November 15, 2024 • 22 mins
Text the show a topic request (or just say hello)
How has psychology evolved from reinforcing racial biases to becoming a powerful tool for health equity? I’m Kapri, and in this episode, I dive into the transformative role of psychological science in advancing racial equity, especially in the workplace. We’ll unpack why inclusivity goes beyond surface-level diversity, demanding systemic change and committed leadership to shift organizational culture truly.
We’ll also explore the critical need for diversity in clinical trials. Historically, the overrepresentation of white male participants has skewed treatment outcomes, creating significant gaps for women, people of color, and low-income communities. Discover how this lack of diversity widens healthcare disparities, particularly in accessing costly treatments. We’ll look at actions and initiatives by industry leaders showcasing the importance of community engagement in building trust and advancing health equity.
This episode is about actionable strategies to foster equity across sectors, from reimagining workplace inclusivity to reforming clinical trials. Tune in for evidence-based insights, expert discussions, and the latest research on bridging these critical gaps.
Find Reframing the Membrane: Crossing Boundaries
- Online @ reframingthemembrane.com
- Instagram @ reframingthemembrane
Disclaimer: This podcast serves solely for informational and entertainment purposes. It is not intended to replace professional medical or mental health advice, diagnosis, or treatment, nor does it substitute for a relationship with a licensed mental health clinician. Always consult your physician before deciding about your physical or mental health.
Resources:
- Equitable Breakthroughs in Medicine Development (EQBMED)
- 988 Suicide & Crisis Lifeline
- National Helpline
- Find a Psychiatrist
- Find Treatment
References:
- Apology to People of Color for APA’s Role in Promoting, Perpetuating, and Failing to Challenge Racism, Racial Discrimination, and Human Hierarchy in U.S.
- Key, A. P. (2024, November 1). How psychological science can advance racial equity. Monitor on Psychology, 55(8). https://www.apa.org/monitor/2024/11/psychological-science-racial-equity
- Neville, H. A., Monette, M., Lewis, J. T., & Safir, S. (2024). Shifting the gaze from racism to healing from racism: A systematic review of selected psychology journals from 1992 to 2022. American Psychologist, 79(5), 706–724. https://doi.org/10.1037/amp0001317
#reframingthemembrane #speakout #advocacyseries
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Kapri (00:00):
Hello, good people and welcome.
I'm your host, Kapri, and Ihope you had a great week and
that an even better weekend isin store for you.
So today we'll explore howpsychological science can play a
crucial role in promotingracial equity.
In today's episode, we'rediving deep into how psychology
the science of understandinghuman behavior and thought can
(00:21):
help dismantle systemic barriersand foster equity.
In 2021, the AmericanPsychological Association, or
APA, issued a public apology forperpetuating racial inequities.
Even in the science itself, thefield has long been complicit
in systemic racism, sometimesproviding evidence that upheld
(00:42):
oppressive systems.
However, psychology as adiscipline has grown and evolved
, and now we're at a turningpoint where psychological
insights can actively be used topromote justice and equity.
So today we'll unpack what thatlooks like in practice and why
it matters.
Let's start by acknowledgingthe context of this work.
For psychology to supportracial equity, it has to
(01:04):
confront the ways it's been usedto justify stereotypes and
biases.
Historically, this field hasparticipated in the perpetuation
, maintenance and reproductionof racial systems, but today,
psychologists are more aware ofthe social impact of their work
and, through that awareness,they're finding new ways to
approach issues of bias anddiscrimination.
So what does this even meanpractically Well.
(01:26):
By studying these processesscientifically, psychologists
are able to identify patternsthat contribute to
discrimination and then createtargeted interventions to
disrupt them.
It's like shining a light intothe unconscious corners of our
mind and addressing what we find.
A major area where psychologicalscience is making strides in
racial equity is in theworkplace.
(01:48):
Now let's think about that fora moment.
Think about the workplace as anenvironment.
Many of us are spending so muchof our lives at work, and it is
a key space for socialinteraction.
It's also a key place forsocial systems and hierarchies.
Psychological studies tell usthat workplaces often reinforce
the status quo because it'scomfortable or familiar, but
(02:09):
holding on to comfort oftenmeans leaving existing biases
unchallenged.
It also often means leavingsome people behind.
Here's where psychology canoffer solutions.
Research shows that promotingequity in the workplace isn't
just about checking off boxes ona diversity report or meeting
quotas.
It has real, tangible benefitsand even though there are a lot
(02:30):
of folks saying, oh, we want toget rid of all this woke stuff,
including people and culture isalways the right thing to do.
For instance, studies publishedin the Academy of Management
Proceedings revealed that teamswith deep-level diversity which
means differences in knowledge,skills, values are actually more
creative and innovative.
(02:50):
But here's the catch For thiscreativity to thrive, the
environment must be inclusiveand supportive.
And I just want to caveat andsay that when I talk about
diversity, many people oftenthink well, you just mean racial
or ethnic diversity.
