NYC eyes human-centered design to solve generational health inequities

By Laura Lovett
04:29 pm

New York is looking to tech as one of the keys to unlocking generational health inequities. Specifically, the city is zeroing in on how it can use human-centered technology design to help tackle the problem. 

“What we are hoping to do is use design thinking to disrupt the intergenerational cycles of health inequities, of opportunity inequities, of wellbeing inequities affecting the most vulnerable people in New York,” Deborah Brown, chief strategy and innovation officer for Health in the New York City Office of the Deputy Mayor for Health and Human Services, said today at Mad*Pow's Health Experience Design (HXD) Conference in Cambridge, Mass.  “We will be focusing initially on pregnant women and families ages zero to two.”

Health inequities are nothing new, and have been the status quo for generations despite years of work by government agencies, Brown said. 

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“We have ... black and brown babies dying at a faster rate or a quicker rate than white babies,” she said.  “Black women are more likely to die from pregnancy-related causes. … This is nothing new. At the same time, the rates [of infant mortality] are largely going down. But that inequity still remains and it is intergenerational.”

New York City officials have been working on the issue of social determinates of health for years, but with inequities persisting Brown said the city knows that it has to look outside of its typical toolset for a solution.

“If there was a solution [within] the current paradigm … we would have found it or frankly someone would have found it before us,” Brown said. “We aren’t asking the right questions so we aren’t getting the right answers.”

However, switching over to a new tech design-driven approach means there will be a lot of unknowns. 

“Being true to design principles, we don’t know what it is going to look like,” Brown said. “But we want systems that are better integrated. The systems historically haven’t been built in a coordinated fashion. We want systems integrated around the end user — around that mother, around that family. We want, in some ways, [to force] the portfolio to work together and all those other agencies to work together, and what we would like to do is build a legacy so that when our time is over … we have left rail tracks for the people who come after us.”

Brown has learned the importance of human-centered design in practice. Before working on this project, she worked for a health system to integrate systems for value-based care. During that time she said she made some major errors and didn’t talk to patients, providers, or community organizations.

While she admitted that this was her error alone, she said many institutions also make these missteps. Going forward, it's important to keep the stakeholders front and center, she said. 

Although human-centric design may be the way of the future it’s not a catch-all, Brown continued. There needs to be a multifaceted approach between the old and the new. 

“I think we need a change [in the system] to include design,” Brown said. “I want to be really clear. I have come really far … I don’t think yet, maybe ever, that human-centered design is the hammer for every nail. I continue to think that there are municipal problems and policy problems that might be solved through more traditional tools, but on those intractable, wicked problems, this makes sense. This is probably the smartest, most enlightened, intelligent, compassionate way to approach these problems, so that’s what we are trying to do.”