3. Inadequacy of Certain Therapies and Technologies: The Oximeter’s Case

Women of Color in Peace, Security and Conflict Transformation The Race Across the Pond Initiative: Women of Color in the Healthcare System Series

If health inequities were better understood before the pandemic, and vulnerable groups were correctly identified, studied, and protected, it is likely that we could have more effectively limited their risks of overexposure to COVID-19.

Since the health crisis continues, we believe it to be essential to urgently document vulnerable populations’ exposure and rates of inflection, in particular RMGs, especially women, people facing great precariousness, and migrants. This scientific documentation will contribute to identify vulnerable groups and confront French decision-making authorities with scientific and empirical data. By informing public health policy-makers, the ultimate goal is to urgently contribute to the reduction of the excess mortality risks incurred by RMG communities.

Without understanding the specific historical, social, economic, geographic, political, ethnic, and cultural factors, these vulnerable groups and sub-groups will remain overexposed to COVID. Despite health policies and vaccination campaigns, RMGs will continue to be affected more severely than the rest of society with short, medium, and long term impacts. Furthermore, they are likely to suffer for years to come, until, at least, the health and socio-economic crisis is fully under control.

3. INADEQUACY OF CERTAIN THERAPIES AND TECHNOLOGIES: THE OXIMETER’S CASE

The oximeter is a tool created in 1972 to quantify the rate of oxygen saturation in individuals. This device is used daily in healthcare settings and its measurement corresponds to one of the physiological constants or “vital signs” monitored as a priority and used for diagnostics.

As early as the 1990s, researchers discovered that oximeters did not work properly on non-white patients. Even today, most of these devices do not correctly estimate the oxygen saturation of this population. The darker the skin, the less reliable the values, especially when the oxygen saturation is below 80%. Indeed, oximeters tend to overestimate measurements on the black population and this phenomenon is exacerbated at the time of hypoxia, which can put the patients in serious life danger.

In a US study (Bickler et al, 2005) about measurement biais focusing on the effects of skin pigmentation, the researchers highlight that over a period of 18 years of testing pulse oximeters' accuracy, the great majority of volunteer subjects were white. They also infer that this probably have been the case for most of the other oximeters' calibrations and confirmation tests marketed in the USA, as laboratory researchers