Studies find inequity in medical treatment and clinical trial participation

Bias against Black patients in the United States was documented in two different reports published last month.

Black patients are two-and-a-half times more likely than white patients to have at least one negative descriptive term in their electronic health record, said a study published in Health Affairs. Another large study, published in JAMA Network Open, found that, while stigmatizing language is not commonly used, “such terms are much more likely to appear in the medical records of Black patients than in those of other races.”

Inequities in treatment, and in recruiting for clinical trials, is blamed for poorer health among Black Americans.

Racial bias and “racism, both structural and interpersonal, are fundamental causes of health inequities, health disparities and disease” which result in “the life expectancy among Black/African Americans being four years lower than that of White Americans,” according to the Centers for Disease Control (CDC).

Bias can negatively impact care for Black patients because they become less likely to listen to health professionals. “The labels have consequences,” Dr. Dean Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital, told The New York Times. “Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall.”

Inequities in clinical trials

The same inequities shown in the care of Black patients has also been documented in the process used to select participants for clinical trials, an area of particular concern to the biotechnology industry.

According to a recent Harvard Business Review article, people of color, especially Black and Hispanic people, represent from 2% to 16% of patients in trials, even though they make up about 39% of the U.S. population.

Another study on clinical trials for cancer, recently published in JCO Oncology Practice, found that, while Black Americans account for around 22% of yearly multiple myeloma (MM) cases, the median enrollment of this patient demographic in clinical trials for MM was only 4.5%.

Inequity in clinical trials results in poorer scientific results, according to the clinical trials website of the Biotechnology Innovation Organization BIO.

“Medications can affect various racial and ethnic groups differently, sometimes to the extent that the FDA recommends separate prescribing instructions,” said BIO’s Clinical Trials Power of Participation. “Increasing diversity better reflects the range of populations that will use the therapy, or vaccine, being studied.”

BIO’s Clinical Trials Power of Participation site seeks to encourage all patients to understand and participate in the clinical trials process.

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