Well, no, actually, what I meanis diversity of all things,
whether it's race, ethnicity,gender orientation,
(03:11):
neurodivergency, cognitiveability, any ability, people and
culture having culturalcompetence to embrace people,
create spaces and places wherepeople feel that they belong and
that these are truly genuineenvironments where we're all
working together, regardless ofour socioeconomic background,
(03:32):
our race, the color of our skin,our hair, the way we look, the
way we dress, what kind of carswe drive, creating environments
that are inclusive andsupportive.
That is diversity at its center, at its core and at its true
level.
So, if we think about anexample of deep level diversity
in the workplace, think about ateam that's in a brainstorming
(03:52):
session.
When everyone in the room has asimilar background, the ideas
that are generated often arelimited and reflect a very
narrow perspective.
But when a team includes peoplefrom all walks of life, like I
just described so that's racial,cultural, educational
backgrounds, et cetera theybring new ideas and ways of
thinking that others might nothave considered.
This is not a bad thing.
(04:13):
This diversity has driveninnovation.
I've seen it firsthand in thecorporations and spaces where
I've worked, and it can alsohelp a team develop unique,
powerful solutions, but only ifthe environment encourages all
voices to be heard and forpeople to be seen.
This is where inclusivepractices make a big difference.
So let's pause for a moment.
When we refer to inclusivepractices, we're not simply
(04:34):
discussing diversity trainingevents that last a day or two.
My research and experience as anexecutive in Fortune 500
companies actually indicatesthat brief training sessions and
mandates have not effectivelycombated deep-seated biases.
These often performativesessions can backfire,
potentially reinforcing thebiases they aim to mitigate.
(04:56):
So genuine inclusionnecessitates structural changes,
embedding equity into anorganization's core and everyday
practices.
So what does meaningful,lasting change look like in an
organization?
In my experience, a keystrategy is to engage leadership
, especially managers, as activeparticipants in promoting
diversity, equity, inclusion andaccessibility.
(05:17):
When managers participate ininitiatives like recruitment
programs for diverse talent ormentoring relationships with
employees, and including thosefrom neurodivergent and
underrepresented backgrounds,they start to see themselves as
advocates.
This isn't just theoretical.
It's backed by psychologicalresearch showing that leaders
who advocate for these causescan help create more inclusive
(05:40):
productive teams.
Also, creating spaces formeaningful interaction between
all organizational groups canreduce bias.
This approach is grounded inwhat is known as contact theory,
and it's been popularized by asocial psychologist, dr Susan
Fisk.
However, contact theorysuggests that, under the right
(06:01):
conditions, interaction betweengroups can reduce prejudice and
promote empathy.
In a Fortune 500 company that Iused to work in, where most
senior executives and CEOs werewhite men, I had an opportunity
to serve as the chief diversity,equity and inclusion officer
and face the challenge ofaddressing the stark inequities
that impacted not only my careertrajectory but those of other
(06:23):
employees and people of color.
As a part of my role, Ideveloped initiatives to
increase workforcerepresentation and foster
authentic inclusion at allcompany levels.
I drew from my experiencesnavigating corporate America,
where race, gender and identityoften intersected in complex
ways, to shape theorganization's inclusion and
belonging strategy.
(06:44):
Recognizing the limitations oftraditional DEIA training, I
decided to implement a newapproach grounded in contact
theory.
The most impactful moments inmy career came from meaningful,
sustained interactions withcolleagues from different racial
and cultural backgrounds, notfrom one-off workshops or
compliance-based mandatedtraining.
To achieve this, I introduced aprogram called Courageous
(07:05):
Conversations where executivesand middle management of diverse
racial and cultural identitiesparticipated in a series of
structured dialogue.
Over a year, I paired twoemployees both were high-level
vice presidents or VPs One we'llcall Joe, a white man who had
been with the company for over20 years, and Renra, a newly
promoted black woman.
(07:26):
During their first session, joeseemed skeptical and I couldn't
help but notice the discomfortin his posture and tone.
However, as they started toshare their personal stories and
professional journeys,something shifted.
Rhaenyra spoke about thebarriers she faced as a black
woman in a predominantly whitemale industry, the
microaggressions, the constantneed to prove herself and the
(07:47):
invisible load she carried daily.
Joe listened intently.
His skepticism graduallyreplaced by a quiet
understanding.
In the subsequent meetings, joeshared his own story a
privileged upbringing where racewas never a barrier but a
shield.
He spoke about his unconsciousbias, which he had never fully
confronted before, and Renealistened with empathy but did
(08:07):
not let him off the hook.
She challenged him with pointedquestions, drawing connections
between his experiences and thesystemic issues that she faced.
Over time, the structuredinteractions that I facilitated
became deeper and more genuine.
Joe began to actively advocatefor changes in hiring practices
and mentorship programs, usinghis influence to open doors that
(08:29):
had long been closed toexecutives like Rennera.
He admitted in one session thathe had never realized how
isolating it could be to be theonly one in the room, a
perspective that Rennera livedwith daily.
I watched this transformationunfold with a sense of quiet
satisfaction.
The program wasn't just aboutincreasing diversity quotas.
No one wants to be a diversityhire.
(08:50):
No one wants to be hired forthe color of their skin.
People want to be hired,respected and brought in because
they have the qualifications,credential and skill to do the
job.
