During Inato’s first episode of Community Conversations on majority-minority demographics, demographer Ken Gronbach estimated that by 2050, the U.S. will be a majority-minority nation due to immigration from Mexico and Central and South America. Today, the country’s healthcare system has a ways to go in providing equitable care for these demographics, begging the question: is the industry at large prepared for a majority-minority shift?
The COVID pandemic revealed how far away the healthcare system is from ensuring equitable care. Latinos in Clinical Research’s Monica Cuitiva shared that the pandemic resulted in a drop in life expectancy for minority populations, pointing directly to the lack of quality healthcare for these populations. She was adamant that change must start with clinical research, saying “We need to increase awareness of healthcare [in the Latino community], as well as awareness that participating in clinical trials is extremely important because that's our voice put in data.”
Hosted by Inato’s Co-founder and Chief Strategy Officer Liz Beatty, this month Inato kicked off the Community Conversations live event series with Ken Gronbach and the Latinos in Clinical Research team, including Judy Galindo, Ashley Margo, in addition to Monica Cuitiva, to break down exactly what majority-minority shifts mean for research. Research is the foundation of healthcare so if treatments are sampled from only one demographic, healthcare cannot be equitable. Cuitiva said ensuring treatments are reaching all people starts with education and awareness. Beatty echoed Cuitiva, "There's a lot of work that needs to be done to build awareness, educate, and provide access to support services." It’s imperative for clinical trials to align with the demographic makeup of the population, especially as minority populations continue to grow. Gronbach furthered the sentiment, "We need to wake up to this reality and ensure that clinical trials reflect the diversity of our nation."
So, what needs to change in the clinical trial ecosystem to adapt to shifting demographics in the US? Beatty asked the panelists to share their strategies for engaging their communities. “It’s not one size fits all,” insisted Galindo in regards to how to approach community engagement. The most valuable community engagement comes from knowing the nuances of the community, understanding their unique needs, and meeting them there. Her site, Sun Valley Research Center, is located in a border town meaning bilingualism and translated materials are non-negotiable. Being in a border town can bring a host of other complications, including barriers around technology and issues with foreign credit cards and cell phones. Margo stressed the need for sponsor support when it comes to the unique intricacies of sites serving underrepresented populations. This support must be tailored to each site's specific requirements and the sponsors must be receptive to feedback from the sites about what approaches work best in their communities.
For the collaboration to be effective though, it’s more than helping sites overcome community-specific barriers. “For the sponsors…everything has to be diverse,” Cuitiva explained, “This includes the protocol, this includes the budget negotiation.” Margo added that, to make this happen, the work has to take place before the trial even starts. As soon as the sponsor knows the populations they’ll need to include in their trial, steps should be taken to shape the trial for those different populations.
As the first Community Conversations wrapped up, Gronbach reiterated the urgency for pharmaceutical companies to adapt to changing demographics. He urged recognition of the demographic shifts occurring, particularly with the growing Latino population: "We need to understand that we are a nation of immigrants and our concentration right now should be with Latinos.” Gronbach warned of the potential consequences of ignoring these demographic changes, "It would be reckless on the part of the pharmaceutical companies not to recognize exactly what you guys are talking about,” adding, "This should be on the news. It should be everywhere."