Health inequalities are well documented in the United States, with Black and brown people bearing a greater burden of chronic disease and death than white people. From chronic illnesses to preventable diseases, the statistics are alarming.
Forehead thermometers may be inaccurate in Black people, which could negatively affect health outcomes.
Skin tone affects how skin emits light and heat, interfering with forehead thermometer readings.
Racial bias is a serious issue in the medical community and needs to be addressed urgently.
The findings underscore the importance of designing medical devices with all skin tones.
The health disparities in black communities are evident across the country, driven by poverty, racism and discrimination, and lack of access to quality healthcare. Another concerning factor is the racial biases in medical equipment.
A new study has found that standard forehead thermometers may be less accurate than oral thermometers in measuring the body temperature of Black people, potentially leading to misdiagnosis and delayed treatment.
Racial differences in detection of fever
Earlier this month, scientists from Emory University in Atlanta, and the University of Hawaii, in Honolulu published research in JAMA exploring racial differences in thermometer readings.
They found that temporal temperature measurement, as taken by forehead thermometers, was around 26% less likely to identify fever in Black patients than traditional oral temperature measurements.
Conversely, there were no significant differences between the two methods of taking temperature readings in white patients.
These findings are significant, as fever is often one of the earliest indicators of illness and can help guide treatment decisions.
If Black patients are less likely to have their fever detected by forehead thermometers, they may be more likely to be undertreated or misdiagnosed. This could lead to delayed treatment and poorer health outcomes.
The study involved a large sample size. There were 4,375 participants, comprising 2,031 Black people and 2,344 white people, who were admitted to certain hospitals over 7 years.
Each individual registered both oral and forehead temperature readings within an hour of each other on the first day of hospital entry.
When comparing the temperatures, the researchers found that the forehead readings were lower than the oral temperature readings in Black patients.
In white individuals, 10.8% had a fever, as indicated by the forehead thermometer, which was similar to the 10.2% rate of the oral thermometer.
However, for Black people, there were considerable differences between the two methods. The forehead thermometer detected fever in 10.1% of the Black participants, but this number jumped to 13.2% with the oral thermometer.
Implications for health disparities
When someone visits a hospital, clinic, or other healthcare setting, their temperature is usually one of the first things measured.
Temperature readings help guide and inform the diagnosis and course of treatment. They provide a baseline for monitoring the progress of an illness, and depending on the measurement, healthcare professionals may order further tests, refer patients, or start treatments. Ultimately, a temperature reading is a key to making patient care decisions.
Fever is often an early symptom of infection or another underlying issue, so delayed detection and treatment could result in a more serious illness. In some cases, as with sepsis, it could even be life-threatening. In addition, even small discrepancies could seriously affect health outcomes, so accurate temperature readings must be taken for every patient, regardless of skin color.
Racial biases in medical equipment
Skin tone affects how skin emits light and heat, which appears to interfere with thermal readings from forehead thermometers. It also appears to affect tools that measure oxygen saturation in the blood, pulse oximeters, as they are less accurate in Black patients.
Like the forehead thermometer, pulse oximeters work by shining a light through the skin. However, rather than temperature, they measure the blood's oxygen-carrying capacity. Data suggests that skin color can also impact readings from pulse oximeters, with some studies finding that they may overestimate blood oxygen saturation levels in darker-skinned individuals.
During the recent COVID-19 pandemic, this discrepancy was particularly concerning as it could mislead doctors and leave people without necessary life-saving treatments.
Sadly, other diagnostic tools are also affected by racial bias. For example, those used to detect skin cancer and remote heart-rate sensors are less accurate in darker skin tones.
Even more medical tools are likely impacted by racial bias, but it's an area of research that's been neglected for far too long. With every new study published, we're learning just how widespread these disparities are.
The need for equity in medical device design
Racial bias is a serious issue in the medical community and needs to be addressed immediately. It's time for a change.
These findings underscore the importance of designing medical devices with all skin tones in mind. For decades, the default has been to design and test new products on limited populations, usually those with lighter skin tones.
As a result, many devices aren't properly calibrated to work on darker skin, which can have severe consequences. To address this issue, we need better representation at all stages of the design and testing process rather than just a subset of the population.
Manufacturers also need to be aware of the potential for racial bias in their products and take steps to mitigate it. This might include developing new ways to test devices on various skin tones or partnering with organizations that focus on health equity.
Ultimately, we need to see a shift in how medical devices are designed, tested, and marketed. Only then will we be able to ensure that everyone, regardless of skin color, has access to the same quality of care.
Until then, healthcare providers must be aware of the potential for inaccurate readings on devices like forehead thermometers and take steps to ensure that everyone receives the best possible care.
Forehead thermometers are a commonly used medical tool, but they may be less accurate than oral thermometers in Black people.
The discrepancy could have serious consequences on health outcomes, so accurate temperature readings must be taken for every patient, regardless of skin color.