Equity by Design: Centering Black and Minoritised Voices in the Future of AI and Healthcare

Artificial intelligence has quickly integrated into nearly every facet of our online worlds; often so seamlessly that we hardly realise it. From chatbots to personalised recommendations, AI is reshaping our experiences. However, when AI tools are designed without the direct involvement of marginalised communities - those most vulnerable to harm - serious flaws emerge.

Intense competition drives major companies to release new AI technologies rapidly, with fixes promised later. The prevailing mindset is not to slow down progress because AI could help solve many social challenges. But responsible development means pausing to identify risks and actively involving marginalised voices, ensuring their perspectives help shape AI from the ground up. Only then can we prevent entrenched biases - racism, sexism, and discrimination - from becoming part of AI’s foundation. 

This is particularly critical in healthcare, where bias can put lives at risk. Women and BME (Black and Minority Ethnic) communities have faced a long history of exclusion and misdiagnosis in medical systems. If their experiences and expertise are absent from the development of AI in healthcare, we risk perpetuating these same injustices. While AI could ease administrative burdens, it must not come at the cost of empathy, trust, and patient safety. 

Mistrust of healthcare systems and technology is already high among BME individuals, who often prefer support from trusted professionals over automated tools. If AI remains untrustworthy, these communities may become further isolated, missing out on potential benefits. 

As Laura Bates warns in 'The New Age of Sexism': 

“When we design shiny, futuristic and seemingly flawless algorithms and then train them with flawed, biased and incomplete data, we risk entrenching into the future of our healthcare systems the damaging cycles that we should instead be breaking. It isn’t an exaggeration to say that people are paying – and will continue to pay – with their lives.” 

To build equitable health solutions, BME-led VCSE organisations must be empowered to connect communities and developers, placing lived experience and genuine engagement at the heart of AI’s future in healthcare. 

To explore these themes further, the following section is written by Aurora Todisco, whose insights as an independent consultant and advocate for community engagement illuminate the path forward at this critical intersection of AI, health equity, and lived experience. 

"Centring Communities: PPIE, AI and the Role of the Black and Minoritised Voluntary Sector 

Artificial Intelligence (AI) is reshaping health and care — influencing how conditions are diagnosed, how resources are allocated, and how services are delivered. But if AI is to be truly fair, effective, and trustworthy, it must be shaped by the communities it serves — especially those historically marginalised within both health and technology systems.

That’s where Patient and Public Involvement and Engagement (PPIE) — and the leadership of the Black and Minoritised voluntary and community sector (VCS) — is essential. 

As an independent health equity and community engagement consultant, I’ve seen the power of community-led approaches to shaping innovation, especially when the stakes involve people’s health, autonomy, and trust. I’ve also seen how marginalised communities are too often excluded from early conversations around technology — despite being most at risk from the unintended consequences of biased systems. 

That’s why I believe collaboration with organisations like Voice4Change England (V4CE) is critical. 

V4CE already plays a vital role as a national advocate for racial justice and community empowerment. A joint exploration of how AI intersects with health inequalities and PPIE could help ensure that Black and Minoritised communities are not only included, but actively leading the conversation — bringing in expertise from the grassroots and the lived experience of navigating unequal systems. 

Together, we can: 

• Challenge bias in AI systems: Many AI models are trained on datasets that don’t reflect the diversity of our communities. This can deepen health inequalities unless addressed through inclusive design from the outset. 

• Ensure community-led priority setting: Black and Minoritised VCS organisations are best placed to identify what matters most to their communities — and to ensure AI is used to meet real needs, not imposed assumptions. 

• Shape national policy on equity in tech: The sector must be at the table when decisions are made about AI ethics, regulation, and investment — to ensure that technology serves social justice. 

• Rebuild trust: Structural racism and exclusion have left many communities justifiably wary of data use. VCS organisations can act as trusted bridges, helping people engage critically and confidently with digital innovation. 

  
  

We believe the future of AI in health and care must be community-powered, anti-racist, and co-designed with the people it affects most. 

This is not about tokenism or consultation after the fact — it’s about real power-sharing, capacity-building, and making sure innovation is guided by the principles of equity and justice. 

A collaboration between V4CE and others working at the intersection of AI, health equity, and community voice could both increase representation in national policy spaces and reimagine what inclusive, community-led innovation truly looks like."

As we look ahead, it is only through genuine partnership - rooted in mutual respect, shared power, and a relentless focus on justice - that we can realise the full promise of AI for every community. In that spirit, we affirm our commitment to work together, upholding V4CE’s unwavering dedication to advocating for the Black and Minoritised Ethnic communities. Together, we will strive for a future where innovation genuinely serves equity, wellbeing, and social justice for all.