Improving Racial Diversity and Equity in Clinical Trials

For decades, researchers and physicians have criticized the lack of diversity in what are called clinical trials – or research studies performed in people to determine the safety and efficacy of medical treatments.

Among many other concerns, scientists and doctors have argued that people who actually bear the burden of disease are not the people who are participating in those trials.

But COVID-19 has perhaps put a brighter spotlight on the issue than ever before. In the first year of the pandemic, Black people, Hispanic/Latinx people and American Indian and Alaskan Native (AIAN) people had disproportionately high mortality rates compared to White people. The disparity in outcomes between minority populations and White people has decreased over time, but a February 2022 age-adjusted analysis showed that Black, Hispanic and AIAN people were still about twice as likely to die from COVID-19 as White people.

That led for calls for people of color to be overrepresented in COVID-19 vaccine trials, a goal that was never reached. It has also led to greater focus on the overall issue of diversity and equity in clinical trials. . .including four publications from Nationwide Children’s Hospital alone on the subject over the last year.

But focusing on the issue doesn’t mean it’s solved.

“We’re so guilty of wanting to come in with one sweeping change and say, ‘we fixed it,’” says Valencia Walker, MD, a neonatologist at Nationwide Children’s and the hospital’s associate chief diversity and health equity officer. “We didn’t get to this point in one year or three years or five years, but that’s how we’re trained to deal with things, because that’s how our grant system works. It’s how our political system works. If we are trying to change generations, centuries, of mistreatment, it doesn’t happen in a year.”