Director’s Corner

Oct. 29, 2020: NCATS’ commitment to community engagement contributes to reducing COVID-19 health disparities

Christopher Austin

The stark disparities in COVID-19 occurrence and death among racial and ethnic populations in our country have been one of the most painful aspects of the pandemic: African Americans, Hispanics/Latinos, and American Indians/Alaska Natives are contracting and dying from COVID-19 at rates more than double those of white and Asian American populations. Although the reasons are complex and under intense study, the immediate imperative is to do everything we can to reduce these disparities in the prevention, diagnosis and treatment of COVID-19.

While we must proactively consider diversity and inclusion of affected populations and communities in our research protocols and design, the opportunity for patients and communities to be included is not enough. As in any relationship, the fundamental ingredient is trust. Trust in medical research historically has been broken in many minority communities, and its restoration requires persistent commitment and the establishment of a track record of inclusion, respecting community values, and aligning with their goals. This is a critical translational science challenge, of which a solution is necessary for the benefits of new interventions to reach all populations in need. For this reason, patient focus is a strategic principle of all NCATS programs, and engaging patients and communities in every phase of the translational process is a key Clinical and Translational Science Awards (CTSA) Program goal

The CTSA Program hubs across the country have long prioritized the development of strong community-engagement research programs and resources dedicated to building partnerships with community organizations and representatives, developing and sharing tools and resources to facilitate community engagement, educating researchers and communities, and engaging communities in the research process. These efforts have made the hubs trusted community partners and have enabled them to pivot rapidly to address COVID-19 health disparities. The hubs are connecting with underserved and vulnerable populations and are swiftly implementing strategies and interventions to reduce disparities and improve health outcomes for those who are disproportionately affected by the COVID-19 pandemic.

The just-launched NIH Community Engagement Alliance (CEAL) Against COVID-19 Disparities initiative is leveraging the CTSA Program hubs’ strong community partnerships and long-standing community-engaged research efforts in 11 states to facilitate the inclusion and participation of ethnic and racial minority communities  in COVID-19 vaccine and therapeutic clinical trials. At the same time, the NIH RADx Underserved Populations (RADx-UP) program is funding six CTSA Program hubs (Medical College of Wisconsin, The Ohio State University, The University of Utah, Rutgers Biomedical and Health Sciences, The University of Texas Health Science Center at Houston, and University of Kansas Medical Center) to gain a better understanding of, and alleviate barriers to, COVID-19 testing and reduce the burden of the disease among underserved and vulnerable populations. My hope is that in addition to swiftly implementing strategies and interventions to increase access to and uptake of COVID-19 testing, clinical trial participation, and vaccination efforts, these efforts and the long-standing commitment to community engagement that made them possible will lead to lasting change in how translational research is conducted for all diseases.

Stay well,

Christopher P. Austin, M.D.
Director
National Center for Advancing Translational Sciences