So this was about creatinggenuine human connections that
broke down preconceived notionsand built empathy by
facilitating sustained,meaningful contact between
(09:10):
employees who would haveotherwise remained strangers.
I leveraged contact theory tofoster an environment where
differences became the startingpoint for collaboration rather
than a source of division.
More than teaching DEIA conceptsis needed.
A real change comes fromcreating the conditions for
relationships that challengebias, break down stereotypes and
(09:30):
reimagine what's possible inthe corporate world.
In the end, joe and Rene'srelationship became a model for
others in the company,demonstrating that when barriers
to contact were removed,empathy and understanding could
emerge, transforming bothindividual perceptions and the
entire organizational culture.
Picture a workplace wherepeople from different racial
(09:51):
backgrounds are encouraged tocollaborate on projects.
They're forced to communicate,problem solve and rely on one
another as they work together.
This breaks down stereotypesand helps people view each other
as individuals with uniquestrengths rather than as members
of a group defined by race orethnicity.
This approach requires theright conditions.
Simply putting people togetheris not enough.
(10:12):
There has to be a shared goal,a mutual respect and equality in
roles to benefit from thisapproach.
After a short break, we'll comeback and continue our
conversation about how diverseracial and ethnic representation
in clinical trials is important.
More in a minute.
Announcement (10:27):
Are you ready to make a difference in your
community?
In our Speak Out Advocacyseries, we're here to empower
you to use your voice for change.
Whether improving access tomental health care, reducing
stigma or shaping importantsocial policies, this series
provides the tools to create alasting impact.
If advocating for better care,breaking down barriers or
(10:48):
transforming mental healthservices speaks to your heart,
this is the perfect space tolearn and take action.
Do you have a topic you'repassionate about or need support
advocating for yourself orothers?
We'd love to hear from you.
Text the show to share yourthoughts.
Just check the details in theshow notes.
Together, let's build acommunity that fosters change.
(11:08):
Keep enjoying reframing themembrane.
Did you know contact theoryisn't just about race or
ethnicity?
It applies to many groups thatare excluded from everyday
activities and spaces.
Think about homelessness.
People often look away,treating people experiencing
homelessness like they'reinvisible, or consider age
(11:28):
discrimination, religiousdivides, socioeconomic status or
even neurodivergent individuals.
The theory even extends tosocial hierarchies, like the
caste system in India.
Fostering positive interactionsbetween outgroups and ingroups
can help us understand andreduce conflict.
Want to learn more and explorereal-world examples?
(11:51):
Text the show now to getresources and actionable tips
for practicing positive contacttheory in your community.
Kapri (11:55):
So let's dive into a critical topic that's at the
intersection of health equityand medical innovation diversity
in clinical trials.
Whether it's a new drug, agroundbreaking therapy or a
medical device, clinical trialsare the backbone of health
advancement.
But if the participants inthese trials don't represent the
diverse population that willultimately use these treatments,
we run the risk of creatingdisparities that could widen
(12:18):
health gaps rather than closethem.
Today, let's explore whydiversity in clinical trials is
more than just a checkbox.
It's a necessity for ensuringequitable health outcomes for
all.
We'll discuss the currentchallenges, the role of systemic
barriers and promisinginitiatives that aim to increase
diverse representation.
So let's get started.
Clinical trials are anessential step in determining
(12:40):
whether medical products likedrugs, vaccines or devices are
safe and effective.
Yet not all bodies react thesame way to treatments.
Factors such as age, gender,race and ethnicity can influence
how individuals respond tomedications, due to differences
in genetics, underlying healthconditions and environmental
exposures.
Historically, clinical trialshave relied heavily on white
(13:03):
male participants, which hasleft us with significant
knowledge gaps about howtreatments work for other groups
.
For instance, research showsthat Black, hispanic, asian and
Indigenous populations are oftenunderrepresented in trials,
even when these groups face ahigher burden of certain
diseases.
This lack of diversity canresult in less effective or even
(13:23):
harmful treatment outcomes forthese underrepresented groups.
Consider the racial bias foundin pulse oximeters, which
measure blood oxygen levels.
During the COVID-19 pandemic,studies revealed that these
devices were less accurate forpeople with darker skin tones,
leading to delays in criticalcare.
This example underscores thebroader issue care.
(13:46):
This example underscores thebroader issue.
When clinical trials don'tinclude diverse participants, we
risk developing tools andtreatments that fail to serve
everyone equitably.
Let's delve into why diverseparticipation in clinical trials
remains so challenging.
Several factors contribute tothe underrepresentation of
people of color, women andlow-income individuals in
clinical research.
First, structural barriers playa significant role.
(14:06):
Many clinical trials areconducted at well-funded
academic medical centers, whichare often far from
under-resourced communities.
This creates logistical hurdles, such as transportation issues,
making it difficult for thosewho would benefit most to
participate.
Additionally, exclusioncriteria based on comorbidities,
like hypertension and diabetes,disproportionately disqualify
(14:29):
older adults and people of color.
Then there's the issue ofmistrust, which I talked about
before.
Rooted in a legacy of unethicalmedical practices, the US
Public Health Service syphilisstudy at Tuskegee and the
unauthorized use of geneticsamples from the Havasupai tribe
are stark reminders of howmedical research has exploited
communities of color.
