What role does a clinical trial investigator’s race play in determining the participant pool? Research from Harvard Kennedy School Angelopoulos Professor of Public Policy Marcella Alsan and her co-authors found that Black participants’ interest in clinical studies increased by 12.6% when the study was led by a Black principal investigator. Racial diversity in clinical trials is essential to equitable health outcomes. A new study by Harvard Kennedy School suggests that having more diverse scientists can increase Black patient participation in medical research. This could close major health gaps and build trust in clinical trials among underrepresented groups.

Black Americans are underrepresented in clinical trials: Despite accounting for 13% of the U.S. population and suffering disproportionately from certain conditions, only 5% of clinical trial participants in the United States are Black. A lack of representation in clinical trials could compromise the validity of research conclusions, reduce opportunities to benefit from medical innovation, and contribute to increasing racial disparities in morbidity rates.

According to the authors, one reason for this underrepresentation is a lack of trust in the medical profession. “Increasing trust among Black communities requires the medical profession to become more trustworthy,” the authors write. “Part of building trust is increasing the opportunity for members of underrepresented groups to be in positions of authority, including as principal investigators and physicians.” Racial concordance—when the principal investigator and the potential participants are the same race—“can improve enrollment of underrepresented racial minorities in medical research by projecting trustworthiness,” the authors write. The Harvard Kennedy School study shows that racial diversity in clinical trials can directly impact Black patient enrollment.

“This research was motivated by a desire to give all patients the opportunity to participate in clinical trials—which has inherent risk but also can be the only way to access life-saving innovative treatments,” Alsan said.

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