failing women of color. How can we address its blind spot and reverse the rising maternal mortality?