Citing racism as the “root cause” of health disparities in the United States and around the world, the Endocrine Society released a policy statement addressing the sources and impact of racism on health disparities. endocrine health. The statement was released recently and posted online in the Journal of Clinical Endocrinology and Metabolism.
The authors of the position paper noted that disparities in endocrine health can be addressed in several key areas, such as facilitating equal patient access to care, supporting diversity among endocrine professionals both at work than in educational institutions, and encourage greater diversity in clinical trial participation and research personnel.
According to data from the Centers for Disease Control and Prevention (CDC) in 2020, racial and ethnic minority groups in the United States have the highest age-adjusted prevalence of diabetes, which has been observed in people who identify as American Indian/Alaska Native (14.7%), Hispanic/Latino (12.5%), Black (11.7%) or Asian (9.2%) compared to white (7.5%). These racial and ethnic minority groups have also been found to be less likely to receive routine diabetes care and have higher rates of complications and death from the disease.
When it comes to bone health, black people were more likely to have longer hospital stays after a hip fracture and a higher risk of disability, death and deprivation compared to white people. Studies have shown that osteoporosis screening rates are approximately 40% lower in communities of color.
The Society noted that the racial and ethnic makeup of endocrinology professionals often did not reflect the populations they served. Black, Hispanic/Latino, and Native American groups represent only 3.3%, 7.1%, and 0.1%, respectively, of the endocrinology workforce. Educationally, the number of black males applying to medical school has declined since 1978, and black and Hispanic groups at the faculty level were more underrepresented in 2016 than in 1990 across all specialties .
According to the Society’s statement, racial and ethnic disparities in clinical trials and research are also considered a concern and may be “essential in evaluating the safety and effectiveness of medical and non-medical therapeutics.”
Black and Hispanic/Latino groups are known to be significantly underrepresented in clinical research studies, an issue the Society has acknowledged is ongoing in endocrine research. About one-fifth of new drugs showed differences in exposure and/or response between racial and ethnic groups, and subgroups of the black population showed different responses to blood pressure and heart failure drugs , diseases that have a high mortality rate in these countries. populations. There are also only a small number of black participants enrolled in cardiovascular outcome trials, so “questions remain about the effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors and peptide receptor agonists 1 glucagon in reducing cardiovascular events in type 2 diabetes,” the authors of the release said.
Regarding research, the Society said a pilot program funded by the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) is working to provide administrative supplements to recruit minority clinical research coordinators. racial and ethnic backgrounds in the clinical trial workforce. The Society noted that it was important to “ensure research staff reflect the racial and ethnic diversity of the populations their research is designed to impact.”
“As we look to the future, we must go beyond pronouncements and plan an ethically and structurally different path to a new future and move forward to eradicate racism in health care,” the leaders said. authors of the policy statement. “Our consistent efforts must be conscious, deliberate, and additive to disrupt the reductive nature of racial and ethnic labels and create a pathway to equitable health for all individuals.”
Dhaliwal R, Pereira RI, Diaz-Thomas AM, Powe CE, Cardozo LLY, Joseph JJ. Eradicating Racism: A Political Perspective from Endocrine Society. J Clin Endocrinol Metab. Published online January 13, 2022. doi:10.1210/clinem/dgab896