(14:50):
These historical abuses haveleft deep scars, fostering a
persistent skepticism towardsthe healthcare system.
Announcement (14:56):
The Reframing the Membrane Crossing Boundaries
podcast is provided solely forinformational and entertainment
purposes.
It is not intended to replaceprofessional medical or mental
health advice, diagnosis ortreatment, nor does it
substitute for a relationshipwith a licensed mental health
clinician.
Always consult your physicianbefore deciding about your
(15:16):
physical or mental health.
Kapri (15:18):
Finally, knowledge gaps and a lack of culturally
sensitive outreach furtherhinder participation.
Research shows that physiciansare less likely to discuss
clinical trial opportunitieswith patients of color.
Without awareness and education, many potential participants
remain unaware of theseopportunities, highlighting the
need for better communicationand engagement strategies.
(15:40):
Despite these challenges, thereare promising efforts underway
to improve diversity in clinicaltrials.
In my work in thebiopharmaceutical industry,
there has been an introductionof guidelines to increase
representation ofunderrepresented groups.
For example, the FDA'sdiversity action plans now
require researchers to outlinestrategies to ensure that trial
(16:02):
participants reflect thedemographics of the intended
user population.
During the COVID-19 pandemic,for example, companies like
Pfizer and Moderna took steps toincrease diverse enrollment by
partnering with historicallyBlack colleges and universities
or HBCUs and communityorganizations, and so this
helped to build some trust anddemonstrated a commitment to
(16:22):
equity, ultimately leading tobetter data on vaccine efficacy
across different racial andethnic groups.
Another noteworthy initiativeis the Equitable Breakthroughs
in Medicine Development, whichis led by PhRMA.
This program collaborates withcommunity health centers serving
predominantly low-income andracially diverse populations,
(16:44):
making clinical trials moreaccessible and ensuring that the
gathered data better representsthe broader population.
So there are a number ofimplications of inadequate
representation, so let's talkabout the consequences of
underrepresentation in clinicaltrials, which is far-reaching.
When certain groups are notadequately included, it can lead
to disparities in treatmentoutcomes and access.
(17:06):
So let's consider a fewreal-world examples.
Recently, there was a drugapproved for Alzheimer's and it
was priced at about $26,500 ayear, although this was covered
by Medicare.
Many older Black and Hispanicadults, who experience higher
rates of dementia and have loweraverage incomes, face
significant out-of-pocket costs.
This is a financial barrierthat highlights a broader issue
(17:29):
of equity and access tolife-saving treatments, and it's
worth noting that the $26,500is a reduction from what was
double the price before it wasslashed in half to 26,500.
Then, when we think about genetherapies for sickle cell
disease, for example, acondition that
disproportionately affects Blackand Hispanic populations,
(17:49):
offered a one-time cure, but itcame with a price tag of over $2
million.
Without comprehensive coverageand financial assistance, these
groundbreaking treatments remainout of reach for many of the
people who need them most.
Obesity medications alsodemonstrate disparities in
access.
Although obesity rates arehigher among people of color,
limited coverage and high costsmake these treatments
(18:10):
inaccessible for many,perpetuating existing health
inequities.
Moreover, biases in clinicaldecision-making tools and
algorithms can exacerbate thesedisparities.
We've seen.
Algorithms that are trained ondata that lack diversity, yield
biased recommendations, and sothis can lead to a sub optimal
or even harmful treatmentdecisions for minority patients.
(18:32):
So, as we move toward inclusiveand equitable clinical trials,
what can be done to addressthese issues?
So let's talk about somestrategies that could make a
significant impact after a shortbreak.
Announcement (18:43):
Are you ready to make a difference in your
community?
In our Speak Out Advocacyseries, we're here to empower
you to use your voice for change.
Whether improving access tomental health care, reducing
stigma or shaping importantsocial policies, this series
provides the tools to create alasting impact.
If advocating for better care,breaking down barriers or
(19:04):
transforming mental healthservices speaks to your heart,
this is the perfect space tolearn and take action.
Do you have a topic you'repassionate about or need support
advocating for yourself orothers?
We'd love to hear from you.
Text the show to share yourthoughts.
Just check the details in theshow notes.
Together, let's build acommunity that fosters change.
(19:25):
Keep enjoying reframing themembrane.
Kapri (19:28):
One strategy is community engagement.
Building trust withhistorically marginalized
communities is essential.
Researchers can collaboratewith community leaders and
organizations to design studiesthat reflect the needs and
concerns of the population.
This approach helps ensure thatthe voices of those most
affected by health disparitiesare heard and valued.
Then there's policy reform.
(19:49):
So legislation like the Foodand Drug Omnibus Reform Act
requires clinical trials toinclude diversity action plans
setting a new standard foraccountability and research.
Such policies can be crucialfor addressing the historical
underrepresentation of certaingroups.
And expanded coverage isanother area where we could
improve.
So expanding Medicare andMedicaid coverage, for example
(20:13):
for new drugs and therapies, canhelp to mitigate some financial
barriers.
Ensuring that all patients,regardless of income, have
access to innovative treatmentsis a vital step toward health
equity In transparent datareporting.
