A failure to understand race means the development and testing of wearable health monitors can exacerbate existing health inequities, according to a new study.

The findings underscore an entrenched problem in the development of these new health technologies, the researchers say.

“This is a case study that focuses on one specific health monitoring technology, but it really highlights the fact that racial bias is baked into the design of many of these technologies,” says Vanessa Volpe, an associate professor of psychology at North Carolina State University and co-author of the study in the journal Health Equity.

“The way that we understand race, and the way that we put that understanding into action when developing and using health technologies, is deeply flawed,” says corresponding author Beza Merid, an assistant professor of science, technology, innovation and racial justice at Arizona State University.

“Basically, the design of health technologies that purport to provide equitable solutions to racial health disparities often define race as a biological trait, when it’s actually a social construct,” Merid says. “And the end result of this misunderstanding is that we have health technologies that contribute to health inequities rather than reducing them.”

To explore issues related to the way the development and testing of health tech can reinforce racism, the researchers focused specifically on photoplethysmographic (PPG) sensors, which are widely used in consumer devices such as Fitbits and Apple watches.

PPG sensors are used in wearable technologies to measure biological signals, such as heart rate, by sending a signal of light through the skin and collecting data from the way in which the light is reflected back to the device.

For the study, the researchers drew on data from clinical validation studies for a wearable health monitoring device that relied on PPG sensors. The researchers also used data from studies that investigated the ways in which skin tone affects the accuracy of PPG “green light” sensors in the context of health monitoring. Lastly, the researchers looked at wearable device specification and user manuals and data from a lawsuit filed against a health technology manufacturer related to the accuracy of technologies that relied on PPG sensors.

“Essentially, we synthesized and interpreted data from each of these sources to take a critical look at racial bias in the development and testing of PPG sensors and their outputs, to see if they matched guidelines for responsible innovation,” Volpe says.

Read the full article about racial bias in healthcare tools by Matt Shipman at Futurity.