When it comes to clinical trials, healthcare’s diversity problem is standing in the way of medical advancement

November 5, 2021, 7:36 PM UTC

The oldest college in Louisiana just announced their first-ever tenured Black professor. What do you think took them so long? Also, the medical community is not prepared to handle the mental health crisis in the Black community, the air is poison, and an essential poem gets a new life as a beautiful short film. All that and a must-read from Jonathan Vanian on medical device maker Abbott Laboratories, and their new plan to diversify clinical trials.

But first, here’s your Diwali 2021 week in review, in Haiku.

Lord Rama comes home,
Narakasura has been
defeated! It’s time

to light the lamps and
let the warmth fill your hearts as
happy faces shine

marigold garlands
joyous ropes of color: No
fireworks this year?

Do not lament! It’s 
better to breathe the clean air
and look toward kinder

days still to come, with
memories of those we lost
sacred in the light

Wishing you a weekend filled with sweetness and light.

Ellen McGirt

In brief

The healthcare industry has long faced a major diversity problem affecting the clinical trials that pave the way for blockbuster medical treatments.

Historically, the type of candidates who have participated in clinical trials tended to be relatively white and homogenous, not truly representative of everyone who needs access to potentially life-saving treatments.

As Diana Zuckerman, the president of the National Center for Health Research, once told Fortune, the lack of Black female participants in original cancer studies unfortunately resulted in fewer research into triple-negative breast cancer, which affects Black women more than white women. As a result, the researchers developing cancer treatments at that time, “didn’t realize that the treatments that they were studying would not work on those types of cancer,” she said.

Increasingly, however, the healthcare industry is trying to enlist more people of color who come from underrepresented communities into clinical trials, with the hope of improving the quality of future medical treatments that can aid everyone. Pharmaceutical giants Bristol Myers Squibb and Pfizer were two healthcare firms, for example, that have recently made public their efforts to improve the diversity of their clinical trials.

This week, Abbott Laboratories announced its own plans to enlist more diverse candidates into the medical device maker’s clinical trials. Lisa Earnhardt, Abbott’s executive vice president of medical devices, says that the company’s “bold goal is to treat or to have our technology impact at least 3 billion people” by 2030.

Abbott is currently conducting a clinical trial involving new technology to treat blocked arteries below the knees, Earnhardt says. It needs to recruit a diverse pool of participants because some patients, like those suffering from diabetes, could respond differently to the treatments.

“Oftentimes, you know, different ethnicities, cultural groups, they can have different comorbidities,” Earnhardt says. If people of color have both diabetes and cardiovascular diseases, “we need to understand that and make sure our medical devices and therapeutic approaches are appropriate.”

One way Abbott is attempting to enlist more diverse clinical trial participants is by “purposely going into communities” that lacked access to clinical trials, Earnhardt says. This means opening up clinical trial sites outside of major metropolitan areas like New York City or San Francisco, which typically contain top-tier universities and healthcare centers. People of color who live outside of these urban centers face a number of hurdles trying to enlist in clinical studies conducted hundreds or even thousands of miles away from where they live.

Some of the new clinical testing sites Abbott has established are in places like Gilbert, Ariz., Jackson, Miss., Tallahassee, FL, and San Antonio, TX.

The company also plans to give $5 million through 300 scholarships to students and members of historically Black colleges and universities like Meharry Medical College and Howard University College of Medicine, and organizations like the National Association of Hispanic Nurses. The goal is to encourage “students to pursue in clinical trials, so that they can serve as the next generation of physicians and nurses and go back to the communities that are really in need,” she said.

Ultimately, these efforts to improve the diversity of people taking part in clinical trials will also have the benefit of lifting Abbott’s overall business, she explained.

“There’s no use for us to develop technology if people can't have access to it,” Earnhardt says.


