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Combatting Structural Inequities in Research

Health disparities exist for people from historically disenfranchised groups who are often at greater risk of disease, lack access to high quality care, and have poorer outcomes. According to the World Health Organization, these differences are generally due to the varied social conditions where people are born, grow, live, work, and age.

In addition to the many factors that contribute to inequities in healthcare access and delivery, these groups are underrepresented in medicine and comprise an even smaller percentage of medical research faculty. Lack of diversity is common among research participants as well.

A recent article in the New England Journal of Medicine highlights how these and other factors needs to be addressed to achieve a reduction in disparities in morbidity and mortality. The authors propose changes recommended by the Clinical and Translational Science Awards National Consortium. Change areas include:

  • leadership that is more committed to cultivating diversity.
  • training program recruitment, content, culture, and partnerships designed to include, value, and support more diverse learners;
  • research funding, practices, and training that will address and prioritize inclusion and community-engaged research; and
  • clinical trials that hire and train diverse staff, integrate people from marginalized groups in design and planning, make use of community partnerships, and recruit diverse participants.

The authors conclude that “Sustained and reinforced initiatives from all parties in clinical and translational research — funders, academic institutions, researchers, and others — are needed to develop a diverse, inclusive, and vibrant research enterprise capable of translating biomedical discoveries into health and health equity for all.”

At the Center of Alcohol and Substance Use Studies, we have a special interest in addressing these issues. Our research and education initiatives often include a focus on diversity and inclusion. For example, our REACH Alliance (Racial Equity, Advocacy, and Community Health) is a diverse group of researchers, students, community members, mental health service providers, and individuals with lived experiences who are dedicated to understanding and addressing health disparities caused by systemic racism.

Source: Boulware, L. E. et al. (2022, January 20). Combatting structural inequities—Diversity, equity, and inclusion in clinical and translational research. New England Journal of Medicine, 386, 201-203.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the Center of Alcohol & Substance Use Studies.