Accurate and transparentreporting of demographic data in
clinical trials is necessary toaddress and assess progress and
(20:34):
hold researchers accountable.
By disaggregating data by race,ethnicity, gender and
socioeconomic status, we canidentify gaps and develop
targeted solutions.
So when we think about a pathforward, the journey toward
inclusive and equitable clinicaltrials is a challenging one,
but it's a journey we mustundertake.
Achieving diverserepresentation is not a checkbox
(20:55):
activity.
It's about conducting betterscience, improving patient
outcomes and creating ahealthcare system that works for
everyone.
So thank you for tuning in totoday's episode.
If you found this discussioninformative, please share with
your friends in your network,leave us a review and follow our
podcast.
In our next episode, we'regoing to dive more into the
topics of trauma-informed care,the art of reframing and letting
(21:19):
go, and implications for mentalhealth treatment across
different communities.
Don't forget to subscribe andfollow and join our
conversations by texting theshow.
Let's keep crossing boundariesand reframing the way we think
about health, equity and theworld around us.
Until next time, good people,be well, stay safe.
Hello, good people and welcome.
I'm your host, Kapri, and Ihope you had a great week and
that an even better weekend isin store for you.
So today we'll explore howpsychological science can play a
crucial role in promotingracial equity.
In today's episode, we'rediving deep into how psychology
the science of understandinghuman behavior and thought can
(00:21):
help dismantle systemic barriersand foster equity.
In 2021, the AmericanPsychological Association, or
APA, issued a public apology forperpetuating racial inequities.
Even in the science itself, thefield has long been complicit
in systemic racism, sometimesproviding evidence that upheld
(00:42):
oppressive systems.
However, psychology as adiscipline has grown and evolved
, and now we're at a turningpoint where psychological
insights can actively be used topromote justice and equity.
So today we'll unpack what thatlooks like in practice and why
it matters.
Let's start by acknowledgingthe context of this work.
For psychology to supportracial equity, it has to
(01:04):
confront the ways it's been usedto justify stereotypes and
biases.
Historically, this field hasparticipated in the perpetuation
, maintenance and reproductionof racial systems, but today,
psychologists are more aware ofthe social impact of their work
and, through that awareness,they're finding new ways to
approach issues of bias anddiscrimination.
So what does this even meanpractically Well.
(01:26):
By studying these processesscientifically, psychologists
are able to identify patternsthat contribute to
discrimination and then createtargeted interventions to
disrupt them.
It's like shining a light intothe unconscious corners of our
mind and addressing what we find.
A major area where psychologicalscience is making strides in
racial equity is in theworkplace.
(01:48):
Now let's think about that fora moment.
Think about the workplace as anenvironment.
Many of us are spending so muchof our lives at work, and it is
a key space for socialinteraction.
It's also a key place forsocial systems and hierarchies.
Psychological studies tell usthat workplaces often reinforce
the status quo because it'scomfortable or familiar, but
(02:09):
holding on to comfort oftenmeans leaving existing biases
unchallenged.
It also often means leavingsome people behind.
Here's where psychology canoffer solutions.
Research shows that promotingequity in the workplace isn't
just about checking off boxes ona diversity report or meeting
quotas.
It has real, tangible benefitsand even though there are a lot
(02:30):
of folks saying, oh, we want toget rid of all this woke stuff,
including people and culture isalways the right thing to do.
For instance, studies publishedin the Academy of Management
Proceedings revealed that teamswith deep-level diversity which
means differences in knowledge,skills, values are actually more
creative and innovative.
(02:50):
But here's the catch For thiscreativity to thrive, the
environment must be inclusiveand supportive.
And I just want to caveat andsay that when I talk about
diversity, many people oftenthink well, you just mean racial
or ethnic diversity.
Well, no, actually, what I meanis diversity of all things,
whether it's race, ethnicity,gender orientation,
(03:11):
neurodivergency, cognitiveability, any ability, people and
culture having culturalcompetence to embrace people,
create spaces and places wherepeople feel that they belong and
that these are truly genuineenvironments where we're all
working together, regardless ofour socioeconomic background,
(03:32):
our race, the color of our skin,our hair, the way we look, the
way we dress, what kind of carswe drive, creating environments
that are inclusive andsupportive.
That is diversity at its center, at its core and at its true
level.
So, if we think about anexample of deep level diversity
in the workplace, think about ateam that's in a brainstorming
(03:52):
session.
When everyone in the room has asimilar background, the ideas
that are generated often arelimited and reflect a very
narrow perspective.
But when a team includes peoplefrom all walks of life, like I
just described so that's racial,cultural, educational
backgrounds, et cetera theybring new ideas and ways of
thinking that others might nothave considered.
This is not a bad thing.
(04:13):
This diversity has driveninnovation.
I've seen it firsthand in thecorporations and spaces where
I've worked, and it can alsohelp a team develop unique,
powerful solutions, but only ifthe environment encourages all
voices to be heard and forpeople to be seen.
This is where inclusivepractices make a big difference.
So let's pause for a moment.
When we refer to inclusivepractices, we're not simply
(04:34):
discussing diversity trainingevents that last a day or two.
