Ethnic inclusivity and preventative health research in addressing health inequalities and developing evidence base.
Ethnic inclusivity and preventative health research in addressing health inequalities and developing evidence base.
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DOI：
10.1016/j.eclinm.2020.100672
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发表时间：
2021-01
影响因子：
15.1
通讯作者：
Ray S
中科院分区：
文献类型：
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作者：
Osuafor CN;Golubic R;Ray S
2019冠状病毒病暴露了我们社会中存在的根深蒂固的健康和更广泛的不平等，特别是生活在最贫困社区的人以及黑人和少数民族社区的人。我们现在有一个前所未有的机会来培养一种研究文化，这种文化将积极吸引那些最有可能出现不良健康结果的人的参与，产生急需的数据和证据来阐明未满足的需求。这可能会缓解在人口风险评估以及规划、提供和利用对这些少数群体的需求敏感的卫生干预措施和保健服务方面代表性不足的问题。种族是一个复杂的结构，可作为慢性疾病表型和治疗反应的代表，反映疾病病理生理学和药物代谢的差异[3]。一些研究充分的例子包括2型糖尿病和高血压。已发表的随机对照试验的荟萃分析得出结论，钠-葡萄糖协同转运蛋白-2（SGLT 2）抑制剂和二肽基肽酶-4（DPP 4）抑制剂在降低亚洲人HbA 1c方面比白色个体更有效[4]。最近，人们强调，黑人和少数民族人群患各种微量营养素缺乏症的风险更大，这可能是导致与COVID-19相关的不良结局风险更高的机制的基础[5]。临床研究中少数民族群体的代表性不足已被广泛报道[6]。这些群体在研究中代表性不足的原因很复杂，可能是由于参与者的犹豫，医疗保健人员或研究人员缺乏包容性，通常以语言障碍为借口，以及其他社会经济因素以及根深蒂固的结构性不平等[7]。驾驭这些复杂性需要大量的规划。在规划过程中，我们应该考虑到，在英国，20.7%的医疗保健工作人员由非白人组成[8]。在美国，34.8%的卫生工作者由西班牙裔、黑人或非洲裔美国人、亚洲人和报告多种族和其他种族的个人组成[9]。医疗保健工作人员的这种多样性需要更好地反映在领导角色中，特别是在研究中。
Covid-19 has exposed the existing deep-rooted health and wider inequalities that persist in our society, especially amongst those living in the most deprived neighbourhoods and people from Black and Minority Ethnic communities [1À2]. We now have an unprecedented opportunity to foster a research culture which will proactively engage participation from those at greatest risk of adverse health outcomes, yielding much needed data and evidence to articulate unmet needs. This can potentially mitigate under-representation in population-level risk assessments as well as the planning, delivery and utilisation of health interventions and healthcare services sensitive to the needs of such minority groups. Ethnicity is a complex construct which acts as a proxy for chronic disease phenotypes and therapeutic response, reflecting the differences in disease pathophysiology and drug metabolism [3]. Some of the well-studied examples include type 2 diabetes and hypertension. Meta-analyses of published randomised controlled trials concluded that Sodium-glucose co-transporter-2 (SGLT2) inhibitors and Dipeptidyl-peptidase-4 (DPP4) inhibitors are more effective in lowering HbA1c amongst Asians than amongst White individuals [4]. Recently, it has been highlighted that Black and Minority Ethnic populations are at a greater risk of various micronutrient deficiencies, which may underpin the mechanisms contributing to a higher risk of adverse outcomes associated with COVID-19 [5].Under-representation of ethnic minority groups in clinical research has been widely reported [6]. The reasons for under-representation of these groups in research are complex and could be attributable to hesitancy on the part of participants, lack of inclusion by healthcare staff or researchers, often on the pretext of linguistic barriers, and other socioeconomic factors as well as entrenched structural inequalities [7]. Navigating these complexities requires considerable planning. In the planning process, we should consider that in the UK, 20.7% of the healthcare workforce comprises of non-White ethnicities [8]. In the US, 34.8% of the health workforce is made up of Hispanics, Blacks or African Americans, Asians and individuals reporting Multiple and Other races [9]. This diversity in the healthcare workforce needs to be better reflected in the leadership roles, especially in research.
影响因子：
--
作者：
McAuliffe S;Ray S;Fallon E;Bradfield J;Eden T;Kohlmeier M
通讯作者：
Kohlmeier M
影响因子：
3.1
作者：
Smart, Andrew;Harrison, Eric
通讯作者：
Harrison, Eric