Equity, Inclusivity, and Innovative Digital Technologies to Improve Adolescent and Young Adult Health

The author Yuval Harari opined, “humans were always far better at inventing tools than using them wisely.” The “tool” to which this caution is most relevant in the 21st century is artificial intelligence (AI), the use of which has proliferated in many fields. Health care is no exception, and adolescent and young adult (AYA) health care is of special interest to AI.

For example, in this supplement, Giovanelli et al. see the hope and promise of carefully leveraging AI to support adolescent health, underscoring the need for multidisciplinary developmental science teams with expertise in cognitive development, medicine, psychology, computer science, and medical informatics. Rowe and Lester contribute a computer science perspective on how emerging AI technologies create new opportunities for personalizing technology-based health interventions to adolescents.

This Commentary explores the other side: the unique perils of applying AI to AYA health care. Given this population’s vulnerability, health care needs, and graduated autonomy from the adults who have thus far governed their lives, centering equitable and inclusive AI is crucial. Consider the Google Nightingale whistleblower case disclosing the “transfer of medical history data, which can be accessed by Google staff.” Add the lifetime risk for vulnerable populations lacking relevant safeguards while profit-motivated organizations compete for health care market share, targeting consumer behavior, and leveraging health care and other data for profit. The potential unintended consequences for personal privacy and equitable inclusion are staggering.