Disparities in Healthcare Delivery with Dr. Liz Chuang

In this episode, Dr. Chuang discusses some of her research, which has focused on racial disparities in health care delivery. She shares her journey to this topic starting with her childhood experiences as a witness to structural racism and implicit bias. She discusses how bias and structural inequities are reproduced in many ways, all affecting health and healthcare outcomes. Her work includes several focuses including interpersonal bias in healthcare communication with patients with serious illness and their families, bias in public health practices and bias in Artificial Intelligence. The discussion concludes with the ways that biomedical research has contributed to bias in healthcare over time. The discussion also includes some ways that researchers can move forward even in a challenging funding environment.

Chuang E, Hope AA, Allyn K, Szalkiewicz E, Gary B, Gong MN. Gaps in Provision of Primary and Specialty Palliative Care in the Acute Care Setting by Race and Ethnicity. J Pain Symptom Manage. 2017 Nov;54(5):645-653.e1.

Chuang E, Yu S, Georgia A, Nymeyer J, Williams J. A Decade of Studying Drivers of Disparities in End-of-Life Care for Black Americans: Using the NIMHD Framework for Health Disparities Research to Map the Path Ahead. J Pain Symptom Manage. 2022 Jul;64(1):e43-e52.

Chuang E, Grand-Clement J, Chen JT, Chan CW, Goyal V, Gong MN. Quantifying Utilitarian Outcomes to Inform Triage Ethics: Simulated Performance of a Ventilator Triage Protocol under Sars-CoV-2 Pandemic Surge Conditions. AJOB Empir Bioeth. 2022 Jul-Sep;13(3):196-204.

Binkley CE, Dellavalle NS, Chuang E. From Mitigation to Flourishing: We Must Harness Emerging Technologies to Improve Health of the Most Vulnerable. Am J Bioeth. 2026 Feb;26(2):127-129.

Cited in this episode:

Barnato AE, Berhane Z, Weissfeld LA, Chang CC, Linde-Zwirble WT, Angus DC; Robert Wood Johnson Foundation ICU End-of-Life Peer Group. Racial variation in end-of-life intensive care use: a race or hospital effect? Health Serv Res. 2006 Dec;41(6):2219-37.

Johnson KS, Kuchibhatla M, Payne R, Tulsky JA. Race and residence: intercounty variation in black-white differences in hospice use. J Pain Symptom Manage. 2013 Nov;46(5):681-90. doi: 10.1016/j.jpainsymman.2012.12.006. Epub 2013 Mar 21.

Ashana DC, Welsh W, Preiss D, Sperling J, You H, Tu K, Carson SS, Hough C, White DB, Kerlin M, Docherty S, Johnson KS, Cox CE. Racial Differences in Shared Decision-Making About Critical Illness. JAMA Intern Med. 2024 Apr 1;184(4):424-432.

Dellavalle NS, Ellis JR, Moore AA, Akerson M, Andazola M, Campbell EG, DeCamp M. What patients want from healthcare chatbots: insights from a mixed-methods study. J Am Med Inform Assoc. 2025 Nov 1;32(11):1735-1745.

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