The United States’ racially biased criminal justice system is having an unintended consequence on medical innovation, according to a new study published in the Health Affairs journal. Researchers suggest that, due to the mass incarceration of African American men in this country, clinical trials are having trouble getting enough black participants — something that’s preventing scientists from adequately examine racial disparities in health outcomes.
Black men in this country have a one in three chance of being incarcerated at some point in their lifetime, according to the Department of Justice, and the United States now imprisons a larger percentage of its black population than South Africa did during the height of apartheid. The racial biases that contribute to those sobering statistics have been well-documented. What’s perhaps less well known is the significant impact on clinical research.
“A black man who begins a research study is less likely to follow up because he is statistically more likely to be jailed or imprisoned during the study than his white counterpart,” Dr. Emily Wang, the new study’s lead author and an assistant professor at Yale School of Medicine, explained.
People participating in ongoing studies must be dropped from the trial if they’re arrested and jailed, thanks to the federal government’s restriction on the use of prison inmates in scientific research. In some jurisdictions, they can’t be tracked after their release, either. That 1978 policy was borne out of good intentions; it was supposed to put an end to the unethical and potentially dangerous experiments from being conducted on prisoners without their consent.
But now, Wang and her colleagues say that restriction should be amended to allow inmates to continue with a trial if they started it before they were put behind bars. They estimated that over the past three decades, incarceration accounted for up to 65 percent of the black men who didn’t follow up in the trials they initially agreed to participate in. The Yale researchers argue that’s undermining analysts’ ability to draw statistically significant conclusions about racial disparities — particularly considering the fact that medical conditions like cardiovascular disease and sickle cell anemia are more common among black men than white men.
For decades, clinical trials have struggled to ensure enough racial diversity. A recent study found that non-white people represent fewer than five percent of overall participants in this type of research — something that’s having a direct impact on the types of treatments we’re able to develop. For instance, certain types of cancer treatments don’t work as well on non-white people. And there’s evidence that the HPV vaccine isn’t as effective for black women because the trials to develop it consisted of mostly white women.
“We are missing opportunities to study the outcomes of research on this population so treatments can be tailored,” Wang pointed out.
This is hardly the only example of racial disparities in medical care. Thanks to the institutionalized structures of racism and poverty, black Americans are still dying younger than white Americans. They’re more likely to suffer from health issues, yet less likely to receive quality health care. And the diseases that disproportionately affect black people remain underfunded.