Racial, Ethnic Disparities Persist in Dermatology Research and in Workforce

Researchers of a new study published in Journal of the American Academy of Dermatology are highlighting a lack of diversity in dermatology that spans across the specialty.

The researchers highlighted that the dermatology field is considered one of the least diverse and most competitive specialties. Between 2019 and 2020, American Indian or Alaska Native, Black, Hispanics/Latinx, and Native Hawaiian dermatologists accounted for 0.7%, 4.6%, 6.6%, and 0.2%, respectively, of all active dermatology residents. The group also highlighted gaps within academic dermatology, citing data showing that in 2018, Black and Hispanic/Latinx academic dermatologists accounted for just 2.7% of academic dermatologists.

“It is imperative that we work towards creating a more representative workforce in dermatology,” wrote the researchers. "Physicians from underrepresented backgrounds are more likely to provide care for underserved populations, patients with Medicaid, and patients from low SES [socioeconomic status] background. In addition, studies have shown value in race-concordant visits for Black American patients in patient satisfaction and health outcomes." They noted that having a diverse medical student body was found to be the strongest modifiable factor associated with subsequent faculty diversity.

Within dermatology studies, data has shown that reporting on race and optimal representation continue to lag despite policies aimed at promoting representation in clinical trials and research emphasizing the importance of broad representation for generalizability of results and reducing healthcare disparities. For example, an analysis of randomized controlled trials for various dermatologic conditions between 2010 and 2015 found that 59.8% of the US studies reported on race, and nearly 3 in 4 (74.4%) study participants were White.

While mistrust in the health care system has been identified as a key barrier to increasing diversity in trials, some research has shown that even among minorities with favorable views toward research, they are not being engaged. In one survey, just 13% of respondents were approached for reached; 93% of those who were approached did participate. To try and mitigate these barriers, the researchers urged research institutions and pharmaceutical companies to create specific enrollment targets for studies.

Within dermatology specifically, the researchers noted that studies exploring perceptions of dermatology research across racial minorities is scarce. The group cited a study that collected perceptions of research from Black and White parents of pediatric patients, which showed that White parents were more likely to be trusting (84% vs 65%) while Black parents were 3 times more likely to feel that their child might be “treated like a guinea pig.”

“While there were several differences in answers, there was no difference in the willingness to potentially allow their child to participate in research amongst the different races,” described the researchers. "Hence, studies such as this demonstrate that distrust should not be used as the sole reason to not meet diverse recruitment goals.”

Previous research has indicated that a lack of education about what clinical research entails, a lack of awareness of available studies, and language barriers may also hinder diverse enrollment. Possible ways to address these barriers include information session to engage the community, which could help overcome mistrust and increase awareness, as well as advertising and outreach in religious venues.

Reference

Omar D, Syder N, Brown-Korsah J, McKenzie S, Elbuluk N, Taylor S. Racial and ethnic disparities in clinical research and the dermatology workforce. J Am Acad Dermatol. Published online April 3, 2022. doi:10.1016/j.jaad.2022.03.052