SYSTEMATIC REVIEW
Examining Inclusivity: The Use of AI and Diverse Populations in Health and Social Care
Artificial intelligence (AI)-based systems are being rapidly integrated into the fields of health and social care, offering substantial improvements in care provision. However, diverse and marginalized populations are often incorrectly or insufficiently represented within these systems. This review assesses AI's influence on health and social care for these populations, focusing on inclusivity and regulatory concerns.
Executive Impact: Key Findings
Our systematic review of 129 articles reveals critical insights into AI's impact on diverse populations in healthcare, highlighting both transformative potential and significant challenges.
Deep Analysis & Enterprise Applications
Select a topic to dive deeper, then explore the specific findings from the research, rebuilt as interactive, enterprise-focused modules.
AI systems often perpetuate existing healthcare disparities due to biased data and lack of representation, leading to unequal outcomes for marginalized groups.
Many AI models frequently rely on datasets that fail to reflect the diversity of global patient populations, particularly in areas like medical imaging and racial bias in algorithms for kidney function, leading to misdiagnoses in marginalized groups. (Based on synthesizing mentions of bias related to racial, ethnic, gender disparities across several cited papers like [16-18], [20-23], [39], [40], [41], [46-48])
| Bias Category | Specific Impact & Evidence |
|---|---|
| Race & Ethnicity Bias |
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| Socioeconomic Bias |
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| Gender & Disability Bias |
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The Dermatology AI Disparity
Scenario: A leading AI dermatology model, trained predominantly on light-skinned individuals, consistently misdiagnoses or delays diagnosis of skin conditions in patients with darker skin tones. This leads to poorer health outcomes and exacerbates existing racial health disparities in dermatological care.
Impact: The model's limited dataset diversity results in a high false-negative rate for non-white patients. This not only delays crucial treatment but also erodes trust in AI among marginalized communities, highlighting the critical need for inclusive training data and rigorous validation across diverse populations [20-24].
Solution Focus: The solution involves re-training the AI with significantly expanded and diversified image datasets that accurately represent all skin tones, combined with ethnically-sensitive validation protocols and community feedback integration.
Robust regulatory frameworks and strong privacy safeguards are essential to ensure ethical AI deployment and protect vulnerable populations from data misuse.
Many existing regulations, despite efforts by WHO, EU, and USA, remain insufficient in comprehensively addressing the complex ethical and technical issues AI presents, especially regarding bias and data privacy for diverse populations [57-62]. Emphasis on stronger standards and benchmarking is evident [63, 64].
Ethical AI Development Lifecycle
| Area | Current Challenges | Proposed Solutions |
|---|---|---|
| Ethical Frameworks |
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| Data Privacy |
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Thorough validation with diverse populations and a commitment to equity are crucial for AI to truly enhance healthcare for all, not just privileged groups.
Despite growing AI research, few applications have undergone the rigorous clinical validation necessary for real-world use, leading to concerns about reproducibility, generalizability, and algorithmic design [42, 56]. Insufficient validation for AI-based medical devices is a major gap [59, 100].
AI for Preventive Screenings: A Missed Opportunity
Scenario: An AI system designed to identify populations at high risk for certain diseases and recommend preventive screenings fails to reach marginalized communities. This occurs because the AI's training data predominantly reflects patients with easy access to healthcare, leading the model to overlook or misprioritize those in underserved areas.
Impact: The lack of diverse geographical and socioeconomic data in training leads to the AI exacerbating existing disparities. Instead of reducing health inequities, it inadvertently widens the gap in preventive care, missing opportunities to identify and support vulnerable populations [89, 91, 42, 45].
Solution Focus: The solution requires proactive inclusion of data from underserved regions, implementing AI models that account for socioeconomic and geographical factors, and community-based testing to ensure equitable outreach and impact [92, 93].
Equitable AI Implementation Steps
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Your AI Implementation Roadmap
Our phased approach ensures a seamless and ethical integration of AI into your enterprise, maximizing benefits while minimizing risks and ensuring compliance.
Phase 1: Discovery & Strategy (1-2 Months)
Comprehensive audit of existing systems, data infrastructure, and identification of key AI opportunities. Focus on stakeholder engagement and initial bias assessment.
Phase 2: Data Curation & Model Development (3-6 Months)
Secure, privacy-preserving data collection and annotation. Development of AI models with emphasis on diverse datasets, fairness, and explainability (XAI).
Phase 3: Validation & Piloting (2-4 Months)
Rigorous clinical and real-world validation with diverse user groups. Pilot deployments in controlled environments, collecting feedback for refinement.
Phase 4: Full-Scale Deployment & Integration (4-8 Months)
Seamless integration into existing healthcare workflows. Training for staff and continuous monitoring for performance, bias, and compliance.
Phase 5: Optimization & Adaptive Governance (Ongoing)
Continuous learning and model updates. Regular audits, adaptive regulatory oversight, and stakeholder feedback loops to ensure long-term ethical and equitable AI use.
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