Friday, January 8, 2010

Health Disparities in Clinical Research

The world is full of diverse populations.

As we round out the week, let's recap what we've discussed so far in the From Ideas to Treatments series.

We now know about basic research, animal research, what clinical research trials are, that recruitment is both extremely important to the success of the trial and difficult to achieve, and that there are regulations in place to insure the safety of participants. But there's one last aspect that we haven't broached yet, and that's the importance of recruiting a diverse population into the trials.

Why is diversity important? Well, think about who takes medications... seniors, adults, kids, all races and ethnicities, and both sexes. So, wouldn't it make sense to make sure that the drug or therapy is being tested on all of these individuals?

This is especially important because of the presence of health disparities. Basically, not everyone in the population has the same access to health care. Generally, when you hear about health disparities, people are referring to minority-based health disparities. Minority populations do not have the same opportunity for access to health care as the non-minority population, and because of this, minorities tend to have a higher instance of disease and death from diseases (like heart disease, diabetes, and cancer).

However, not all health disparities are based on race.

Have you ever watched the reality-TV show The Biggest Loser? Each week, people compete to lose weight, with the women tending to drop less weight than the men in any given episode. A guy might lose 15 pounds over the course of the week, whereas his female counterpart may lose 6-8 pounds (if she’s lucky). A lot of that has to do with the genetic difference between males and females. Females happen to be better at storing fat.

Based on that, and many other differences between women and men, there are sex-based health disparities. Women's bodies respond differently to medications, and they also tend to be more prone to certain diseases; like osteoporosis - which appears in older women frequently - heart disease and depression, among other things.

So, sex-based differences should also be an important consideration for researchers when testing new drugs and treatments in clinical trials. If you don't believe me, believe history:

In the 1980s, there was a trial held to test the effect of aspirin on heart attacks in men. The trial found that the aspirin decreased the chance of heart attacks in men. In 1995, a similar trial was started for women. Much to the surprise of the researchers, aspirin didn't decrease the instance of heart attack in women, but did decrease the chance of stroke. Same drug. Different response.

That means for years, aspirin might have been prescribed falsely for approximately half the population and hadn't been being prescribed members of that same half who might be predisposed to stroke.

Race, sex, age, pre-existing conditions, and environment all influence health, so what has been/is being done to make sure all potential groups are included in clinical research? Come back next week to find out how and why health disparities are playing a role in clinical research today.

This is Part 9 of 13 in our From Ideas to Treatments series.
Part 1 - From Ideas to Treatments
Part 2 - Basic Research: It Starts with an Idea
Part 3 - You're an Animal!
Part 4 - Can I care about animals and do research too?
Part 5 - Regulations for Animal Research
Part 6 - Clinical Research Trials
Part 7 - Patient Safety in Clinical Trials: IRB Approval
Part 8 - Recruitment
Part 9 - Health Disparities in Clinical Research
Part 10 - A Brief History of Inclusion Policies
Part 11 - Breaking News: Women and Men are Different
Part 12 - Including Minorities in Clinical Trial Research
Part 13 - Bringing From Ideas to Treatments Home


  1. Where's the picture from?

  2. Nice post...All your points are valuable to us...Its very interesting to read....Also, there is nice information about clinical research....Keep posting....