The unprecedented speed of development of the Covid-19 vaccines has raised serious questions about the representativeness of their clinical trial participant pools.

Indeed, many of the more prominent vaccine trials failed to recruit racial and ethnic minorities at levels that would be representative of the wider US population. This phenomenon is nothing new, as for much of recent history minority groups have been significantly underrepresented in medical research studies.

This project examined the underrepresentation of racial and ethnic minority groups in American medical research through the lens of the socio-medical theory known as the social determinants of health. In doing so, it analyzed causal factors at each level of the socioecological model via literature reviews of institutional practices, research methodologies, epidemiological studies, and researcher and research participant qualitative interviews.

Several factors were determined to contribute to the noted disparities including racially biased study inclusion methodologies, prejudiced and inaccurate beliefs on behalf of research coordinators, overly discretionary National Institutes of Health (NIH) research policies, and psychosocial barriers prevalent in otherwise eligible minority groups. The resulting lack of representation of minority groups in clinical trials was further shown to have direct consequences on the short- and long-term health outcomes for underrepresented racial and ethnic groups.

In light of these findings, this project advocates for a reframing of the issue of underrepresentation of minorities in medical research away from a policy focused perspective towards a more interdisciplinary approach that incorporates social theory as to better identify and target upstream causal factors.

Nicholas Chen would like to thank Ajlina Karamehic-Muratovic for her support on this project and her years of indispensable guidance and mentoring.