How to support underserved communities in healthcare

maninon0
Sep 26
3 min read

Updated: Sep 30

Black women are up to three times as likely to die during pregnancy. Hispanic adults see worse diabetes outcomes. Native American populations have higher incidences of heart disease.

These aren’t just statistics; they’re serious ethnic and racial disparities that exist in today’s healthcare landscape. While a complex web of factors can contribute to these challenges, one critical piece is often overlooked: a lack of representation in clinical trials.

Meet Amy, a 45-year-old Black woman with heart disease. She is serious about managing her condition and is hopeful for a treatment that will make things a little easier, but when her cardiologist suggests she participate in a promising new clinical trial, she’s hesitant.

Amy is not alone. Clinical trials for cardiovascular treatment options have historically excluded Black participants, leading to a dearth of evidence that can apply to diverse populations.

This can have devastating consequences: many common cardiovascular treatments have been shown to be less effective on Black individuals.

That’s one reason why Black adults in the United States are almost 50% more likely to suffer a stroke than their white counterparts and are at a greater risk of death from heart disease overall.

So, why have patients like Amy been continually excluded from clinical trials? And what can trial sponsors do to better recruit and retain diverse participants?

Barriers to Recruiting and Retaining Diverse Trial Participants

Amy has to make a choice. She is eager to explore a new treatment option for her heart disease diagnosis, but participating in the study will be difficult, both practically and emotionally.

Like many Black Americans, Amy knows that the healthcare industry has historically exploited the Black community. Injustices like the Tuskegee syphilis study, where Black men were made to endure syphilis for decades, are a reminder of how the medical establishment has victimized minority groups. She knows that medical bias is still prevalent in our current system, and she instinctively questions whether she can trust a research team.

Then there are the practical concerns, like needing time off from work, transportation to a separate facility where the trial is being conducted, and the associated costs. Multiple visits will be required to participate, which multiplies the impact.

Even if Amy can absorb these hardships in the short term, her likelihood of dropping out of the study before it is completed is high. She may lose faith in the research team if facing a lack of cultural competency and materials that were clearly not designed for her. These barriers may prevent her from participating in the way she wants to or hinder her ability to provide meaningful data for the trial.

Tips for Researchers to Better Support Underserved Communities

The good news for trial sponsors? There are a few steps that they can take to recruit and retain diverse trial participants like Amy, including:

Diverse communities shouldn’t be an afterthought – their needs should be incorporated from the start of the trial design process.

A “traditional” trial design may work for a patient group composed entirely of retired, affluent participants, but the resulting data will only represent that specific group.

Patients like Amy can be more likely to drop out of a clinical trial if they feel that the researchers are not communicative – it signals a lack of trust and respect. Researchers should ensure that participants know how the trial is being conducted, any adjustments or changes made along the way, and what initial results are being gathered (when possible).

What Researchers Need to Know: Key Questions and Answers

What barriers reduce participation from underserved communities?
While every patient is different, a historical mistrust of the medical establishment, inflexible work schedule, transportation challenges, and cultural/language barriers are some of the most pressing concerns.
Why does this lead to health outcome disparities?
Trials that don’t include a diverse patient pool mean the resulting treatments may not work for other demographics. Genetic differences and unpredictable medication reactions across a wide range of ethnicities mean reduced effectiveness or even harmful side effects.
How can trials better support diverse participants?
Identify, engage with, and accommodate a diverse population. Provide support to underserved communities throughout the process and recruit culturally-competent advisors to guide trial design.
How can public health data support recruitment efforts?
Public health data provides insights into where certain underserved populations receive care as well as their unique challenges and communication preferences. Researchers who utilize this information can design trials that work for everyone.

The Result: More Inclusive Science, Better Outcomes

Research teams that prioritize inclusive trial designs from the start benefit everyone.

In Amy’s case, a positive experience and successful trial participation may make her an advocate for clinical research within her community, leading to further participation and better health outcomes for her friends and family.

This is the power of truly inclusive clinical research: It’s not a token exercise in diversity, it’s a path to better science that serves everyone equally.

Designing more inclusive trials doesn’t just mean adjusting methods; it means reframing the entire process to put underrepresented patients' needs at the center. That’s where a CRO like Rubix LS can help.

For more information, please visit https://www.rubixls.com/.