Within the next 20 years, racial and ethnic minorities will make up more than half of the U.S. population. More diversity calls for a greater commitment by everyone to equity and inclusion in all areas of life. This is especially important in health care.
The field of dermatology is grappling with a lack of diversity in several ways. Researchers need more people of color in clinical studies so their data is accurate. Dermatology students and professionals need more inclusive educational resources so they can better treat people in these groups.
How does this impact the study and treatment of a condition like plaque psoriasis? And how are those who work in dermatology aiming for change?
How Does Psoriasis Education and Research Underrepresent Minorities?
Researchers carry out clinical trials to find out if medicines, vaccines, or devices are safe and work well. It makes sense for those who take part in clinical trials to reflect the people who go on to use the products that researchers are studying. But this doesn’t always happen.
Many times, people from diverse racial and ethnic groups are poorly represented in clinical studies. This includes research on psoriasis.
The reasons for these differences are complex. Minority groups may need more education about clinical trials. Some people from these groups could have language barriers or live too far from study sites. A high number of people of color, especially people who are Black or Hispanic, say they distrust medical research. And many may simply not know that research studies are happening.
On top of that, there’s often a lack of diversity among both dermatology health professionals and researchers. While Black and Latino people represent 12% and 16% of the U.S. population, they make up only 3% and 4% of dermatologists. Dermatology is currently one of the least diverse medical fields.
Researchers of all races and ethnicities can capably carry out clinical trials. But, “There’s a better sense of trust … when potential study participants see a more diverse research workforce that includes people who look like them,” says Junko Takeshita, MD, an assistant professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine.
Until recently, psoriasis images and descriptions have mainly featured lighter skin. One reason for this is that doctors diagnose fewer people of color with psoriasis. This is despite the fact that the actual numbers of nonwhite people living with the condition are likely higher.
Why Is Diversity Important in Psoriasis Education and Research?
Your genetic ancestry or biological background plays a vital role in clinical research. It can impact how you react to a specific medicine, how your body breaks it down, and side effects.
More diversity in clinical studies helps doctors, researchers, and people living with psoriasis to better understand these differences. You can learn if a particular treatment is safe, works well, and its possible effects on your quality of life – no matter your racial or ethnic background. In the long run, diversity in research improves the quality of health care for everyone.
Diversity in psoriasis education means several things. It includes talking about the differences in treating skin of color and the impact psoriasis can have on racial and ethnic minorities. One of the most important things is including a broader range of skin tones in learning materials.
Andrew Alexis, MD, is a clinical dermatologist with Weill Cornell Medicine in New York City and president of the Skin of Color Society. He says that when health care providers have access to learning materials that show how psoriasis looks in people of color, they’re better able to make the right diagnosis and to treat it in a nuanced way whenever possible.
These nuances can include treating scalp psoriasis in Black women with awareness of their unique hair texture and styling needs. Another area of cultural concern is that of skin tanning while using phototherapy.
How Is the Dermatology Community Advancing Diversity and Inclusion?
The dermatology community has started to understand the need for racial diversity in clinical trials and education. Today, there are more educational programs, books, online resources, and conferences focused on skin of color. These resources help dermatology professionals to better diagnose and treat people across the spectrum of skin tones. Researchers are also engaging with communities of color to raise awareness about clinical trials.
More universities, hospitals, and private practices are opening skin of color clinics. The goal is to address gaps in dermatology care and the unique needs of people of color.
Takeshita views these clinics as a step in the right direction, but says, “We need to be careful that taking care of individuals who have darker skin tones doesn’t become a specialty within a specialty. Instead, it needs to be the norm that all dermatologists are able to diagnose and treat skin diseases across all skin tones.”
Show Sources
Photo Credit: KTSDesign / SCIENCEPHOTOLIBRARY / Getty Images
SOURCES:
Andrew Alexis, MD, clinical dermatologist, Weill Cornell Medicine, New York City.
Junko Takeshita, MD, PhD, assistant professor of dermatology and epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
American Journal of Clinical Dermatology: “Psoriasis in Skin of Color: Insights into the Epidemiology, Clinical Presentation, Genetics, Quality-of-Life Impact, and Treatment of Psoriasis in Non-White Racial/Ethnic Groups.”
FDA: “Clinical Trial Diversity.”
JAMA Dermatology: “Suggestions for Increasing Diversity in Clinical Trials.”
International Journal of Women’s Dermatology: “Embracing diversity in dermatology: Creation of a culture of equity and inclusion in dermatology.”
Skin of Color Society: “Psoriasis in Patients of Color.”
American Journal of Public Health: “Racial/Ethnic Differences in Physician Distrust in the United States.”