My research and experience as anexecutive in Fortune 500
companies actually indicatesthat brief training sessions and
mandates have not effectivelycombated deep-seated biases.
These often performativesessions can backfire,
potentially reinforcing thebiases they aim to mitigate.
(04:56):
So genuine inclusionnecessitates structural changes,
embedding equity into anorganization's core and everyday
practices.
So what does meaningful,lasting change look like in an
organization?
In my experience, a keystrategy is to engage leadership
, especially managers, as activeparticipants in promoting
diversity, equity, inclusion andaccessibility.
(05:17):
When managers participate ininitiatives like recruitment
programs for diverse talent ormentoring relationships with
employees, and including thosefrom neurodivergent and
underrepresented backgrounds,they start to see themselves as
advocates.
This isn't just theoretical.
It's backed by psychologicalresearch showing that leaders
who advocate for these causescan help create more inclusive
(05:40):
productive teams.
Also, creating spaces formeaningful interaction between
all organizational groups canreduce bias.
This approach is grounded inwhat is known as contact theory,
and it's been popularized by asocial psychologist, dr Susan
Fisk.
However, contact theorysuggests that, under the right
(06:01):
conditions, interaction betweengroups can reduce prejudice and
promote empathy.
In a Fortune 500 company that Iused to work in, where most
senior executives and CEOs werewhite men, I had an opportunity
to serve as the chief diversity,equity and inclusion officer
and face the challenge ofaddressing the stark inequities
that impacted not only my careertrajectory but those of other
(06:23):
employees and people of color.
As a part of my role, Ideveloped initiatives to
increase workforcerepresentation and foster
authentic inclusion at allcompany levels.
I drew from my experiencesnavigating corporate America,
where race, gender and identityoften intersected in complex
ways, to shape theorganization's inclusion and
belonging strategy.
(06:44):
Recognizing the limitations oftraditional DEIA training, I
decided to implement a newapproach grounded in contact
theory.
The most impactful moments inmy career came from meaningful,
sustained interactions withcolleagues from different racial
and cultural backgrounds, notfrom one-off workshops or
compliance-based mandatedtraining.
To achieve this, I introduced aprogram called Courageous
(07:05):
Conversations where executivesand middle management of diverse
racial and cultural identitiesparticipated in a series of
structured dialogue.
Over a year, I paired twoemployees both were high-level
vice presidents or VPs One we'llcall Joe, a white man who had
been with the company for over20 years, and Renra, a newly
promoted black woman.
(07:26):
During their first session, joeseemed skeptical and I couldn't
help but notice the discomfortin his posture and tone.
However, as they started toshare their personal stories and
professional journeys,something shifted.
Rhaenyra spoke about thebarriers she faced as a black
woman in a predominantly whitemale industry, the
microaggressions, the constantneed to prove herself and the
(07:47):
invisible load she carried daily.
Joe listened intently.
His skepticism graduallyreplaced by a quiet
understanding.
In the subsequent meetings, joeshared his own story a
privileged upbringing where racewas never a barrier but a
shield.
He spoke about his unconsciousbias, which he had never fully
confronted before, and Renealistened with empathy but did
(08:07):
not let him off the hook.
She challenged him with pointedquestions, drawing connections
between his experiences and thesystemic issues that she faced.
Over time, the structuredinteractions that I facilitated
became deeper and more genuine.
Joe began to actively advocatefor changes in hiring practices
and mentorship programs, usinghis influence to open doors that
(08:29):
had long been closed toexecutives like Rennera.
He admitted in one session thathe had never realized how
isolating it could be to be theonly one in the room, a
perspective that Rennera livedwith daily.
I watched this transformationunfold with a sense of quiet
satisfaction.
The program wasn't just aboutincreasing diversity quotas.
No one wants to be a diversityhire.
(08:50):
No one wants to be hired forthe color of their skin.
People want to be hired,respected and brought in because
they have the qualifications,credential and skill to do the
job.
So this was about creatinggenuine human connections that
broke down preconceived notionsand built empathy by
facilitating sustained,meaningful contact between
(09:10):
employees who would haveotherwise remained strangers.
I leveraged contact theory tofoster an environment where
differences became the startingpoint for collaboration rather
than a source of division.
More than teaching DEIA conceptsis needed.
A real change comes fromcreating the conditions for
relationships that challengebias, break down stereotypes and
(09:30):
reimagine what's possible inthe corporate world.
In the end, joe and Rene'srelationship became a model for
others in the company,demonstrating that when barriers
to contact were removed,empathy and understanding could
emerge, transforming bothindividual perceptions and the
entire organizational culture.
Picture a workplace wherepeople from different racial
(09:51):
backgrounds are encouraged tocollaborate on projects.
They're forced to communicate,problem solve and rely on one
another as they work together.
This breaks down stereotypesand helps people view each other
as individuals with uniquestrengths rather than as members
of a group defined by race orethnicity.
This approach requires theright conditions.
Simply putting people togetheris not enough.
(10:12):
There has to be a shared goal,a mutual respect and equality in
roles to benefit from thisapproach.
After a short break, we'll comeback and continue our
conversation about how diverseracial and ethnic representation
in clinical trials is important.
