By Gwen Feeny, JD, Science Policy Fellow.
Attention is increasingly—and necessarily—being paid to disparities in the biomedical research workforce. The improved inclusion and representation of people from diverse backgrounds across all areas of research, as well as the diversification of the research workforce, are crucial for reducing health disparities and ultimately improving health and health care for all.
SWHR, as part of its mission, advocates for inclusion and representation of women in research and considers a diverse research workforce a necessary component for improving women’s health. In fact, SWHR was founded to further the inclusion of women and minorities in research. This year alone, SWHR has been engaged on this subject by providing commentary to the National Cancer Institute about diversifying the cancer research workforce and participating in STrategies to enRich Inclusion and achieVe Equity (STRIVE) Initiative workshops.
This blog summarizes the state of disparities in biomedical research and how they might be addressed:
- Taking a Lifespan Approach. Just as SWHR looks to address women’s health across the lifespan, health research must take a life course approach to the study of health disparities. For example, adverse childhood experiences can have mental and physical health impacts throughout a person’s life, as can experiences of stress from discrimination, which can manifest in many different ways over the lifespan (Murry et al., 2018). The STRIVE workshops highlighted the need to further study and document these types of longitudinal effects.
- Focusing on Disability. While strides are being made with some understudied and underserved communities, people with disabilities remains a population who are rarely included in health research, despite facing some of the most significant disparities (Krahn et al., 2015). Since women are disproportionately affected by disability, their health issues suffer as a result of insufficient research attention and funding (Wisdom et al., 2010).
- Disaggregating Data to Improve Understanding. In addition to improving inclusion and equity for populations researched, attention must be given to how the research is conducted so that data and analyses can be disaggregated to properly address the diverse needs and disparities for different subpopulations. Diversifying health research should extend to all stages of a project – from initial proposals and experimental design to data collection and the interpretation of results that can promote additional research, better health care, and effective policy solutions. Thus, bringing additional perspectives and encouraging researchers to both question assumptions and broaden their research scope is crucial to ultimately delivering health research that serves the whole population.
- Engaging Communities as Partners. To improve health equity, there is a need to engage communities as partners—and not just participants—in health research and programming. Community-based research should be prioritized, with the research teams including multiple perspectives. Here, too, research should consider incorporating disabled populations in study designs to overcome some of the common barriers that hinder positive health outcomes (Sabatello, 2018). There is also an overarching need to train all researchers, no matter their background, to work with communities and individuals that are different from them.
- Diversifying the Health Research Workforce. Diversifying the health research workforce is a crucial strategy to expand the target populations for research investments and affect how those populations are engaged with or represented in studies. Research has shown that researchers from underrepresented groups are more likely to research the particular health needs of underserved and underrepresented communities, especially their own (Gibbs & Griffin, 2013). In fact, many choose biomedical research careers specifically because of their interest in reducing disparities (Hemming et al., 2019). More diverse research teams also lead to improved outcomes. By including multiple perspectives, teams can more creatively solve problems and consider questions or aspects of the research work that might not otherwise be apparent (Gibbs & Griffin, 2013).Moreover, researchers who look like or are familiar with the communities they study run into fewer communication barriers and perceptions of being an outsider, both of which can hinder community participation. Study participants may prove more forthcoming with information when they feel investigators are more understanding of their lived experiences, producing better research outcomes. This also highlights the need for trainees from diverse backgrounds to be equipped with the tools they need to pursue health research career paths. As for researchers who are from different backgrounds than study participants, investments should be made to build trust, addressing both communication and participation barriers.
From improving access to training, education, support, and mentoring for underrepresented researchers to increasing the inclusion of underrepresented populations in clinical trials, much remains to be done to address the disparities in the biomedical research workforce. SWHR will continue to advocate for policies that will reduce disparities and enhance participation as well as participate in initiatives, such as the STRIVE workshops, where we can learn from underrepresented and marginalized researchers.