Disparities in diversity and inclusion continue to permeate every aspect of healthcare. Despite guidance from the FDA, a significant portion of the population remains underrepresented within the healthcare continuum.
In the U.S., stark statistics reveal the extent of these imbalances. Only about 36% of active physicians are female, with even fewer identifying as non-White. While Black and Hispanic Americans comprise a considerable portion of the population, their representation among healthcare practitioners is disproportionately low. Moreover, clinical trials—the cornerstone of medical advancement—suffer from a glaring lack of diversity, with minority groups significantly underrepresented. Although this data is less available for other countries, the same trends are noticeable. Improving diversity remains one of the most pressing global imperatives throughout the industry.
As these disparities have real implications for health outcomes, healthcare leaders need to take proactive steps to foster diversity and inclusivity throughout every facet of drug development and care delivery. Here, we look at a few of the top diversity challenges facing healthcare leaders today, and steps they can take to start closing these gaps.
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Lack of diversity among clinical trial participants
A research study from Johns Hopkins on clinical trials over a 27-year period found that only 40% included data on patient race or ethnicity and of that, 94% of participants were White.
Inadequate representation in clinical trials hampers our understanding of how different populations respond to medical interventions. It’s critical to take steps to remove bias from the trial design process and make trials more accessible to diverse patients. To do so, we need to address the ABCD Diversity Factors, which include lack of awareness of clinical trial opportunities, the burden of participating in trials, lack of confidence in the pharmaceutical industry, and processes that unknowingly disqualify diverse participants from participating.
Healthcare organizations must remain agile in their approach, adapting outreach and tailoring strategies to meet the diverse needs of constituents. By identifying the ideal target patient pool and locations (based on geography or sociodemographic characteristics), we can pinpoint shared common ground of diverse patients and potential risk factors that might increase drop-out rates, such as lack of awareness, too high of a trial burden, or lack of confidence.
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Lack of understanding around SDOH
While clinical care impacts 20% of health outcomes, social determinants of health (SDOH) affect as much as 50%. SDOH are the conditions where people are born, live, learn, work, play, worship, and age that contribute to health risks and outcomes.
Factors such as socioeconomic status, education, nutrition, environmental factors, access to transportation, and proximity to care facilities all profoundly influence a person’s health. Failure to understand and address SDOH perpetuates disparities in health outcomes, clinical trial recruitment and engagement, and treatment access, particularly among marginalized communities.
By analyzing socioeconomic factors, geographical disparities, and access to healthcare services, organizations can develop targeted interventions to mitigate these disparities and improve health outcomes for all individuals. In the U.S., organizations can also get involved in the Department of Health & Human Services’ Healthy People 2030 initiative, which is spreading awareness around the impact that SDOH have on healthcare, and helping communities and healthcare leaders take steps to improve these factors.
Lack of diverse thought leadership
Homogeneity in perspectives and experiences among healthcare leaders and decision-makers stifles innovation, limits critical analysis, and perpetuates unconscious biases. Embracing diversity of thought is essential for fostering creativity, empathy, and inclusive decision-making processes within healthcare.
Part of this involves acknowledging the lack of diversity among practitioners and within healthcare leadership. The healthcare workforce remains disproportionately homogeneous, with limited representation of racial and ethnic minorities, women, and other marginalized groups. This lack of diversity undermines cultural competency, patient-provider trust, and the ability to understand and address diverse patient needs effectively. One study reports that if there were more Black doctors, the gap in cardiovascular mortality and life expectancy between racial groups would be substantially less.
Promoting diversity and inclusion within healthcare organizations requires efforts across multiple fronts. For example, recruiting more diverse medical students can help transform practitioner demographics and foster a more representative workforce, which in turn fosters diversity of thought. Furthermore, implementing cultural competency training across the organization ensures effective communication and collaboration among healthcare providers and patients from diverse backgrounds.
Lack of data-driven diversity insights
There are a lot of misconceptions around patient willingness and accessibility, true disease burden, and the financial implications and value of improving diversity gaps. Much of this can be tracked to a clear lack of data analysis related to diversity.
Leaders need a framework to identify, understand, effectively address diversity gaps, and measure improvement across the continuum of care. A data-driven approach can provide valuable insights into demographic trends, disparities in healthcare access and outcomes, and the underlying factors contributing to these discrepancies.
Advanced analytics, machine learning, and AI can identify patterns, trends, and correlations within vast datasets faster than any human can. AI-driven algorithms can also remove biases in trial design, automate patient matching processes for trial participants, and optimize trial recruitment strategies to ensure inclusion of diverse patient populations.
Moreover, data-driven strategies extend beyond clinical research to workforce diversity and inclusion efforts. By analyzing demographic data and workforce metrics, organizations can identify areas for improvement, develop targeted recruitment strategies to increase diversity among healthcare practitioners (and therefore increase diversity of thought), and implement the right types of cultural competency training.
Improving representation through comprehensive strategies
Addressing diversity gaps within healthcare is essential for ensuring equitable treatment and accurate outcomes measurement for all individuals.
Beyond the need for data and technology, stakeholder engagement and regulatory frameworks are also crucial for promoting diversity and inclusion. Actions like collaborating with patient advocacy groups and community leaders helps healthcare organizations develop effective, patient-centric approaches that address the unique needs of diverse populations. Likewise, government guidance and legal mandates reinforce the importance of diversity efforts, foster an environment for progress, and build consensus across all levels of the healthcare ecosystem.
To effectively bridge these gaps, a comprehensive approach is necessary, integrating data-driven strategies, technological advancements, policy changes, and stakeholder commitment to foster a more inclusive and equitable healthcare ecosystem.
Photo credit: Andrii Shyp, Getty Images
Alexandra Moens, PharmD, is the director of product marketing at H1. She is a thought leader and frequent speaker on the need for diversity and performance data in clinical trials, as well as the impact it has on clinical decision-making. As a pharmacist with an innovative business mindset, Alexandra makes an impact on the life of patients by working on improved solutions, diversity implementation, and working on enhanced clinical strategies. Her scientific and business experience has taught her to make fast but data-driven decisions to successfully manage a portfolio strategy in the evolving pharmaceutical industry. Alexandra has worked closely together with clinical, data intelligence, and medical affairs teams of pharma and biotech companies across the globe to help roll out new clinical and medical methodologies and strategies.
