# The Optics of Health: Race Skin Tone Minority Health and Health Disparities in the U.S.

> **NIH NIH DP2** · HARVARD UNIVERSITY · 2022 · $1,521,000

## Abstract

Project Summary
In 1980 Black male youths in Harlem, New York City were estimated to being less likely to
survive to the age of 65 than male youths in Bangladesh. Mortality rates in 1980 were
estimated to be roughly 6 times greater among Black Harlem men and women than White men
and women in the same age groups. Research has shown that these profound disparities –
often understood to the be result of social stress and other factors that produce earlier onset
of disease, greater disease severity, and poorer quality healthcare to deal with morbidity –
remain considerable. The COVID-19 pandemic has not only wiped away any forward progress
in these disparities but has actually seemed to cause larger ethnoracial health disparities.
Estimates show that COVID-19 will reduce US life expectancy in 2020 by a full year for Whites
and the reductions for African Americans will be 3-4 times this. Additionally, this reduction in life
expectancy will likely persist beyond 2020 because of continued COVID-19 mortality and long-
term health, social, and economic impacts of the pandemic. Understanding minority health and
health disparities has long been a core priority of the NIH. Among the key strategies for
advancing the science of minority health and health disparities are: 1) comprehensively
measuring how social stress, which affects health by causing dysregulation of the Hypothalamo-
Pituitary-Adrenocortical axis (HPA axis), 2) rigorous methodological approaches that enable
causal inference approaches (e.g. longitudinal analyses), and 3) improving patient-clinician
relations and diagnostic procedures for equitable care across ethnoracial categories.
Accordingly, this project considers two pathways through which skin tone may affect minority
health: social stress and differential quality of healthcare related to algorithmic biases built into
medical technology – pulse oximetry. Pulse oximetry, in particular, is especially critical during
the age of COVID where overestimating the oxygen saturation of minorities may lead to them
not receiving treatment even though they need medical intervention. The former pathway will
be investigated through a longitudinal, nationally representative survey of African Americans
(with sub-sample of Whites) with a host of measures of heretofore unexamined sources of
social stress. The latter pathway will be investigated in collaboration with experts in optics who I
will work with to assess algorithmic biases in pulse oximetry and, ultimately, design solutions to
ensure that pulse oximetry works equally well across the skin color continuum.

## Key facts

- **NIH application ID:** 10473113
- **Project number:** 1DP2MH132941-01
- **Recipient organization:** HARVARD UNIVERSITY
- **Principal Investigator:** Ellis Monk
- **Activity code:** DP2 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,521,000
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-03-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10473113

## Citation

> US National Institutes of Health, RePORTER application 10473113, The Optics of Health: Race Skin Tone Minority Health and Health Disparities in the U.S. (1DP2MH132941-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10473113. Licensed CC0.

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