More in a minute.
Announcement (10:27):
Are you ready to make a difference in your
community?
In our Speak Out Advocacyseries, we're here to empower
you to use your voice for change.
Whether improving access tomental health care, reducing
stigma or shaping importantsocial policies, this series
provides the tools to create alasting impact.
If advocating for better care,breaking down barriers or
(10:48):
transforming mental healthservices speaks to your heart,
this is the perfect space tolearn and take action.
Do you have a topic you'repassionate about or need support
advocating for yourself orothers?
We'd love to hear from you.
Text the show to share yourthoughts.
Just check the details in theshow notes.
Together, let's build acommunity that fosters change.
(11:08):
Keep enjoying reframing themembrane.
Did you know contact theoryisn't just about race or
ethnicity?
It applies to many groups thatare excluded from everyday
activities and spaces.
Think about homelessness.
People often look away,treating people experiencing
homelessness like they'reinvisible, or consider age
(11:28):
discrimination, religiousdivides, socioeconomic status or
even neurodivergent individuals.
The theory even extends tosocial hierarchies, like the
caste system in India.
Fostering positive interactionsbetween outgroups and ingroups
can help us understand andreduce conflict.
Want to learn more and explorereal-world examples?
(11:51):
Text the show now to getresources and actionable tips
for practicing positive contacttheory in your community.
Kapri (11:55):
So let's dive into a critical topic that's at the
intersection of health equityand medical innovation diversity
in clinical trials.
Whether it's a new drug, agroundbreaking therapy or a
medical device, clinical trialsare the backbone of health
advancement.
But if the participants inthese trials don't represent the
diverse population that willultimately use these treatments,
we run the risk of creatingdisparities that could widen
(12:18):
health gaps rather than closethem.
Today, let's explore whydiversity in clinical trials is
more than just a checkbox.
It's a necessity for ensuringequitable health outcomes for
all.
We'll discuss the currentchallenges, the role of systemic
barriers and promisinginitiatives that aim to increase
diverse representation.
So let's get started.
Clinical trials are anessential step in determining
(12:40):
whether medical products likedrugs, vaccines or devices are
safe and effective.
Yet not all bodies react thesame way to treatments.
Factors such as age, gender,race and ethnicity can influence
how individuals respond tomedications, due to differences
in genetics, underlying healthconditions and environmental
exposures.
Historically, clinical trialshave relied heavily on white
(13:03):
male participants, which hasleft us with significant
knowledge gaps about howtreatments work for other groups
.
For instance, research showsthat Black, hispanic, asian and
Indigenous populations are oftenunderrepresented in trials,
even when these groups face ahigher burden of certain
diseases.
This lack of diversity canresult in less effective or even
(13:23):
harmful treatment outcomes forthese underrepresented groups.
Consider the racial bias foundin pulse oximeters, which
measure blood oxygen levels.
During the COVID-19 pandemic,studies revealed that these
devices were less accurate forpeople with darker skin tones,
leading to delays in criticalcare.
This example underscores thebroader issue care.
(13:46):
This example underscores thebroader issue.
When clinical trials don'tinclude diverse participants, we
risk developing tools andtreatments that fail to serve
everyone equitably.
Let's delve into why diverseparticipation in clinical trials
remains so challenging.
Several factors contribute tothe underrepresentation of
people of color, women andlow-income individuals in
clinical research.
First, structural barriers playa significant role.
(14:06):
Many clinical trials areconducted at well-funded
academic medical centers, whichare often far from
under-resourced communities.
This creates logistical hurdles, such as transportation issues,
making it difficult for thosewho would benefit most to
participate.
Additionally, exclusioncriteria based on comorbidities,
like hypertension and diabetes,disproportionately disqualify
(14:29):
older adults and people of color.
Then there's the issue ofmistrust, which I talked about
before.
Rooted in a legacy of unethicalmedical practices, the US
Public Health Service syphilisstudy at Tuskegee and the
unauthorized use of geneticsamples from the Havasupai tribe
are stark reminders of howmedical research has exploited
communities of color.
(14:50):
These historical abuses haveleft deep scars, fostering a
persistent skepticism towardsthe healthcare system.
Announcement (14:56):
The Reframing the Membrane Crossing Boundaries
podcast is provided solely forinformational and entertainment
purposes.
It is not intended to replaceprofessional medical or mental
health advice, diagnosis ortreatment, nor does it
substitute for a relationshipwith a licensed mental health
clinician.
Always consult your physicianbefore deciding about your
(15:16):
physical or mental health.
Kapri (15:18):
Finally, knowledge gaps and a lack of culturally
sensitive outreach furtherhinder participation.
Research shows that physiciansare less likely to discuss
clinical trial opportunitieswith patients of color.
Without awareness and education, many potential participants
remain unaware of theseopportunities, highlighting the
need for better communicationand engagement strategies.
(15:40):
Despite these challenges, thereare promising efforts underway
to improve diversity in clinicaltrials.
In my work in thebiopharmaceutical industry,
there has been an introductionof guidelines to increase
representation ofunderrepresented groups.
For example, the FDA'sdiversity action plans now
require researchers to outlinestrategies to ensure that trial
(16:02):
participants reflect thedemographics of the intended
user population.
