Health disparities in allergic and immunologic conditions in racial and ethnic underserved populations: A Work Group Report of the AAAAI Committee on the Underserved.

Health disparities are health differences linked with economic, social, and environmental disadvantage. They adversely affect groups that have systematically experienced greater social or economic obstacles to health. Renewed efforts are needed to reduced health disparities in the United States, highlighted by the disparate impact on racial minorities during the coronavirus pandemic. Institutional or systemic patterns of racism are promoted and legitimated through accepted societal standards, and organizational processes within the field of medicine, and contribute to health disparities. Herein, we review current evidence regarding health disparities in allergic rhinitis, asthma, atopic dermatitis, food allergy, drug allergy, and primary immune deficiency disease in racial and ethnic underserved populations. Best practices to address these disparities involve addressing social determinants of health and adopting policies to improve access to specialty care and treatment for the underserved through telemedicine and community partnerships, cross-cultural provider training to reduce implicit bias, inclusion of underserved patients in research, implementation of culturally competent patient education, and recruitment and training of health care providers from underserved communities. Addressing health disparities requires a multilevel approach involving patients, health providers, local agencies, professional societies, and national governmental agencies.

The project IMPACT experience to date: increasing minority participation and awareness of clinical trials.

OBJECTIVE: This study evaluated activities of Project IMPACT (Increase Minority Participation and Awareness of Clinical Trials), a National Medical Association (NMA) project chartered to identify ways to increase minority physician and patient involvement in clinical trials. Project IMPACT included physician education and training workshops, establishment of a physician-investigator database and other activities to facilitate minority-physician clinical trial participation. METHODS: A descriptive survey was used. The survey was distributed to 542 African-American physicians. Physicians were queried about prior involvement in clinical research, barriers and facilitators to clinical trial participation by patients and physicians, and perceptions regarding Project IMPACT. RESULTS: Two-hundred physicians responded to the survey. Common practice characteristics were self-employment (51%), solo practice (39%) and office based (58%). Prior involvement in clinical trials was generally low. Barriers to participation included lack of awareness of clinical trial opportunities and lack of resources to conduct clinical trials. However, most respondents had referred patients to clinical trials. Project IMPACT participants who responded were highly satisfied with the project. CONCLUSIONS: Minority physicians are interested in participating in clinical trials. However, multiple barriers, including lack of awareness and lack of access to clinical research coordinators, continue to exist and must be addressed. Clinical trials training programs alone are not enough.