A Proposed Framework on Integrating Health Equity and Racial Justice into the Artificial Intelligence Development Lifecycle

The COVID-19 pandemic has created multiple opportunities to deploy artificial intelligence (AI)-driven tools and applied interventions to understand, mitigate, and manage the pandemic and its consequences. The disproportionate impact of COVID-19 on racial/ethnic minority and socially disadvantaged populations underscores the need to anticipate and address social inequalities and health disparities in AI development and application. Before the pandemic, there was growing optimism about AI's role in addressing inequities and enhancing personalized care. Unfortunately, ethical and social issues that are encountered in scaling, developing, and applying advanced technologies in health care settings have intensified during the rapidly evolving public health crisis. Critical voices concerned with the disruptive potentials and risk for engineered inequities have called for re-examining ethical guidelines in the development and application of AI. This paper proposes a framework to incorporate ethical AI principles into the development process in ways that intentionally promote racial health equity and social justice. Without centering on equity, justice, and ethical AI, these tools may exacerbate structural inequities that can lead to disparate health outcomes.