AI Is a Health Equity Issue for Us

At the Black Women’s Health Imperative, we are clear about this: artificial intelligence is not just a technology issue. It is a health equity issue. That is why AI and emerging technologies are a core pillar of our National Health Policy Agenda. As these tools become more embedded in healthcare, insurance systems, and public health decision-making, the risks and benefits are not being distributed evenly.

With the launch of tools like ChatGPT Health, AI is increasingly positioned as a trusted source for medical information, decision support, and patient engagement. These tools promise efficiency and access, but they also raise urgent questions about oversight, data integrity, and who is being protected as AI becomes more deeply embedded in healthcare.

Dr. Uché Blackstock, a physician, bestselling author, and leading national voice on health equity, recently shared her concerns directly with the Black Women’s Health Imperative following the announcement.

“My concern is the degree to which AI has been unregulated so far,” she wrote. “Without guardrails in place, there is real potential for harm, especially if there is no assessment of how biased a data set is or who is included in it. That harm can be perpetuated quietly and at scale.”

Dr. Blackstock emphasized that the risks extend beyond code to the people developing and deploying these systems.

“We have to ask who is building these tools and what lens they are using. Are they applying an equity lens and considering the groups most likely to be negatively impacted? And who are these tools being applied to, knowing they may be used in our daily lives?”

She also cautioned against overconfidence in the data powering these platforms.

“Applications like ChatGPT Health are gathering available patient data and making assumptions based on it. Some of that data may not reflect Black women or our lived experiences, but the outputs will still be applied to us. If clinical trials are not diverse, we are not guaranteed that the medications or treatments being tested are either effective or safe for our bodies.”

While acknowledging that AI is inevitable, Dr. Blackstock stressed what must come next.

“What is absolutely necessary over the coming months and years is regulation around the development and use of this technology. Black women, in particular, should exercise heightened caution when it comes to the expanding use of AI in healthcare. We are often not considered in the assumptions built into these tools.”

AI Is Already Health Policy

AI is already embedded in the national health policy landscape, from federal healthcare programs and insurance systems to hospital decision-making tools. Its technologies are shaping care decisions, and its assumptions are shaping outcomes. What has not kept pace is the policy infrastructure needed to ensure these systems protect health rather than deepen existing inequities.

But AI in healthcare does not exist only on screens.

The Environmental Footprint We Are Ignoring

Behind every AI tool is physical infrastructure. Data centers power healthcare algorithms, insurance platforms, and government databases, and their rapid expansion is one of the least examined but fastest-growing health policy issues facing Black communities.

These facilities are increasingly being built in regions with limited political power and longstanding environmental vulnerabilities, particularly across the South. In Texas alone, reporting shows that large-scale data centers are projected to consume as much as 2.7 percent of the state’s total water supply by 2030, even as many communities face persistent drought and strained infrastructure. Similar patterns are emerging across Georgia, Louisiana, and Mississippi, where residents have raised concerns about water depletion, increased heat, diesel generator emissions, and rising utility costs tied to data center operations.

Environmental justice advocates warn that these facilities are often sited in or near predominantly Black and low-income communities, continuing a familiar pattern where industrial burden arrives without meaningful community consent or health impact assessments.

Despite their growing role in healthcare delivery, AI infrastructure remains largely unregulated from a public health standpoint. As hospitals, insurers, and public health agencies increasingly rely on AI for diagnostics, billing, predictive modeling, and patient management, the physical systems supporting these tools are expanding faster than the policies designed to protect communities from environmental harm.

What Policy Is Acknowledging and What It Is Not

This gap is explicitly identified in the Black Women’s Health Imperative’s National Health Policy Agenda 2025–2026, which names the environmental and health consequences of AI expansion as a critical and emerging health equity issue. BWHI’s agenda calls for safeguards to ensure that technological innovation does not exacerbate environmental exposures, health disparities, or resource inequities for Black women and families.

Community leaders across the South have voiced frustration with limited transparency, rushed zoning approvals, and minimal public input. In some cases, residents report learning about data center projects only after construction is underway, with little access to environmental monitoring data or long-term health protections.

“When AI infrastructure is built without regulation or accountability, the risks are shifted onto communities that already carry too much,” said Candace Bond-Theriault, Esq., LL.M., Senior Director of Policy at the Black Women’s Health Imperative. “We cannot separate digital health policy from environmental health. If AI is part of our health system, then its footprint must be governed with equity, transparency, and public health protections at the center.”

Why This Matters Now

AI is shaping healthcare decisions today. Its environmental footprint is reshaping neighborhoods. Its algorithms are influencing care pathways. And its assumptions are affecting outcomes.

For Black women and families, this convergence of technology, environment, and health policy is not abstract. Environmental exposures are linked to chronic disease and pregnancy outcomes. Algorithmic bias can influence diagnosis, treatment, and access to care. Without guardrails, these risks compound.

If AI is going to be part of our health system, then it must be governed as a health issue. That means regulation, transparency, community input, and an explicit equity lens from development through deployment.

At the Black Women’s Health Imperative, we will continue to elevate the data, center community voices, and push for policies that ensure innovation does not come at the expense of our health, our environments, or our dignity.