Notes on Engineering Health, January 2021: Health Equity

Jonathan Friedlander, PhD
Geoffrey W. Smith

Jonathan Friedlander, PhD & Geoffrey W. Smith

January 31, 2021

The global COVID-19 pandemic caused an unprecedented number of challenges for our health systems during 2020. Many of these health challenges, however, have been persistent problems for years. For example, according to data released by the Center for Disease Control and Prevention (CDC), almost one-third of COVID-19 infections in the U.S. have affected black Americans though they represent only 13% of the U.S. population. The death toll due to the COVID pandemic on the black community has clearly been extraordinary and disproportionate. The trend continues when it comes to vaccination, with poor planning potentially deepening the pandemic racial divide further.

However, issues related to access and quality of health care for black Americans are not new problems. Prior to the onset of the pandemic, black patients would lose limbs due to diabetes at a rate triple that of others. Amputations occur often in low-income and underinsured neighborhoods. Similarly, Pregnancy Related Mortality Rate (PRMR) was 3.2 times higher in black women than in white women according to the CDC. The PRMR for black women with at least a college degree was 5.2 times that of their white counterparts.

While the COVID-19 pandemic has cast a strong spotlight on many of the root causes underlying health inequities and disparities in our society, the goal of achieving health equity remains clear as well. Health equity means that everyone has a fair and just opportunity to be as healthy as possible. Achieving health equity requires us to acknowledge and address a number of issues including the social determinants that affect health, such as poverty, discrimination, and access to quality education, safe environments, and health care. Reducing these disparities requires the participation of multiple systems, from how we pay for health, to understanding how and why diseases occur and persist and how to diagnose and treat them, to identifying and addressing biases in health care.

As we enter 2021, Digitalis wishes you a safe and healthy New Year, and hopes to share with all of you its energy to take on the important problems of our times.

Jonathan Friedlander, PhD & Geoffrey W. Smith

First Five
First Five is our list of essential media for the month which spans a range of content including scientific papers, books, podcasts, and video. For our full list of interesting media in health and science, updated regularly, follow us on Twitter or Instagram.

1/ New Year’s Resolutions
With the New Year upon us, and its attendant annual ritual of committing to positive new habits, this New York Times article is an interesting read on the intersection of exercise and metabolic health.

2/ Haute Cuisine meet AI
Ever wonder why different cultures and geographies produce different types of cuisine? Two recent studies show that some of the differences may come down to anatomical differences in our tongues. Perhaps it is not a surprise that new AI methods were involved in these findings.

3/ Beethoven meet AI
Data science is delving into the world of music as well. There has been a long running question among musicians about the tempo of many of Beethoven’s pieces. Sixty-six out of 135 of them have been regarded as “absurdly fast and thus possibly wrong,” according to one group. Their conclusion in a 2013 paper was that Beethoven’s metronome could have been broken therefore accounting for improper notations in the original sheet music. A new PLoS ONE paper uses mathematical methods to suggest that the problem with Beethoven’s tempo is that he read his metronome incorrectly when using it to measure the beat of his symphonies. The researchers analyzed 36 symphonic recordings by different conductors and found a “systematic deviation” from the tempos noted in the original music. However, they were unable to recreate this deviation by simulating issues with the metronome as had been suggested in the 2013 paper. Their novel conclusion is that Beethoven did not know whether to read the tempo markings from the top or the bottom of the metronome’s moving weight. Thus, music marked as 120 was in fact meant to be played at 108, 116 at 104, etc. There are many lessons here…

4/ Over Night Success Story
While it feels like AI is all of a sudden cropping up in every facet of research and life these days, the march of computation has of course been on the move since the 1950s. This recent Nature piece provides an interesting review of 10 computer codes that have transformed science.

5/ Trends
The changing of the year also raised to our attention a number of pieces analyzing trends in a number of areas of concern:

– Cancer incidence in US adolescents and young adults (JAMA Network)
– Impact of climate change on health (The Lancet)
– Leading causes of death and disability (WHO)

There is a lot of work to do…

Digitalis Commons
Public-Interest Technologies for Better Health

Digitalis Commons is a non-profit that partners with groups and individuals striving to address complex health problems by building public-interest technology solutions that are frontier-advancing, open-access, and scalable.

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Digitalis Commons is proud to be a founding sponsor of Columbia University’s Program for Diversity & Inclusion in Commercialization & Entrepreneurship (DICE). The program aims to support early-career individuals who identify as being from traditionally underrepresented groups in life science entrepreneurship and commercialization as defined by the NIH. DICE will provide eligible Columbia graduate students and postdocs with educational programming, mentorship, networking, and funding opportunities to prepare participants for careers in bringing life science innovation to market.

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