Jonathan Vanian 

On point

The mental health epidemic facing Black youth  Dr. Amanda Calhoun is adult/child psychiatry resident at Yale Child Study Center/Yale School of Medicine. In this piece, she makes it clear that the lack of attention to the mental health issues facing Black people is a crisis. She cites recent preliminary federal data showing the suicide rate for Black girls and women ages 10 to 24 increased more than 30% in 2020, and by 23% among Black boys and men. “So, what's contributing to these trends? In 2019, the American Academy of Pediatrics released a policy statement naming racism as a driver of health inequities in Black children and adolescents, including but not limited to, mental health,” she says. And the health care system, and especially mental health providers, are utterly unprepared to address the crisis.
MedPage Today

The oldest college in Louisiana grants tenure to the first Black professor It only took 196 years. Centenary College Associate Professor Andia Augustin-Billy sounds amazing: She’s an award-winning teacher of French and Francophone Studies, who grew up in Haiti as the daughter of missionaries. She leads trips to Paris and Haiti, and also teaches African and Caribbean literature. And now, she has tenure. The student body of Centenary is nearly 20% Black. School archivist Chris Brown says there is no mystery as to why it took so long. “Structural and institutional and systemic racism has been present ever since the college was founded, largely by enslavers,” he told ABC News.
ABC News

Can you breathe freely where you live? ProPublica has created a first-of-its-kind map identifying communities where cancer causing chemicals were released by industrial plants into the air from 2014-2018. “The result is an unparalleled view of how toxic air blooms around industrial facilities and spreads into nearby neighborhoods.” They have identified a thousand “hot spots” across the country, and they are not evenly distributed. There is, however, a clear pattern. “Census tracts where the majority of residents are people of color experience about 40% more cancer-causing industrial air pollution on average than tracts where the residents are mostly white. In predominantly Black census tracts, the estimated cancer risk from toxic air pollution is more than double that of majority-white tracts.”


This edition of raceAhead was edited by Wandy Felicita Ortiz.

On background

Try a little kindness Naomi Shihab Nye, is an American poet whose work explores the depth behind the mundane, “local life, random characters met on the streets, our own ancestry sifting down to us through small essential daily tasks.” Her father was a Palestinian refugee, and her mother is an American of German and Swiss descent. She wrote “Kindness” in the 1960s, about finding empathy despite differences. Her poem has been translated into a short, animated film as part of the On Being Project, an initiative that explores the intersection of social healing and poetry. “These are very relevant words in today’s political climate, and that is why I took a typographical approach to the piece,” says filmmaker Ana Pérez López. “Words can’t kill, but they pave the roads of death and in the same way, they can make us better.” Nye reads the poem. “Before you know what kindness really is, you must lose things,” she begins. Enjoy.
Kindness film

The Harvard Indigenous Design Collective's stated mission is to support the the work of “Indigenous architects, planners, designers, scholars, allies, and alumni of the Harvard Graduate School of Design.” They are getting the job done with a Twitter stream honoring extraordinary individuals. Here’s just one, and I'd love to interview her: Tamara “Tammy” Eagle Bull, Oglala Lakota and the first Native American woman to be licensed as an architect. Check her out her work here, more on HIDC below.
Harvard Indigenous Design Collective

The whitewashed way we study music Hannah Marie Robbins, the Frederick Loewe Research Associate at the University of Sheffield, was well into secondary school before she noticed the perpetual whiteness of arts education in Britain. It was in profound contrast to the children in the classroom, who hailed from a wide variety of countries and heritages. As a music student working with a mostly Western canon, “diversity” mostly focused on “black suffering” narratives and not on the rich cultural offerings of non-Western modes. Things haven’t, but must, improve, she says. “Shockingly, it remains possible and, according to considerable anecdotal evidence, normal to deliver introductions to Popular Music without covering any work by creatives of colour,” she says.
Media Diversified

Mood board

A woman places an oil lamp or "diya" on a rangoli during celebrations for the Hindu festival Diwali or the Festival of Lights in New Delhi on November 4, 2021.
Looking towards kinder days to come this weekend, with Diwali on our minds.
Sajjad Hussain—AFP/Getty images

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