During the COVID-19 pandemic,for example, companies like
Pfizer and Moderna took steps toincrease diverse enrollment by
partnering with historicallyBlack colleges and universities
or HBCUs and communityorganizations, and so this
helped to build some trust anddemonstrated a commitment to
(16:22):
equity, ultimately leading tobetter data on vaccine efficacy
across different racial andethnic groups.
Another noteworthy initiativeis the Equitable Breakthroughs
in Medicine Development, whichis led by PhRMA.
This program collaborates withcommunity health centers serving
predominantly low-income andracially diverse populations,
(16:44):
making clinical trials moreaccessible and ensuring that the
gathered data better representsthe broader population.
So there are a number ofimplications of inadequate
representation, so let's talkabout the consequences of
underrepresentation in clinicaltrials, which is far-reaching.
When certain groups are notadequately included, it can lead
to disparities in treatmentoutcomes and access.
(17:06):
So let's consider a fewreal-world examples.
Recently, there was a drugapproved for Alzheimer's and it
was priced at about $26,500 ayear, although this was covered
by Medicare.
Many older Black and Hispanicadults, who experience higher
rates of dementia and have loweraverage incomes, face
significant out-of-pocket costs.
This is a financial barrierthat highlights a broader issue
(17:29):
of equity and access tolife-saving treatments, and it's
worth noting that the $26,500is a reduction from what was
double the price before it wasslashed in half to 26,500.
Then, when we think about genetherapies for sickle cell
disease, for example, acondition that
disproportionately affects Blackand Hispanic populations,
(17:49):
offered a one-time cure, but itcame with a price tag of over $2
million.
Without comprehensive coverageand financial assistance, these
groundbreaking treatments remainout of reach for many of the
people who need them most.
Obesity medications alsodemonstrate disparities in
access.
Although obesity rates arehigher among people of color,
limited coverage and high costsmake these treatments
(18:10):
inaccessible for many,perpetuating existing health
inequities.
Moreover, biases in clinicaldecision-making tools and
algorithms can exacerbate thesedisparities.
We've seen.
Algorithms that are trained ondata that lack diversity, yield
biased recommendations, and sothis can lead to a sub optimal
or even harmful treatmentdecisions for minority patients.
(18:32):
So, as we move toward inclusiveand equitable clinical trials,
what can be done to addressthese issues?
So let's talk about somestrategies that could make a
significant impact after a shortbreak.
Announcement (18:43):
Are you ready to make a difference in your
community?
In our Speak Out Advocacyseries, we're here to empower
you to use your voice for change.
Whether improving access tomental health care, reducing
stigma or shaping importantsocial policies, this series
provides the tools to create alasting impact.
If advocating for better care,breaking down barriers or
(19:04):
transforming mental healthservices speaks to your heart,
this is the perfect space tolearn and take action.
Do you have a topic you'repassionate about or need support
advocating for yourself orothers?
We'd love to hear from you.
Text the show to share yourthoughts.
Just check the details in theshow notes.
Together, let's build acommunity that fosters change.
(19:25):
Keep enjoying reframing themembrane.
Kapri (19:28):
One strategy is community engagement.
Building trust withhistorically marginalized
communities is essential.
Researchers can collaboratewith community leaders and
organizations to design studiesthat reflect the needs and
concerns of the population.
This approach helps ensure thatthe voices of those most
affected by health disparitiesare heard and valued.
Then there's policy reform.
(19:49):
So legislation like the Foodand Drug Omnibus Reform Act
requires clinical trials toinclude diversity action plans
setting a new standard foraccountability and research.
Such policies can be crucialfor addressing the historical
underrepresentation of certaingroups.
And expanded coverage isanother area where we could
improve.
So expanding Medicare andMedicaid coverage, for example
(20:13):
for new drugs and therapies, canhelp to mitigate some financial
barriers.
Ensuring that all patients,regardless of income, have
access to innovative treatmentsis a vital step toward health
equity In transparent datareporting.
Accurate and transparentreporting of demographic data in
clinical trials is necessary toaddress and assess progress and
(20:34):
hold researchers accountable.
By disaggregating data by race,ethnicity, gender and
socioeconomic status, we canidentify gaps and develop
targeted solutions.
So when we think about a pathforward, the journey toward
inclusive and equitable clinicaltrials is a challenging one,
but it's a journey we mustundertake.
Achieving diverserepresentation is not a checkbox
(20:55):
activity.
It's about conducting betterscience, improving patient
outcomes and creating ahealthcare system that works for
everyone.
So thank you for tuning in totoday's episode.
If you found this discussioninformative, please share with
your friends in your network,leave us a review and follow our
podcast.
In our next episode, we'regoing to dive more into the
topics of trauma-informed care,the art of reframing and letting
(21:19):
go, and implications for mentalhealth treatment across
different communities.
Don't forget to subscribe andfollow and join our
conversations by texting theshow.
Let's keep crossing boundariesand reframing the way we think
about health, equity and theworld around us.
Until next time, good people,be well, stay safe.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
The Breakfast Club
The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy, Jess Hilarious, And Charlamagne Tha God!
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.