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Individuals from diverse racial and ethnic backgrounds are underrepresented in clinical trials and cancer research studies (Siegel, Miller, & Jemal, 2015), contributing to the lack of generalizability. The Social Determinants of Health (SDOH), such as healthcare access and quality, education, social and community context, economic stability, and the environment, are interrelated constructs that may negatively affect diverse patients' ability and willingness to participate in cancer research (Asare, Flannery, & Kamen, 2017). For example, patients from diverse backgrounds with low socioeconomic status may have living conditions that could increase their cancer risk. Moreover, low social economic status can affect the ability to afford quality cancer care.
Additionally, diverse communities exposed to discrimination result in mistrust and suspicion of cancer research based on historical discrimination precedents and past unethical research experiments (Shavers, Lynch, & Burmeister, 2002). Understanding the social determinants of health can help clinical researchers and healthcare providers assess and address barriers to research participation. Thus, leading to trial design that could improve cancer-related health among individuals from diverse racial and ethnic backgrounds. However, we must remember it is imperative to consider the unique factors that diverse populations experience at each step, thus effectively applying a health equity lens to the implementation of screening (Tucker-Seeley, 2021).
What can we do to increase diversity in our accruals?
A diverse clinical research workforce emphasizes the importance of cultural perspectives and participation in clinical research and can improve cancer health outcomes. A diverse workforce builds an open and trusting healthcare environment and encourages patients to openly discuss the risks, burdens, and benefits of research participation. Culturally appropriate care provides a better future for our patients and the communities. In addition, healthcare literacy training and practicing supports diversity and keeping health equity at the forefront of our research studies.
To learn more about the growing need for diversity, equity and inclusion (DEI) in cancer care and clinical trials, read the journal article below
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