Asian Chinese senior woman using smart phone reading text message in the living room of her apartment in the city
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Earlier this year, OpenAI was launched ChatGPT Healthoffering digitally savvy consumers a tool to aggregate health data scattered across different websites and portals. The burden and cost of chronic disease in the US is often disproportionately concentrated in underserved communities where people are least likely to use or benefit from this innovation. Health technology is not designed and marketed with these communities in mind, so who is it for?
In one recent postSergei Polevikov, technology expert and founder AI Health Uncutdescribes uploading his health records to the new OpenAI health platform and offers a cautionary tale. The analysis was confounded by his health history and faced administrative hurdles in the process. Polevikov says, “Automation helps me be efficient and saves me time, but I don’t need artificial intelligence to explain what’s happening to me health-wise. The distribution of [these tools] it’s one-sided and people like me need them less.”
If someone like Polevikov faces obstacles navigating AI-based tools, what does that signal for those with low digital literacy and whose health and technology concerns are not included in the design and marketing of these tools?
Tech-Ignored, Not Tech-Averse
My recent AI interviews in Mobile, Alabama provide context for the disconnect between the rise of AI tools and the technical support needs of people with low digital literacy. Leevonis Fisher, community leader and founder Bay Area Women’s Coalitionhighlighted how far we have left people behind. When I asked what he thought about artificial intelligence, he said, “I think it’s all fake.” I turned around to ask about her smartphone usage. Fisher has an iPhone and uses Siri, Alexa and voice-to-text almost every day. Despite how ingrained these tools are in her routine, she had no idea they were based on artificial intelligence. To her, AI was a buzzword for an untrustworthy computer robot that creates fake videos for social media.
This is relevant. While engineers and tech gurus continue to create tools for convenience and efficiency for those who need them least, those who could benefit the most are left out of design discussions and, like Fisher, often don’t even know they’re already using AI-based solutions every day. These communities are also less likely owning wearables, purchasing direct-to-consumer diagnostics, or consistently connecting to their electronic health records. Unless we close these information and access gaps, continued artificial intelligence and technological innovation will widen them. Furthermore, innovation that misses out on underserved and high disease burden communities is a missed market opportunity. The full economic potential of AI in healthcare will not be realized if the tools are only used by the healthiest and most tech-savvy.
Are we ok with that?
Fisher likely represents millions of people across the country who might be labeled tech-averse. But given the everyday use of technology, it’s not. it’s tech…ignored. She doesn’t trust AI because no one has invited her to understand its usefulness or function in her life beyond Siri and Alexa. Unless we understand its habits, limitations and specific needs, the most advanced AI in the world will only serve to expand knowledge and exploit gaps.
Shaping AI By And For People
We are not powerless to face this. Organizations and efforts are emerging to shape AI policy and access. Last fall, the MacArthur Foundation, the Omidyar Network and eight other major philanthropies launched Humanity AIa five-year, $500 million initiative to ensure that artificial intelligence is shaped by and for people. According to Michele Jawando, president of the Omidyar Network, “Technology has incredible potential, but it must be driven by people, not the other way around. The future will not be written by algorithms, it will be written by people as a collective force.”
We should wrestle with these questions and work toward a consensus to build technology for all, but not before raising awareness and seeking context, experience, and insight from the people we continue to leave behind.



