Quote (Goomshill @ Jan 24 2022 01:40pm)
Discrimination being mixed in with other factors is still discrimination. Redlining by banks wouldn't be legal if the bankers were putting a penalty on the credit score of black people, even if its not the only factor in a credit score. And likewise, using zip codes is just the jim crow version of that, trying to obfuscate discrimination by applying an ostensibly neutral criterion of purely arbitrary distinction with no causal relationship. There's a century of precedent in tearing down those kinds of 'what if we just...' rules as being racist.
Where's the medical necessity in all this? What makes Wentworth Miller more likely to die of covid than Iron Eyes Cody? Does Emilia Clarke really need preferential treatment for being 1/8th Indian? If you were a doctor looking for outcomes overall, would you really want to be dabbling in the third rail of invoking explicitly racist healthcare coverage for little or no practical reason on a case by case basis? There's a reason Minnesota and Utah and the multi-state agency all dropped these methods when it came to the public's attention, its not worth it.
While I don't think that the system being utilized (formally or currently) at Utah, Minnesota, and New York sufficiently or effectively addresses disparate health outcomes, I do think the underlying principle of incorporating sociological data into triage calculations is sound and beneficial. I also don't think we'll ever get to a place where the data is so granular that we've established Factor X or Factor Y as being "causal" for these disparities, and as such, some form of succinct shortcut will inevitably be applied.
Personally, I think zip codes would be a better succinct tool as it speaks better to resource availability and would more than likely 'capture' many of the same demographics that the original tool was attempting to capture anyway.