health insurance. However, access to quality health care for these populations may also be affected by the diversity of the healthcare and clinical research workforce (NIH, 1994; Corbie-Smith et al., 1999; Giuliano et al., 2000; Killien et al., 2000; Gifford et al., 2002).

Gender adds yet another dimension to an already complex problem. Since the establishment of the Office of Research on Women’s Health at the National Institutes of Health, a tremendous amount of information has been gained. In biomedical research, gender is clearly a critical factor in understanding human health (IOM, 2001a). Minority women and white women experience different rates of disease. Among Hispanic and Vietnamese American women, cervical cancer rates are higher. African American women are also less likely to survive breast cancer, although they are less likely than others to develop it (Haynes, 1999).

Women are critical to clinical research not only as participants in clinical trials but also as researchers. A driving factor in the need to recruit women into the clinical research workforce is that they are likely to be the majority of M.D. recipients in the future and therefore the pool from which researchers must be drawn. In the past few decades the number of M.D.s awarded to women has steadily increased; in 2003 females accounted for almost 50 percent of medical school enrollment (AAMC, 2003). In the basic sciences women currently receive half of the bachelor’s degrees issued in the biological sciences and over 40 percent of the Ph.D.s (NSF, 2004), and the trend is toward continued increases in their proportions of these degrees.

Clearly then, women and underrepresented minorities are crucial to replenishing the clinical research workforce. A diverse workforce in the sciences leads to many benefits—among others, a wide diversity of perspectives leading to better opportunities for scientific advancement, and a potentially intensified focus on understanding and eradicating health disparities among different ethnic and racial groups (Crowley et al., 2004). Research indicates that cultural differences are often at the core of miscommunication and dissatisfaction in the physician–patient relationship; culture also can significantly influence patient health outcomes (Anderson, 1995; Airhihenbuwa et al., 1996; Berger, 1998; Hunt et al., 1998). Moreover, diverse teams can outperform homogeneous ones (Lippman, 2000; Sessa and Taylor, 2000). Managers who are exposed to professionally and culturally diverse colleagues cultivate new ideas by drawing on a larger pool of information and experiences.



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