Breath, Light, Skin: Colorism & Race Correction in Middletown Pulse Oximeters
Student Researchers: Sarah Asiedu and Angie Collado
Faculty Sponsor: Anthony Ryan Hatch
Breath, Skin, Light is an interactive art and public health education project by Research Associates Sarah Asiedu and Angie Collado that investigates the pulse oximeter, a small medical device placed on the fingertip that uses a beam of light to estimate the level of oxygen concentration in the bloodstream. The pulse oximeter has become ubiquitous during the COVID-19 pandemic as millions of people have purchased them for home use. We studied STS research demonstrating how colorism impacts pulse oximetry performance across skin gradients for Black patients. We learned that the pulse oximeter provides less accurate results to its users who happen to have darker skin tones. This is due to its design. The beam of light emitted by pulse oximeters is not calibrated to penetrate through skin with higher levels of melanin.
Following STS researchers who have identified practices of discriminatory design in devices like the pulse oximeter, the spirometer, and the eGFR test (learn more below), Asiedu and Collado attend to the localized context of pulse oximetry with a walking experiment to buy pulse oximeters at the local CVS pharmacy in Middletown. During the walk to the pharmacy, they recorded audio and video and took photographs of their journey, taking notice of their own respiration and the open sky as they walked the one mile to and from the CVS. We invite visitors to this site to experience Breath, Skin, Light in this 2-minute video and then learn more about the racial biases in pulse oximetry.
The live exhibition of Breath, Skin, Light invites people to learn more about the practices of race correction in medical technologies and to participate in creating a community collage. We invite people to use a pulse oximeter to measure their oxygen saturation, use Crayola skin tone crayons or gold and silver markers (for those who refuse racial categorization) to color their individual percentage onto paper. Inspired by the pioneering data visualizations of W.E.B. Du Bois, we will combine these individual pieces to form a larger community collage, a mosaic of pulse oximeter data.
Learn more about equity and practices of race correction in medical and health technologies
National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Creating a Framework for Emerging Science, Technology, and Innovation in Health and Medicine. Advances in biomedical science, data science, engineering, and technology are leading to high-pace innovation with potential to transform health and medicine. These innovations simultaneously raise important ethical and social issues, including how to fairly distribute their benefits and risks. The National Academies of Sciences, Engineering, and Medicine, in collaboration with the National Academy of Medicine, established the Committee on Creating a Framework for Emerging Science, Technology, and Innovation in Health and Medicine to provide leadership and engage broad communities in developing a framework for aligning the development and use of transformative technologies with ethical and equitable principles. The committee’s resulting report describes a governance framework for decisions throughout the innovation life cycle to advance equitable innovation and support an ecosystem that is more responsive to the needs of a broader range of individuals and is better able to recognize and address inequities as they arise.
Lundy Braun. Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics. University of Minnesota Press, 2014.
Amy Moran-Thomas. “How a popular medical device encodes racial bias.” Boston Review. August 5, 2020.
Ashraf Fawzy, Tianshi David Wu, Kunbo Wang, Matthew L. Robinson, Jad Farha, Amanda Bradke, Sherita H. Golden, Yanxun Xu, and Brian T. Garibaldi. “Racial and Ethnic Discrepancy in Pulse Oximetry and Delayed Identification of Treatment Eligibility Among Patients With COVID-19.” JAMA Internal Medicine 2022; 182(7): 730–738.
Dorothy Roberts. “Abolish Race Correction,” The Lancet 2021; 397 (10268): 17-18.
