Dark Skin, Utah Sun: Tech That Misses Vital Health Data

By Franklin Everett Shaw

May 19, 2026

The crisp mountain air of Park City, Utah, is a siren song to skiers and snowboarders. But that same thin air, combined with the intense Utah sun, can mask a silent threat, especially for those with darker skin: inaccurate pulse oximeter readings. This isn’t just a theoretical concern; it’s a real-world problem that can lead to delayed or missed diagnoses of altitude sickness, respiratory distress, and other serious conditions.

Pulse oximeters, those ubiquitous little devices that clip onto your finger, measure blood oxygen saturation (SpO2). They work by shining light through the skin and measuring how much is absorbed. Melanin, the pigment that gives skin its color, absorbs light. Studies have shown that this absorption can interfere with the accuracy of pulse oximeters, particularly in individuals with darker skin tones.

The problem is exacerbated in sunny environments like Utah. The bright sunlight further interferes with the device’s ability to accurately measure oxygen saturation. This creates a perfect storm of factors that can lead to falsely high readings, masking true hypoxemia (low blood oxygen).

Imagine a Black tourist from Atlanta arriving in Salt Lake City for a ski trip. They start experiencing symptoms of altitude sickness: headache, nausea, and shortness of breath. A quick check with a pulse oximeter shows an SpO2 of 95%, seemingly within the normal range. Reassured, they dismiss their symptoms. However, the true SpO2 might be significantly lower, say 88%, indicating a serious problem requiring immediate medical attention.

This scenario isn’t hypothetical. Research has consistently demonstrated the racial bias inherent in pulse oximetry. A 2020 study published in JAMA Internal Medicine found that pulse oximeters overestimated oxygen saturation in Black patients compared to white patients. This discrepancy can lead to delayed treatment and poorer outcomes.

So, what can be done, especially in a place like Utah where altitude and sunshine are prevalent? First, awareness is key. Healthcare providers in Utah, particularly those in mountain towns like Park City, Moab, and St. George, need to be acutely aware of the limitations of pulse oximetry in individuals with darker skin.

Reliance on a single pulse oximeter reading is a dangerous game. Instead, consider these alternative monitoring methods:

Arterial Blood Gas (ABG) Test: This is the gold standard for measuring blood oxygen levels. It involves drawing blood from an artery and analyzing it in a lab. While more invasive than pulse oximetry, it provides a much more accurate assessment.
Clinical Assessment: Don’t rely solely on technology. A thorough clinical assessment, including listening to lung sounds, observing breathing patterns, and evaluating overall symptoms, is crucial.
Co-oximetry: This technology can measure different types of hemoglobin in the blood, including carboxyhemoglobin (carbon monoxide) and methemoglobin, which can interfere with pulse oximetry readings.
Look for Trends: Instead of focusing on a single reading, monitor trends over time. A consistently low or declining SpO2, even if it appears within the “normal” range, should raise concern.

For individuals with darker skin traveling to or living in Utah, here’s what you can do at home:

Know the Symptoms: Be aware of the signs and symptoms of altitude sickness, respiratory distress, and other conditions that can cause hypoxemia. These include headache, nausea, shortness of breath, dizziness, confusion, and bluish discoloration of the skin (cyanosis).
Acclimatize Gradually: If traveling to a high-altitude area, ascend gradually to allow your body to adjust to the lower oxygen levels.
Hydrate Well: Drink plenty of fluids to help your body function optimally.
Consider Supplemental Oxygen: If you have a pre-existing respiratory condition or are at high risk for altitude sickness, talk to your doctor about whether supplemental oxygen is appropriate.
Advocate for Yourself: If you are concerned about your oxygen levels, don’t hesitate to advocate for yourself and request an ABG test or other more accurate assessment.

Common mistakes developers face when designing pulse oximeters include:

Lack of Diverse Testing Data: Many pulse oximeters are developed and tested primarily on individuals with lighter skin tones. This leads to algorithms that are biased and less accurate for darker skin.
Ignoring Ambient Light Interference: Developers often fail to adequately account for the effects of ambient light, particularly sunlight, on the accuracy of pulse oximeter readings.
Over-Reliance on SpO2: Developers sometimes prioritize SpO2 readings over other important physiological parameters, such as heart rate and respiratory rate.

To overcome these challenges, developers need to:

Include Diverse Populations in Testing: Ensure that pulse oximeters are tested on a diverse range of skin tones to identify and correct biases.
Develop Algorithms that Account for Melanin: Incorporate algorithms that compensate for the effects of melanin on light absorption.
Improve Ambient Light Filtering: Implement better filtering mechanisms to minimize the interference of ambient light.
Integrate Multiple Physiological Parameters: Develop devices that integrate multiple physiological parameters to provide a more comprehensive assessment of a patient’s condition.

The ultimate solution is to develop more inclusive medical device technology that is accurate for all skin tones. This requires a concerted effort from researchers, developers, and regulatory agencies. Pharmacies and clinics in Utah should prioritize stocking and using pulse oximeters that have been validated for accuracy across diverse populations.

We need to demand better. We need to demand devices that accurately reflect the health of all individuals, regardless of their skin color. The lives of people in Utah, and everywhere else, depend on it.