Minority children: over- or underrepresented in medical research?

Despite efforts to include them in medical research, minority adults have historically been underrepresented. In a new study, however, published in the October issue of the journal Pediatrics, researchers from the University of Chicago show that African American children are overrepresented in research, including clinical trials. White and Hispanic children are underrepresented.

Although African Americans have less access to health care in general, "our data suggest that black children do have fair access to the potential benefits of clinical trials," note the authors.

"Hispanic children may not," added co-author Lainie Ross, M.D., Ph.D., associate professor of pediatrics and assistant director of the McLean Center for Clinical Medical Ethics at the University of Chicago, "but that may reflect language barriers and how race and ethnicity data are reported. We are currently trying to tease this out in a follow up study."

Twenty-five years ago, the primary concern of organizations that oversee human research was fairness in the distribution of risk. More recently, the pendulum has swung toward fairness in the distribution of benefits, with the chance to participate in clinical trials seen as a substantial benefit. Clinical trials, especially phase III trials, sometimes offer the best chance of therapeutic success.

For many years, children were "protected" from those benefits. A 1977 report recommended that research be done first on animals, then adults and only afterward on children. Since 1998, however, the National Institutes of Health have required researchers they fund to include children earlier in the process.

To measure minority participation, Ross and Catherine Walsh, a medical student at the University of Chicago, combed through all the full-length articles in the three main pediatric research journals (Pediatrics, Journal of Pediatrics, and Archives of Pediatrics and Adolescent Medicine) from July 1999 through

Contact: John Easton
University of Chicago Medical Center

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