bronx science

South Bronx-Born AI App Aims to Change Maternal Health Disparities

The “Radical Relay” app wants to help women navigate a healthcare system that can be discriminatory.
The “Radical Relay” app wants to help women navigate a healthcare system that can be discriminatory. Photo: Ben Fractenberg/THE CITY

Women of color, immigrants and low-income workers who are pregnant are particularly vulnerable to discrimination in workplaces, hospitals and even public agencies, a new report by the city Commission on Human Rights found.

And that discrimination can lead to devastating maternal health outcomes — especially in places like the South Bronx, which has one of the highest rates of pregnancy-related complications in the city.

South Bronx native Ivelyse Andino wants to help change that, with an app.

“Radical Relay” is expected to launch at the end of the month, said Andino, founder and chief executive of Radical Health, the company behind the program.

Built by the same team that developed the ACLU’s “Mobile Justice” app, Radical Relay relies on the machine-learning capabilities of IBM’s Watson artificial intelligence system to help guide women through pregnancy.

In recent tests observed by THE CITY, the application quickly answered common questions — such as, “What do I do if my doctor isn’t listening to me?” — in simple language.

It’s like talking “to an aunt or a best friend,” Andino said of the free app.

“And if it can’t answer the question, it uses peer experience to help answer those questions,” she said. “So it’s a real-life person on the end, that’s like, chatting.”

For the doctor-listening question, the app responded, “Making sure your concerns are listened to is super important to your health. You can always ask for a second opinion or ask to speak with an attending.” Radical Relay also advised specifically asking the doctor to document the patient’s concerns on their medical chart.

Link Between Discrmination and Health

The announcement of the launch comes the same week as Wednesday’s release of the NYC Commission on Human Rights report on discrimination against those who are pregnant as well as people who take care of a child or older adult.

The report notes that challenges at work and poor maternal health outcomes are connected: “Often the same people impacted by substandard prenatal and birthing care must also endure inhospitable, stressful, and physically-demanding workplaces prior to giving birth.”

“You should be able to keep your job, and support your family, and be pregnant all at once,” said Dana Sussman, deputy commissioner of policy at the NYCCHR.

But often — as legal and social services providers, advocates and others testified to the Commission — that’s not the case.

Since 2016, the Commission says it has levied about $560,000 in penalties against companies because of this kind of discrimination.

An ‘Impossible Choice’

In one case, an employee was fired after a brief dizzy spell at work. In another, a woman lost work hours after revealing that she was pregnant. Another was sacked after she was hospitalized due to pregnancy complications.

“Every day in America pregnant women face the impossible choice between maintaining a healthy pregnancy and earning a paycheck,” Dina Bakst, co-founder and co-president of the nonprofit legal organization A Better Balance, testified before the Commission at a January hearing.

Ivelyse Andino, the founder of Radical Health.
Ivelyse Andino, the founder of Radical Health. Photo: Ben Fractenberg/THE CITY

“Consider for example the pregnant cashier who is rushed to the ER when she fainted on the job because her boss would not let her drink water, or another retail worker pushed off the job in her trimester after requesting light duty to avoid miscarriage and wound up in a homeless shelter because she could no longer afford rent,” Bakst said at the time, citing cases her organization had handled.

These are familiar scenarios in the neighborhood Andino grew up in. According to the city health department, the South Bronx has one of the highest rates of pregnancy-related complications in the city, in a borough that repeatedly ranked dead last in rankings of health outcomes in the state’s 62 counties.

The Radical Relay project was inspired by stories shared during the regular, health-related conversations Andino and her staff host in a number of neighborhoods across the city, including Mott Haven in the Bronx, where she lives, Brownsville in Brooklyn, and Hollis, Queens.

Andino’s own experience as a mother informed the concept as well.

“I had to have an emergency C-section, even though I had great insurance, I had a doula and a midwife, and an acupuncturist, and all the fun things,” she said. “I still found myself right at the mercy of a physician who really didn’t know my full story and couldn’t really help me the ways that I needed help.”

She hopes her app, along with efforts to identify and eliminate pregnancy discrimination, will improve conditions for other women.

“When we look at, overall, the maternal health crisis, as it’s being called, it’s a matter of equity,” Andino said. “Do we have equal access? Are we being treated fairly? Do we have the same type of providers that other folks have? Are people looking at us as humans? Or just brushing us aside?”

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