Statement of principles. Epidemiology and minority populations

Diversity and Political Leaning: Considerations for Epidemiology

The positive effects of increased diversity and inclusion in scientific research and practice are well documented. In this issue, DeVilbiss et al. (Am J Epidemiol. 2020;189(10):998-1010) present findings from a survey used to collect information to characterize diversity among epidemiologists and perceptions of inclusion in the epidemiologic profession. They capture identity across a range of personal characteristics, including race, gender, socioeconomic background, sexual orientation, religion, and political leaning. In this commentary, we assert that the inclusion of political leaning as an axis of identity alongside the others undermines the larger project of promoting diversity and inclusion in the profession and is symptomatic of the movement for "ideological diversity" in higher education. We identify why political leaning is not an appropriate metric of diversity and detail why prioritizing ideological diversity counterintuitively can work against equity building initiatives. As an alternative to ideological diversity, we propose that epidemiologists take up an existing framework for research and practice that centers the voices and perspectives of historically marginalized populations in epidemiologic work.

Lessons learned from a decade of focused recruitment and training to develop minority public health professionals

From 1999 to 2009, the Eliminating Health Disparities Pre-doctoral Fellowship Program provided specialized education and mentoring to African American graduate students in public health. Fellows received a public health degree, coursework in understanding and eliminating health disparities, experiential learning, mentored research, and professional network building with African American role models. We describe successful strategies for recruiting and training fellows and make 5 recommendations for those seeking to increase workforce diversity in public health: (1) build a community of minority students, not a string of individual recruits; (2) reward mentoring; (3) provide a diverse set of role models and mentors; (4) dedicate staffing to assure a student-centered approach; and, (5) commit to training students with varying levels of academic refinement.

The training of epidemiologists and diversity in epidemiology: findings from the 2006 Congress of Epidemiology survey

PURPOSE

In the past decade, we have witnessed increasing numbers of individuals entering the field of epidemiology. With the increase also has come a diversity of training and paths by which individuals entered the field. The purpose of this survey was characterization of the epidemiology workforce, its job diversity, and continuing education needs.

METHODS

The Minority Affairs and Membership committees of the American College of Epidemiology (ACE) prepared and administered a workforce survey to identify racial/ethnic diversity, demographic background, workplace type, credentials, income, subspecialties, and continuing education needs of epidemiologists. The survey was self-administered to attendees of the Second North American Congress of Epidemiology in June 2006.

RESULTS

A sample of 397 respondents of the 1348 registered for the Congress was captured (29.5% response). Epidemiologists who participated were from 36 states and 18 countries; 54.6% were trained at the doctoral level; 19.1% earned $120,001 or more a year. A wide range of epidemiology subspecialties and continuing education needs were identified.

CONCLUSIONS

This preliminary snapshot of epidemiologists indicates a wide range of training mechanisms, workplace sites, and subspecialties. Results indicate a need for examination of the core graduate training needs of epidemiologist as well as responding to desired professional development needs through the provision of continuing education efforts.

Achieving healthy weight in African-American communities: research perspectives and priorities

The longstanding high burden of obesity in African-American women and the more recent, steeper than average rise in obesity prevalence among African-American children constitute a mandate for an increased focus on obesity prevention and treatment research in African-American communities. The African-American Collaborative Obesity Research Network (AACORN) was formed to stimulate and support greater participation in framing and implementing the obesity research agenda by investigators who have both social and cultural grounding in African-American life experiences and obesity-related scientific expertise. AACORN's examination of obesity research agenda issues began in 2003 in conjunction with the Think Tank on Enhancing Obesity Research at the National Heart, Lung, and Blood Institute (NHLBI). The assessment was subsequently expanded to take into account the overall NIH strategic plan for obesity research, literature reviews, and descriptions of ongoing studies. In identifying priorities, AACORN members considered the quality, quantity, focus, and contextual relevance of published research relevant to obesity prevention and treatment in African-American adults or children. Fifteen recommended research priorities are presented in five categories adapted from the NHLBI Think Tank proceedings: health effects, social and environmental context, prevention and treatment, research methods, and research training and funding. These recommendations from an African-American perspective build on and reinforce certain aspects of the NHLBI and overall NIH research agendas by providing more specific rationale and directions on areas for enhancement in the type of research being done or in the conceptualization and implementation of that research.

Improving the validity and generalizability of studies with underserved U.S. populations expanding the research paradigm

The gap in cancer incidence and mortality between ethnic minority groups and European Americans in the U.S. is significant and growing. Compared with a drop in incidence and mortality rates in the U.S. since 1992, the rates for ethnic minority groups have increased or stayed the same. A major transformation in the predominantly deductive social and behavioral research paradigm in cancer is required to reduce these disparities in cancer outcomes and improve the quality of life for ethnic minority populations with cancer. This article highlights the fundamental changes that are required to transform the prevalent paradigm for social and behavioral research in cancer care from a monocultural, Eurocentric framework to a multicultural one. Use of the expanded framework would enhance the scientific rigor, validity, generalizability, applicability, and acceptability of multicultural behavioral research. The strategies developed from such research would have a greater likelihood of success in providing optimal cancer care for underserved populations and reduce the disparities in cancer outcomes between U.S. ethnic minority populations and the white population. Examples from the cancer literature are used to illustrate each of the seven steps of the expanded paradigm.

A partnership study of PCBs and the health of Mohawk youth: lessons from our past and guidelines for our future

This paper describes a research partnership between the people of Akwesasne and researchers from the State University of New York at Albany for the study of polychlorinated biphenyls and the health of Mohawk youth. The study is distinctive because its goals have been set by the scientists and the community members and is being conducted jointly by these groups. The research partnership recognizes the history of relationships between native and nonnative peoples, particularly scientists, and seeks not only to fulfill certain scientific goals but to further community ones as well. The relationship is based on three principles: mutual respect, mutual equity, and mutual empowerment. These principles guided every aspect of the research process. The project goals were determined jointly to maximize data quality and minimize the intrusion of research activities into the lives of community members. Data collection is performed by research assistants who received extensive and ongoing training in data collection methods, and who are members of the community. Feedback procedures were designed by community members and scientists jointly to maximize understanding. Feedback regarding individuals' pollutant levels and assessments of growth and development are provided to each individual. Information about community pollutant levels are provided to the community. Hypothesis testing is carried out by research scientists, and the results presented first at a community meeting. Research conducted in this way--as a partnership--requires more communication, discussion, and travel, but the result is mutual satisfaction and growth.