⚠️ This Comes With a Warning:
I’m fucking angry. And you should be too.
Because awareness isn’t saving lives. And equity doesn’t come from posters in waiting rooms.
Health disparities aren’t bugs in the system. They are the system. Coded into devices. Baked into funding. Signed off by policy. Hidden behind polite panels and polished language.
So no—this won’t be a gentle read. Because people are dying. Not from medical mystery. But from systems designed to miss them.
Let’s begin.
First: Bias isn’t inevitable.
It’s not human nature. It’s human design.
And we know this not just from theory, but from evidence.
“Discrimination on the basis of gender, race, sexuality, and other categories is a human invention. We know this because it has not always existed.” — Jessica Nordell, The End of Bias: A Beginning
Nordell is a science journalist and bias researcher who spent years investigating how prejudice is formed—and more importantly, how it changes. Her work doesn’t just argue that bias can be unlearned. It shows it—across neuroscience, institutions, even entire cultures.
Bias isn’t some ancient instinct. It’s a shitty line of code that got normalized. And the beauty of code?
You can rewrite it.
We’ve done it before. We forced civil rights into law. We rewired hiring algorithms. We removed race-based equations from medical practice.
So no—we’re not stuck with this. We’re just still running outdated software.
Second: If we want equity, we have to break the machine.
1. Clinical tools aren’t neutral. They’re biased by default.
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Pulse oximeters misread Black skin—underreporting low oxygen during COVID
Kidney function tests once “corrected” for race—delaying care for Black patients
AI triage systems learn from racist historical data—and “predict” it back to us as truth
Drug dosing still assumes a 70kg white male body as standard
That’s not just oversight. That’s science shaped by who had the mic when the protocol was written.
2. Follow the money—and torch what it protects.
Let’s talk rare diseases.
Cystic Fibrosis vs. Sickle Cell Disease
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Cystic Fibrosis: ~30,000 people in the U.S. (mostly white)
Sickle Cell Disease: ~100,000 people in the U.S. (mostly Black)
NIH funding per patient: → CF: $2807 → SCD: $812
Philanthropy per patient: → CF: $7690 → SCD: $102
So: 3x the patients. 10x less investment. That’s not a disparity. That’s a decision.
Women’s Health? Same story.
Women are half the population. They get just 10.8% of NIH funding.
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Endometriosis affects 1 in 10 women—takes 7–10 years(!!!!!!!) to diagnose
Most drugs are tested on men, dosed for men, and assumed to “just work” for everyone else
This is what happens when you treat male as default, and everything else as a rounding error.
Mental Health for the Poor? Forget it.
Living below the poverty line? You’re:
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Twice as likely to suffer anxiety or depression
Four times less likely to get care
Now add race. Add housing insecurity. Add stigma. And now try booking a therapist that doesn’t charge $200/hour.
Meanwhile, VC-funded apps promise “mental wellness for all”—but only work for people with WiFi, a smartphone, insurance, and a morning yoga slot.
This isn’t mental healthcare. It’s market segmentation disguised as progress.
3. The drug development model is broken by design.
Big Pharma isn’t evil. But its incentives are.
We fund what’s profitable. We ignore what’s urgent. And we call that innovation.
If your disease doesn’t affect rich, white, insured patients in G7 countries? You’ll wait. Maybe forever.
Alternatives exist:
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Open-source pharma (DNDi)
Non-profit biotechs
Crowdsourced, low-cost trials
They’re working. They just don’t fit the existing system. So the system ignores them.
We don’t need more pipelines. We need fire escapes—out of the model we’re trapped in.
4. Tech won’t save us unless we force it to.
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Wearables that don’t work on dark skin? Still shipping
Chatbots that don’t understand accents? Still “live”
AI that replicates historic bias? Still scaling
Tech is only neutral if you pretend data isn’t biased, access isn’t unequal, and your users are all affluent and English-speaking.
Let’s be clear: If equity isn’t coded in, bias will be.
And maybe the most radical idea?
Design for the margins.
Make your product work for:
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The trans woman misgendered in every form
The 68-year-old Black man whose symptoms don’t match the textbook
The single mother with no WiFi, no PTO, and a chronic illness she can’t afford to name
Build for them. And everyone else benefits too.
This isn’t idealism. It’s functional justice.
So yeah—I'm angry.
Not performative angry. Not “write-a-thought-piece” angry. System-smashing angry.
Because people aren’t dying from medical mystery. They’re dying from predictable ones— Ignored, delayed, underfunded, misdiagnosed.
You don’t just fix that with awareness campaigns. We need redistribution, disruption, and a willingness to be unreasonable.
“The reasonable man adapts to the world. The unreasonable one persists in trying to adapt the world to himself.” – George Bernard Shaw
So let’s be unreasonable. Let’s be uninvited. Let’s be exactly as disruptive as equity demands.
No more admiring the problem. It’s time to tear it down and build something better.