Nonprofit Leadership Podcast: How AI is Changing Medical Research

Hosted by Rob Harter | Release Date: December 8, 2024

Introduction

In this episode of the Nonprofit Leadership Podcast, host Dr. Rob Harder engages in a profound conversation with Dr. Kristin Brown from the Urban Institute. The discussion centers on the transformative role of Artificial Intelligence (AI) in medical research, with a specific focus on maternal health disparities in the United States.

Dr. Kristin Brown's Journey to the Urban Institute

Dr. Kristin Brown shares her academic and professional journey, emphasizing her commitment to understanding and addressing racial health disparities.

• Academic Background: Dr. Brown double-majored in biology and psychology during her undergraduate studies, aiming to dissect the biological and social underpinnings of health disparities.

• Shift to Public Health: Realizing the limitations of a purely biomedical approach, she pursued graduate studies at the University of Michigan's School of Public Health. Here, she collaborated with experts like social epidemiologist Ana Diaz Roux and genetic epidemiologist Sharon Cardea to explore how social factors influence health outcomes.

• Professional Experience: Her postdoctoral work at the National Institutes of Health (NIH) focused on evaluating the generalizability of risk scores across diverse populations, highlighting the potential of scientific practices to inadvertently perpetuate inequities.

• Transition to Urban Institute: The onset of the COVID-19 pandemic steered Dr. Brown towards applied public health efforts, particularly addressing racial inequities exacerbated by the pandemic. At Urban Institute, she expanded her focus to include policy-level interventions aimed at mitigating health disparities.

Notable Quote:

"My career is a journey upstream...from the very biological aspects of diseases to the broad strokes of policy-making."
— Dr. Kristin Brown [02:25]

The Maternal Health Crisis in the United States

Dr. Brown elucidates the stark realities of maternal and infant health in the U.S., juxtaposing them against peer high-income nations.

• Comparative Outcomes: The U.S. lags significantly behind countries like Australia, Canada, and the UK in maternal and infant mortality rates.

• Racial Disparities: Black women experience maternal mortality rates two to four times higher than their white, Hispanic, or Asian counterparts.

• Systemic Issues: High healthcare expenditures in the U.S. do not translate to commensurate health outcomes, pointing to systemic inefficiencies and inequities.

• Contributing Factors:

  • Paid Leave: Unlike other nations, the U.S. lacks comprehensive paid maternity leave, impeding mothers' recovery post-childbirth.
  • Healthcare Workforce: A shortage of obstetricians and midwives limits access to quality prenatal and postnatal care.
  • Insurance Coverage: The absence of universal healthcare leaves many reproductive-age women uninsured, adversely affecting prenatal care and outcomes.

Notable Quote:

"Our maternal health rates are just way worse, and it's not just the money issue because we actually spend a lot of money in healthcare and we're not getting the outcomes that we should."
— Dr. Kristin Brown [05:46]

The Intersection of AI and Maternal Health Research

Dr. Brown delves into her current research project, which examines the integration of AI into maternal healthcare decision-making processes, particularly within Medicaid agencies.

• Project Focus: Understanding how Medicaid incorporates AI systems to identify high-risk pregnancies, such as those susceptible to preeclampsia or postpartum hemorrhage, and determining the implications of these practices on health equity.

• Methodology:

  • Data Collection: Utilizing web scraping techniques to gather information from state Medicaid websites, including managed care contracts and health equity plans.
  • Qualitative Research: Conducting interviews with Medicaid representatives to assess the development and implementation of equity-focused policies.

Notable Quote:

"AI is being used to categorize patients as high risk...so Medicaid pays for 41% of births nationwide. Getting this right really has very broad implications for maternal health."
— Dr. Kristin Brown [10:25]

Initial Findings and Insights

While the research is ongoing, Dr. Brown provides preliminary observations:

• Variation Across States: There's significant heterogeneity in how different states adopt and implement AI in maternal healthcare, with some states leading as trailblazers while others lag behind.

• Data Challenges: The unstructured nature of the collected data poses challenges in standardizing and analyzing policies uniformly across states.

Notable Quote:

"Some states have information out there and other states do not. There's a lot of variation, heterogeneity, and in what's already out there so far."
— Dr. Kristin Brown [14:51]

Ethical Considerations and Equity in AI Implementation

A critical aspect of Dr. Brown's work is ensuring that AI applications do not exacerbate existing health disparities.

• Potential Benefits:

  • Bias Mitigation: Properly designed AI systems can help identify and mitigate implicit biases in medical decision-making.

• Risks:

  • Data Bias: AI models trained on flawed or inequitable data can perpetuate and magnify existing disparities.
  • Accountability: There's a risk of deflecting responsibility by attributing biased outcomes to "the model," overlooking the flawed data inputs.

• Strategic Imperative: Dr. Brown emphasizes the necessity of embedding equity at the foundational level of AI development to prevent the widening of health disparities.

Notable Quotes:

"AI just has so much potential, but it has so much potential in both directions...because the data that is being used to develop these AI models, if that data itself is flawed, if that data itself is inequitable, then it's only going to be magnified."
— Dr. Kristin Brown [16:36]

"History tells us that new technologies increase disparities because the haves get it, the have-nots don't."
— Dr. Kristin Brown [19:54]

Collaboration with GE Healthcare Foundation

Dr. Brown acknowledges the pivotal role of the GE Healthcare Foundation in advancing her research.

• Support and Synergy: The foundation's alignment with equitable healthcare goals has been instrumental in facilitating the project's progress.

• Impact of Funding: Enhanced funding allows for more comprehensive data analysis and broader outreach to policymakers and stakeholders.

Notable Quote:

"Research equips policymakers and stakeholders with evidence of what decisions to make...this project is just so critical at this moment, when AI is just being developed so rapidly."
— Dr. Kristin Brown [16:55]

Concluding Insights and Call to Action

Dr. Brown imparts crucial takeaways for listeners and stakeholders:

• Vigilance in Equity: Continuous efforts are required to integrate equity into AI and healthcare policies to prevent exacerbating existing disparities.

• Sustained Engagement: Addressing maternal health crises and AI integration is an ongoing process that demands persistent attention and intervention.

Notable Quotes:

"Keep being vigilant, to make sure that equity is baked in at the ground level...we have to realize the moment that we're in and make sure that...we do this right."
— Dr. Kristin Brown [21:08]

"AI is here to stay...we need the morale and the will to actually intervene on these issues."
— Dr. Kristin Brown [21:08]

Connecting with Dr. Kristin Brown and the Urban Institute

For those interested in Dr. Brown's work or the Urban Institute's initiatives:

• Social Media: Dr. Brown is active on LinkedIn and X (@KristinBrownPhD), while the Urban Institute maintains a presence across platforms including X, Facebook, LinkedIn, and YouTube.

• Further Information: Visit the Urban Institute's website and follow their social media channels for updates on ongoing research and policy developments.

Final Thoughts

Dr. Kristin Brown's insightful discussion underscores the dual-edged nature of AI in medical research. While AI holds immense potential to revolutionize maternal healthcare and address health disparities, it also poses significant risks that demand careful, equity-focused implementation. Her work at the Urban Institute exemplifies a proactive approach to harnessing technology for social good, ensuring that advancements in AI contribute to a more equitable and healthier society.

This summary encapsulates the key discussions from the "Nonprofit Leadership Podcast" episode featuring Dr. Kristin Brown. For a deeper dive into the conversation and additional resources, listeners are encouraged to tune into the full episode available on major podcast platforms.