Health disparities are an important public policy concern, and one that particularly impacts clinical trials.
In its continuing effort to carry out research to improve minority health and reduce health disparities, the NIH, through its National Institute on Minority Health and Health Disparities (NIMHD), has launched two new funding initiatives.
In the first, the NIMHD is funding seven new awards—adding up to approximately $122 million in funding over five years—to support the Research Centers in Minority Institutions (RCMI) Specialized Centers Program.
According to NIMHD, this program is “designed to support institutional research capacity and foster the career development of new and early career investigators conducting minority health and health disparities research.”
The grantees include:
In another initiative, NIMHD is funding 12 research centers designed to conduct multidisciplinary research, research training and community engagement activities focused on improving minority health and reducing health disparities.
This program, called the Centers of Excellence program, is designed to strengthen research and training activities designed to both support the development of trained researchers—including those from minority and health disparity populations—and increase the number of individuals from those populations participating in research and clinical trials.
NIMHD Director Eliseo J. Pérez-Stable, M.D., said there are several objectives behind the launching of these programs.
“First, we want to see good research coming out of these grants,” he said. “After all, we are investing money into research.”
“But we also want to see [these centers] produce new investigators and new scientists who come from underrepresented groups, who can be guided to new levels of success,” he added. “That includes poor people, and not just underrepresented minorities.”
In addition, Pérez-Stable said that an objective of this funding is to get more applications for NIH grants coming from these institutions, “and not just our institute, but from anywhere in NIH.”
Despite concerted efforts by NIH to mitigate the problem of minority representation in clinical research, progress hasn’t been as fast as it would have hoped.
In 2015, Sam Oh, Ph.D., MPH, University of California School of Medicine, and colleagues published an article in PLOS Medicine titled, “Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled,” in which they detailed how disparities in research persist despite the passage of the NIH Revitalization Act in 1993 that required federally funded clinical research prioritize the inclusion of women and minorities.
For example, Oh and his colleagues observed that since 1993 less than 2% of more than 10,000 of cancer clinical trials funded by the National Cancer Institute included enough minorities to meet NIH criteria, despite the existence of “striking racial/ethnic disparities in cancer incidence and mortality.”
They also pointed out that as of 2014, less than 2% of NIH principal investigators on research grants were African-American, while just 3.4% were Latino. Similar disparities were seen for Native Americans, Native Hawaiians and other Pacific islanders.
Furthermore, based on data obtained from the NIH, the article authors found that the proportion of applications funded by NIH was 13% lower for blacks or African-Americans than among whites.
“So it’s encouraging that NIH is funding these centers to reduce disparity,” Oh said.
There is a relationship between the number of underrepresented minorities conducting research and the number of those participating in clinical trials, Oh said.
“Researchers will usually study those people who are easiest to recruit, and easiest to get access to,” he said. “On the other side, potential research participants are more likely to relate to people who speak their language, or look like them, or understand their culture or ethnicity.”
“The greater the match between the racial, ethnic or cultural background between those doing the research and those who are approached as potential research participants, the more likely you’ll get a higher level of participation,” he added.
Pérez-Stable called the issues “separate, but related.”
“We’ve actually made more progress in [minority participation in clinical trials] than in training the workforce,” he said, adding that over the last five years or so the number of minorities participating in NIH-funded studies has consistently been between 25-30%.
“That’s not quite representative, but it’s not the discordance we see among scientists,” Pérez-Stable said. “In science, only 7% of principal investigators of research grants of NIH are African-American or Latinos. The pipeline is getting better, but we have a ways to go. Everywhere I speak, I make this an urgent issue that everyone should be aware of. I think [these NIMHD funding initiatives] is a response to addressing this.”
This article was reprinted from Volume 21, Issue 41, of CWWeekly, a leading clinical research industry newsletter providing expanded analysis on breaking news, study leads, trial results and more. Subscribe »