White Men in Research
I am Dr. Jeff Kingsley and this is another edition of Riding in Cars With Researchers! Today we are going to talk about white men in research. How’s that for a topic? Interested? What could we be talking about – white men in research?
As odd as it may seem, there are more white men in research as proportioned to the population than any other demographic. Why is that a problem? It is a problem for two reasons – one is ethical and one is medical.
Ethically the basic tenant of research is that research should be conducted on the patient population that stands to benefit from that research. Now, white men stand to benefit from the research they are participating in, but that is not the issue. The issue is the under-represented populations. We are conducting research with more white men than other demographics – than women, than people of Asian descent, than African descent, etc. And we are extrapolating that research data, and giving those medicines to women, and to people from other descent, and that I have an ethical problem with.
One example is pediatrics. We do research on adults, largely white men, and then we give those medications to kids at an extrapolated smaller dose, or larger dose, depending on how it is processed. There needs to be research done on kids. There is an inadequate amount of pediatric research being done. That’s an ethical problem to do that.
Now let’s talk about why it is a medical issue. It’s a medical issue because the smarter we get, the more we are realizing that we are not all made the same. There are subtle, but important, differences. For example, we have learned that there are blood pressure medicines that are more, or less effective, in people of African descent than Caucasians. But because the majority of the research was done on Caucasians, it took us a while to learn that. We are learning that there are differences in how anticoagulants are processed in people of different genetic make-ups. Increasingly, we are learning that the genetics behind medicine is of the utmost importance, so in doing research and having most of the research done on white men, there are too many demographics that aren’t represented in research. That is a medical issue, a medical concern, for me.
What Does This Mean?
So, what does this mean? It means that if you are in research today, you have to reach out into your community and build bridges. You have to get to the point where your research looks like the demographics of the community you are in. That’s important! It’s not a “nice to have”, it is a MUST from an ethical and medical standpoint. We have to do what is necessary – fight that fight and build those bridges – so we gain diversity in clinical research.
If you are a patient, and anything other than a white man, you are underrepresented in research data. That means if you need a medication, you were underrepresented in the research data. And I don’t want to make guesses about the right dose for you, or how this medicine is going to be processed in your kidney or liver. I want to know that this research was done including your demographic, so I know precisely how to prescribe for you.
What Can You Do?
What can you do? Get involved in research! Find what research is going on in your community or assist researchers into getting into research in your demographic. We, of course, need more participation from all ethnical groups, but we have to achieve diversity in clinical research for those two reasons – ethical and medical science.
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