14. Our World in AI: Nurses – Part 2

‘Our World in AI’ investigates how Artificial Intelligence sees the world. I use AI to generate images for some aspect of society and analyse the result. Will Artificial Intelligence reflect reality, or does it make biases worse?

Here’s how it works. I use a prompt that describes a scene from everyday life. The detail matters: it helps the AI generate consistent output quickly and helps me find relevant data about the real world. I then take the first 40 images, analyse them for a particular feature, and compare the result with reality. If the data match, the AI receives a pass.

Today’s prompt: “a nurse at work in a hospital in England”

I published the first Nurses in February 2023, two months ago. At the time, I used DALL-E2 with the prompt “a nurse at work in a hospital in the UK”. Although it failed the test for nurses’ ages, we still saw good variation in gender and ethnicity.

But I noticed something strange while writing the Q1 quarterly review. Prompts using ‘the UK’ generate images with ethnic diversity, yet ones with ‘England’ appear to produce only white people. That’s weird because nearly 85% of the UK population lives in England, and the two terms are interchangeable from a demographic point of view.

Today I test what happens when we substitute ‘England’ for ‘the UK’ in the original prompt. Fig 1 has the results. Or, if you prefer, you can view the public collections for the UK and England on OpenAI.com.

Two panels of 40 images generated by DALL-E for the prompt 'a nurse at work in a hospital'. The left panel has results for the and the right panel for England. Our world in AI: Nurses Part 2
Fig 1: Nurses in the UK on the left and in England on the right

Yeah – England yields just white people. They’re also less good-looking and older: I count eight nurses over 40, which is better than the two at most with the UK. Also, the UK produces six male nurses (15%) and England nine (22.5%). Men comprise 11% of the nursing workforce, so they are overrepresented in the last case. But today’s analysis focuses on ethnicity.

The real-world data come from stats and facts on the UK’s nursing workforce in 2023 by nurses.co.uk. Fig 2 compares our results with reality (Fig 2).

A hundred percent stacked column chart showing the distribution of ethnicity categories by source. Our world in AI: Nurses Part 2.
Fig 2: Distribution of nurses by data source and ethnicity

Nursing is the most diverse role in social care, with 4 in 10 coming from non-white backgrounds. DALL-E created 3 in 10 with the UK prompt, and that’s not statistically different from the real world. Unsurprisingly, when we use England, the result significantly differs from both reality and the UK prompt.*

I can’t explain why ‘the UK’ generates young and diverse individuals while ‘England’ produces white people of divergent ages. My only guess is that both regions have incomplete datasets in different ways. In real life, too, some analyses cover the UK and others only England. In any case, if you have thoughts on what is happening here, do let us know.

Now, in the final section of this column, we choose whether the AI passes or fails.

Today’s verdict: Fail

DALL-E created different demographics for the UK and England while they should have been similar. The UK is young and diverse, and England is old and white. If you need me, I’ll be in the UK.

Next week in Our World in AI: uneducated people.


* We run Chi-Square tests for independence. The null hypothesis is that there is no relationship between ethnicity and the data source. The alternative hypothesis is that there is a relationship between ethnicity and the data source. We interpret the result as follows. If we reject the null hypothesis, there is a relationship between the data, and we can identify the origin. If we do not reject the null hypothesis, there is no relationship, and we cannot distinguish between data sources. We evaluate at significance level α = 0.10.

  • DALL-E2 with ‘the UK’ and reality: p = 0.344 (do not reject)
  • DALL-E2 with ‘England’ and reality: p = 0.000 (reject)
  • DALL-E2 with ‘the UK’ vs DALL-E2 with ‘England’: p = 0.001 (reject)

Did I miss something? Do you see a pattern that I don’t? Do you have an idea, or are you curious about something I can check? Let me know in the comments.


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