Diversity in medical research is about more than just inclusion; it is the key to ensuring that research is meaningful and applicable to a broader range of people. By studying participants who differ from one another, we can discover critical insights that pave the way for more accurate diagnoses, better treatments, and overall improved health outcomes.
How is diversity defined in medical research?
When we think of diversity, it’s common to focus on categories such as race or ethnicity. While racial and ethnic diversity is important, these are just two of many factors that contribute to diversity. The Multi-Regional Clinical Trials (MRCT) Center of Brigham and Women’s Hospital and Harvard breaks down diversity into three categories:
- Demographic Factors: These include sex, race, ethnicity, age, location, genetics, and sexual orientation. Demographic factors help researchers analyze how diseases present themselves across different populations.
- Non-Demographic Factors: These include comorbidities, organ dysfunction, concurrent medications, and environmental influences. Non-demographic factors allow researchers to study how a person’s current health status and environmental exposures contribute to disease diagnosis and progression.
- Social Factors: These include education level, economic status, family size, food insecurity, etc. Social factors help researchers understand how determinants of health affect disease development, treatment response, and overall well-being.
What purpose does diversity serve in medical research?
In medical studies focused on diseases affecting a wide range of people, it is critical to include a diverse pool of participants. By recruiting participants from different backgrounds, researchers can yield findings that are more accurate and beneficial to the entire affected population. Diversifying the study population leads to more comprehensive data and helps identify key differences and patterns between different types of people. This increases the accuracy of findings and provides more inclusive healthcare opportunities therefore reducing health disparities. We have learned through diversity in research “that patients’ reactions to medical treatments vary depending on race, ethnicity and gender.”[1] Knowing that there are differences in how a treatment affects a patient of one race, ethnicity, or gender as compared to another offers medical professionals’ guidance on how to treat the patient in front of them more effectively.
What have we learned so far specifically in Alzheimer’s disease research by studying diverse populations?
Alzheimer’s disease research studies that include racially diverse participants have provided valuable insights into the risk factors the disease has on people with different backgrounds. Below are a few findings detailed in the 2023 Emory Healthy Brain Study Annual Report.
- Family History: Individuals with a first-degree relative diagnosed with Alzheimer’s are more likely to develop the disease. If multiple family members have been diagnosed, the risk is even higher. Genetic factors, such as the presence of the APOE-e4 gene, increase the risk but do not guarantee the development of Alzheimer’s.
- Cardiovascular Disease and Diabetes: Conditions like heart disease, diabetes, stroke, high blood pressure, and high cholesterol compromise blood flow to the brain, increasing the risk of Alzheimer’s. Studies have shown that damaged blood vessels can accelerate the formation of plaques and tangles in the brain, which are associated with Alzheimer’s.
- Racial Background: According to the Alzheimer’s Association, African Americans are twice as likely to develop Alzheimer’s compared to Caucasians, and individuals with Latin heritage are one-and-a-half times more likely. Including participants from all racial backgrounds is essential for the accuracy and quality of research data.
- Socioeconomic Status: Utilizing data from over 12,000 participants aged 50+ from the Emory Healthy Aging Study in Metro Atlanta, researchers examined how neighborhood socioeconomic status (N-SES) affects the relationship between air pollution and cognitive function in older adults. They found that people living in low N-SES areas were more vulnerable to the negative effects of air pollution on cognitive function. The study highlights the importance of considering N-SES when studying the health impacts of air pollution and suggests that disadvantaged neighborhoods may need more targeted interventions.
How has the Emory Healthy Aging and Emory Healthy Brain Study grown minority engagement?
Within the Emory Healthy Aging Study (EHAS) and Emory Healthy Brain Study (EHBS), researchers observe the effects of aging on both the body and the mind. Since aging affects everyone, studying people from all walks of life is crucial to producing the highest quality research findings.
With much help from the Goizueta Alzheimer’s Disease Research Center (GADRC) Minority Engagement Core team, both EHAS and EHBS have grown their minority participation significantly over the past few years. In 2021, the GADRC outreach team launched the Minority Men’s Health (MMH) event. The mission of this program is to provide minority men, particularly Black men, with essential health resources and information. The event is held on the second Thursday of each month and features diverse medical professionals who discuss various health topics, particularly how these issues affect communities of color. During the event, men are encouraged to learn about participation in the Emory Healthy Aging and Emory Healthy Brain Studies. The MMH program has referred more than 160 African American men to the Emory Healthy Brain Study and continues to enhance the research’s impact.
To register for future events or learn more about the Minority Men’s Health programs please contact Crystal Davis at cpdavis@emory.edu.
[1] https://recruit.ucsf.edu/diversity-research-participation-why-its-important