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I speak to patients of color all the time who express an awareness of the fact that their dermatologist is unfamiliar with diagnosing skin disease in their skin tone or uncomfortable teaching them how to care for their hair or scalp.
我和有色人种的病人一直在沟通，他们会感受到这一现实情况：他们的皮肤科专家对于诊断他们肤色的皮肤疾病并不是很熟悉，也不愿意教他们如何护理头发和头皮。
And I wonder, what does this awareness that your doctor is uncomfortable with you due to the physician-patient relationship;
而且我纳闷是什么使你觉察到医生和你之间别扭呢？是源自于医师和病患的关系，
to trust in the medical establishment; or to the likelihood that someone returns for additional care?
源自于对医疗机构的信任，还是源自于可能得要回诊接受额外的治疗呢？
A problem in dermatology is that we're not taught how skin disease appears in all skin tones.
皮肤科存在的一个问题是我们并没被教皮肤疾病在各种肤色中显现的样子。
As a medical student, my classmates and I quickly realized that we only saw dark skin when we were learning about syphilis.
我和我的医学生同学们很快就意识到我们只有在学习梅毒的时候看到过深色皮肤。
And this observation is supported by research that I published in the British Journal of Dermatology in 2019 that shows an overrepresentation of dark skin in chapters focused on sexually transmitted infections, even while those same skin tones are underrepresented elsewhere in the same textbook.
我于2019年发表在《英国皮肤病学杂志》上的研究支持这一观察结果，发表的论文表明在性传播感染的章节中黑皮肤的比例过高，然而黑皮肤在同一本教科书中的其他地方出现得太少。
What does this do to impressionable learners?
这给学习的人留下了什么样的印象呢？
Does it make them think that someone with dark skin is more likely to have a sexually transmitted infection?
他们会不会觉得有深色皮肤的人更可能通过性传播感染疾病？
Now, I know some of you may be thinking, I know an algorithm that can solve this or machine learning to the rescue.
现在，我知道你们当中肯定有人在想我知道有个算法可以解决这件事或者机器学习可以对此进行补救。
And I'm here to gently disagree.
在这里我提出一些异议。
And that's because the data from which these algorithms learn are the same photos that overrepresent dark skin in certain skin conditions, even while underrepresenting them in others.
这是因为那些算法学习的数据都是在特定情况下，相同类型的被过度滥用的深色皮肤的照片，同时在别的地方又被引用的过少。
In other words, these algorithms will be as biased as we are unless we make significant change.
换句话说，这些算法会和我们一样充满偏见，除非我们做出巨大的改变。
I started the Skin of Color program at the University of California, San Francisco, where I work with medical students and residents in an effort to begin to help them unlearn some of these harmful patterns
我在三藩市的加州大学开始多彩肤色的项目，与和我共同工作的医学生和住院医师齐心合力的去除这些有害的图案学习，
that make it easier to see some things, like dark skin with syphilis, and harder to see others, like dark skin with erythema migrans.
这样把看到一些事情变得更容易，像是有梅毒的深肤色，以及那些很难被看到的其他图片，像是存在游走性红斑的深肤色。
I teach everything from how to identify inflammation in dark skin to how to talk to a Black woman about her hair care practices.
从如何在深肤色上识别发炎，到与黑人女性去谈论如何做头发护理我都进行教授。
And one important fact that I always make sure to mention is that it's neither good nor common for Black women to wash their hair every day.
一个重要的事实，我每次都确保自己提及到：对黑人女性每天洗头既不好也不常见。
And any treatment regimen focused on taking care of the hair and scalp should reflect this important understanding.
任何一种注重保护头发和头皮的治疗规划，都应反映出对此的重要性的理解。
My work at the Skin of Color program, as well as the work of similar programs across the country, demonstrate the importance of creating a dedicated educational environment for residents and medical students to learn the full spectrum of skin disease as they appear in all patients, regardless of skin tone.
我在色彩肤色项目中的工作，和国内其他类似项目的工作，都展示出了为住院医师和医学生创造专注的学术环境的重要性。使他们能够学习到皮肤疾病的方方面面，因为不管肤色如何，这些疾病可能会出现在所有病人身上。
This is an important first step on a long road towards eliminating health care disparities in dermatology.
这是消除皮肤健康保健差异这条长路中至关重要的第一步。
But let's commit to taking this journey together.
但是来让我们共同开启这段旅程。
Thank you.
谢谢大家！
