临床试验参与者非裔仅占8%，美国医学种族主义令少数族裔对医疗系统失去信任

Mistrust in U.S. medical system leads to lack of diversity in clinical trials

据雅虎新闻2月6日报道，美国在历史上实行“医学种族主义”的做法使得少数族裔不信任现有医疗体系，导致临床试验少数族裔样本不足。研究显示，占美国总人口13%的非裔仅占临床试验参与者的8%。此外，美国医疗卫生系统仍存在种族歧视，一些医生称，少数族裔很难获得参与临床试验的机会。

For decades, racial and ethnic minorities have been underrepresented in clinical trials even though they are disproportionately affected by several health issues such as diabetes and hypertension. According to the Robert A. Winn Diversity in Clinical Trials Award Program, 80% of individuals involved in clinical trials are white, compared to 58% in the U.S. population as a whole, which negatively affects the care that people of color receive.

几十年来，尽管美国少数族裔受糖尿病和高血压等多种健康问题的影响尤为严重，但他们在临床试验中的代表性仍不足。根据罗伯特·A·韦恩临床试验多样性奖励计划，参与临床试验的80%是白人，而白人在美国整体人口中占比为58%，这对有色人种接受治疗产生了不利影响。

“If you look nationally, the number of folk of color [in clinical trials] are minuscule,” said Dr. Robert Winn, director of the Virginia Commonwealth University Massey Cancer Center, to Yahoo News.

弗吉尼亚联邦大学梅西癌症中心主任罗伯特·韦恩博士告诉雅虎新闻：“如果在全美范围内看，（临床试验中）有色人种的数量是很少的。”

Studies estimate that Black Americans make up about 8% of participants in clinical trials but represent 13% of the U.S. population, and Hispanics account for 11% in trials, even though they are 16% of the national population.

研究估计，占美国总人口13%的非裔约占临床试验参与者的8%，占美国总人口16%的西班牙裔在临床试验中占11%。

“Not having that diversity in clinical trials prevents us from having information that can inform both patients, caregivers, and physicians around the appropriate medication that might be best for a particular patient,” Maria Apostolaros, a deputy vice president at PhRMA, a biopharmaceutical research company, told Yahoo News.

生物制药研究机构美国药品研究与制造商协会（PhRMA）副总裁玛丽亚·阿颇斯托拉罗斯表示：“临床试验缺乏种族多样性，我们就无法获得信息来告知患者、护理人员和医生可能最适合特定患者的药物。”

Experts say the lack of diversity in trials is due to “a mistrust of the medical system by many underrepresented minority populations in the United States, and there’s historical sort of events that have caused that,” John Damonti, the president of Bristol Myers Squibb Foundation, which focuses on health equity, told Yahoo News.

专注于健康公平的百时美施贵宝基金会主席约翰·达蒙蒂告诉雅虎新闻，专家表示，临床试验缺乏多样性是因为“美国许多未被充分代表的少数族裔对医疗系统的不信任。这种情况是由历史原因导致的”。

The most notable instance of medical racism occurred in 1932 when doctors from the United States Public Health Service embarked on the Tuskegee Syphilis Study in which hundreds of Black men were used as subjects for experimentation and research.

1932年，美国公共卫生署的医生开始了塔斯基吉梅毒研究，引发了臭名昭著的医学种族主义事件，在这项研究中数百名黑人男性被当做实验体和研究对象。

“Tuskegee is just one really terrible example but there have been so many examples of these kinds of abuses and clinical research throughout the years, especially here in the United States,” Dr. Joshua Budhu, a neurologist at Memorial Sloan Kettering Cancer Center in New York City, told Yahoo News.

纽约斯隆·凯特琳癌症中心的神经学家约书亚·布杜博士说告诉雅虎新闻：“塔斯基吉梅毒只是多年来众多骇人听闻的种族主义虐待和临床研究案例之一，尤其在美国还有很多。”

“Now that we are creating therapies and creating trials that would also benefit people of color, we still have this leftover mistrust,” Winn said.

韦恩说： “现在我们研究的治疗方法、进行的临床试验也会使有色人种受益，但不信任仍然存在”。

For racial and ethnic minorities discrimination in health care is a problem that still plagues our society today. Over 40% of African American, Native American and Latinos have experienced unfair treatment in the medical field, according to a 2021 study by the Brookings Institute.

对于少数族裔来说，医疗卫生系统的种族歧视是一个仍然困扰着美国社会的问题。根据布鲁金斯学会2021年的一项研究，超过40%的非裔美国人、美洲原住民和拉美裔美国人在医疗系统遭受过不公平待遇。

Along with a lack of trust, doctors say minorities have trouble getting access to clinical trials. “We’re actually depriving people of first-line therapy,” Budhu said. “One other kind of practical point about why clinical trial diversity is important is that it actually saves lots of money.”

除了缺乏信任，医生们表示少数族裔很难获得临床试验。布杜说：“我们实际上是在剥夺人们接受一线治疗的机会。另一种观点认为，临床试验多样性很重要，是因为实际上这样可以节省很多钱。”

A 2022 University of Southern California study found that clinical trials save lives and money. “Health disparities in general cost trillions of dollars, but just by improving clinical trial diversity, which helps to decrease health disparities, it will actually save billions of dollars,” Budhu said.

2022年南加州大学的一项研究发现，临床试验可以挽救生命和节省金钱。布杜说：“一般而言，医疗差距的缺口达数万亿美元，通过提高临床试验多样性有助于缩小医疗差距，实际上这样能节省数十亿美元的治疗费用。”

来源：雅虎新闻