‘Our voices are not heard.’ How Latinos are underrepresented in biomedical research

The Latino community represents about 19% of the population in the United States, but less than 5% of participants in clinical trials are Latino, according to a National Institute of Health (NIH) report.

“Even though we are 19% of the current total population, we need to understand that the fastest growing part of kids are Hispanic kids,” Dr. Ilan Shapiro from AltaMed Health Services said. 

According to the data from the All of Usprogram that is part of NIH, heart disease is more common among Latinos than past studies showed, affecting 42.7% of Latina women and 52.3% of Latino men. Also, the CDC states that the Latino community is 50% more likely to develop prediabetes and diabetes type 2 at a young age. 

Dr. Shapiro discussed with CALÓ News how the Latino community is underrepresented in biomedical research. He said that the people who usually show up to clinical trials are not the underrepresented communities taking part in research. “What ends up happening, well, our voices are not heard,” he said.

“We saw what happened during COVID-19 where our community was out in the fields, making sure that the services were still working. That's the connection that I want to amplify, that we are a crucial part of the community and, actually, the economy and the health of our entire country. So it’s important that we emphasize these services and, most importantly, preventive services,” Dr. Shapiro said.

Dr. Shapiro is a practicing community pediatrician who is working as chief health correspondent and medical affairs officer at AltaMed Health Services. He said the most crucial health topics in the Latino community are anxiety, depression, diabetes, high blood pressure and heart problems. “It's quite shocking that we sadly suffer from them,” he said.

An analysis published in the Journal of the American Heart Association in 2020 found that Hispanic people made up just 11% of clinical trial participants for cardiometabolic medications seeking Food and Drug Administration approval from 2008 to 2017. Participating in clinical studies can help determine if new treatments work well with Latino individuals. That's why it’s crucial for the Latino community to be more involved in clinical trials, according to Dr. Shapiro.

“At the moment, we have all these barriers around our community. First of all, we have never been invited. And after that, there's other barriers, like making sure that, you know, we make time to get there because usually our family is working or doing a lot of other things,” Dr. Shapiro said. “A lot of the time research sounds weird to our community, and it can bring [up] a lot of sentiments.”

That’s the reason why National Minority Health Month was created, to increase research within the community and reduce premature deaths and preventable illness in minority populations.

It is an inclusive initiative that addresses the health needs of people of color during the month of April to raise awareness and provide help on prevention, early detection and control of disease complications in minority populations, including the Latino community.

For Dr. Shapiro, National Minority Health Month is important for Latinos. “We have different flavors, different places that we're coming from, and especially as Hispanos, we come from different places even in Mexico. You know, it's very different if you come from the south, the center or a big city. The same thing happens all over, so recognizing that we have a language and also the cultural aspect of it is extremely important.Then celebrating that diversity, and especially understanding that, is what actually amplifies the way that we appreciate health. It's an amazing connection,” he said.

In addition to being a practicing physician, Dr. Shapiro is actively involved in creating binational public health programs to reach Hispanic communities on both sides of the border. He acted as the Medical Advisor for the General Consulate of Mexico in Chicago and was a member of the Editorial Board for A Tu Salud (For Your Health), a health bulletin representing Hispanic health topics and resources. Dr. Shapiro is part of the National Hispanic Medical Association and a spokesperson for the American Academy of Pediatrics.

Dr. Shapiro earned a medical degree from Anahuac University in Mexico, and had the opportunity to practice medicine in several main hospitals in Mexico and has been serving in federally qualified health clinics in Chicago, Fort Myers, Florida and Los Angeles.

He has also been supporting the All of Us Research Program through his work with the National Hispanic Medical Association. The mission of the program is simple: to speed up health research.They're doing this by reaching out directly to groups that have been historically underrepresented in biomedical research. 

AltaMed Health Services is a federally qualified community health company, with health centers in Los Angeles and Orange county. AltaMed serves people regardless of their ability to pay. About 80% of AltaMed’s patient demographic is Latino and on Medi-Cal.

Since April is also Stress Awareness Month, Dr. Shapiro shared with CALÓ News how the Latino community is affected by stress every day, not just physically but also emotionally and mentally. “Right now, as parents, as family members, as grandparents, and as people who take care of other children, we want them to have a better future. So, that’s an ongoing stressor. So right now, there's a lot of mental health aspects that we need to cater to,” he said. He also added a couple of other stressors that the Latino community often suffers from, which are worrying about good eating habits, weight control, health care coverage and being financially stable.

“At the moment, we need to participate more and be a part of research because those are the changing factors. If we participate more, we are going to be more represented, and we will actually have more resources and opportunities to have a healthier life,” Dr. Shapiro said.