Black Americans are more willing to enroll in clinical trials led by Black doctors and researchers, according to a new study published in the Journal of Health Economics.
Black Americans account for about 13% of the U.S. population and face disproportionate rates of disease and premature death. Despite this, Black Americans make up just 5% of clinical trial participants, according to a Cornell University news release.
A recent review of cancer trials found that Black patients made up 5% of the samples in trials for novel checkpoint inhibitors, which are standard treatments for dozens of cancer types. What’s more, in a clinical trial for a drug to treat Alzheimer’s disease, which disproportionately affects Black Americans, only 19 of more than 1,700 people involved were Black.
It has been well documented that medical distrust contributes to the underrepresentation of Black Americans in clinical trials.
The new study highlights the need for more proportional racial representation in clinical trials to help increase the benefits and reduce the risks of new treatments across all racial groups.
“If clinical trials don’t adequately represent all the populations that are going to use a drug, this may threaten the generalizability you would hope to have,” said study coauthor Romaine Campbell, PhD, MA, a postdoctoral researcher and incoming faculty member in the Cornell Jeb E. Brooks School of Public Policy and in the Department of Economics, in the news release. “You don’t fully understand whether subpopulations will benefit in the same way as those involved in the trials do.”
In 2022, the National Academies of Sciences, Engineering and Medicine released a report offering more than a dozen recommendations for improving diversity in clinical trials and research. The report highlights issues such as compensation and schedule flexibility and suggests diversifying principal investigators who lead clinical trials. The report also notes that less than 4% of investigators funded by the National Institutes of Health (NIH) are Black.
To test the report’s recommendations, researchers surveyed more than 320 Black Americans. Participants were shown a randomly selected headshot of a principal investigator—Black or white, male or female. Based on the headshot, participants were asked how interested they would be in participating in a medical study to prevent a disease relevant to their community that was being led by that person.
About 12.6% of participants were willing to participate in clinical trials run by investigators of the same race. Researchers note that the investigator’s gender was not a factor. The most important factor influencing the willingness to participate was trust, according to researchers.
To diversify the health care community, medical schools around the country are trying to recruit Black, Latino and Native American students, all of whom remain disproportionately underrepresented in the medicine. While this is a long-term solution, Campbell hopes the survey findings can be used more broadly to improve patient representation in trials in the short term.
“We should be more deliberate about diversifying the pool of medical professionals, and in the interim, there are benefits to being strategic about diversity within the existing pool of principal investigators,” Campbell said. “Particularly for clinical trials, we want to make sure we have representative samples so we can best extract the benefits of medical innovation.”
To read more, click #Diversity or #Clinical Trial. There, you’ll see headlines such as “Physicians of Color More Likely to Care for Medicaid Patients,” “NIH Adds Funds to Long COVID-19 Research, Advances Work on New Clinical Trials” and “The Enduring Impact of Black Hospitals.”
