National Institute of Health Establishes UNITE Initiative to Combat Structural Racism

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The National Institute of Health (NIH) has announced a new initiative to address structural racism – the UNITE Initiative.

“With representation from across the NIH Institutes and Centers, UNITE aims to establish an equitable and civil culture within the biomedical research enterprise and reduce barriers to racial equity in the biomedical research workforce,” according to the NIH website.

NIH hopes that this initiative will help address racism and discrimination that has impacted healthcare throughout history.

“Historical racism has led to the marginalization and oppression of Indigenous peoples, African Americans, Latinos, and other communities of color. … Structural racism has resulted in persistent health disparities, poor health status, and premature mortality as demonstrated by the current disproportionate burden of morbidity and mortality from COVID-19. Within the biomedical research enterprise, structural and institutional racism has resulted in inequitable access to funding, training, and workforce opportunities,” according to the NIH website.

The UNITE initiative will help Latinos and other people of color in multiple ways, such as providing more research on minority health and health disparities and improving workforce diversity so that Latino healthcare workers can thrive at NIH.

What is the UNITE Initiative?

The UNITE initiative comprises five committees focused on addressing structural racism and promoting racial equity.

The five committees are the following:

• U — Understanding stakeholder experiences through listening and learning
• N — New research on health disparities, minority health, and health equity
• I — Improving the NIH culture and structure for equity, inclusion, and excellence
• T — Transparency, communication, and accountability with our internal and external stakeholders
• E — Extramural research ecosystem: changing policy, culture, and structure to promote workforce diversity

Each committee has about 15 members, all of which are experts who work across the 27 different institutes and centers at NIH.

These committees will work individually and together to advise NIH leadership on how to create an equitable culture.

“To reach this goal, UNITE is facilitating research to identify opportunities, make recommendations, and develop and implement strategies to increase inclusivity and diversity in science. These efforts will bolster the NIH’s effort to continue to strive for diversity within the scientific workforce and racial equity on the NIH campus and within the extramural community,” according to the NIH website.

As NIH is a federal institution, the UNITE initiative is in line with the Biden administration’s commitment to addressing racial equity.

“NIH’s efforts are consistent with President Joe Biden’s Executive Order on Advancing Racial Equity and Support for Underserved Communities and is part of an overall effort by the Department of Health and Human Services to respond to the EO to improve equity, diversity, and inclusion in the federal workplace,” according to the NIH website.

How Systemic Racism in Healthcare Impacts Latinos

Because NIH is one of the largest biomedical research centers in the world, the UNITE Initiative will have a large impact on Latinos and other people of color living in the U.S., including the thousands of doctors and patients at the institute.

The initiative is working to address systemic racism in healthcare, which unfortunately affects many Latinos.

For example, racism and bias in the doctor’s office can affect Latinos.

Many studies have shown that physicians have implicit, subconscious preferences for white patients over patients of color.

Some ways that Latinos experience implicit bias are:

• Latino men are less likely to receive treatment for high-risk prostate cancer than white men.
• Latinas and other pregnant women of color face discrimination from healthcare providers. This is due not only due to their race, but also their socioeconomic status.
• White male doctors are less likely to prescribe pain medications to black patients than white patients.
• People of color who visit an emergency room in the U.S. are less likely to receive prescriptions for certain medications than white people.

Not only do Latino patients experience racism and bias, but so do Latino doctors.

More than 40% of Latino and Black resident physicians experience racial discrimination and bias from the patients they serve, according to a study published in JAMA Network Open.

The study also found that 84% of resident physicians do not report these biased and discriminatory instances, indicating a lack of resources or trust from doctors of color in their institutional leadership.

Another instance of systemic racism in healthcare is the lack of diversity and representation of Latinos and other people of color in clinical trials and research.

Although Latinos represent 18.5% of the U.S. population, they make up less than 10% of participants in federal cancer clinical trials and fewer than 4% of FDA drug trials. This is one of the aspects of the UNITE initiative – to increase research on health equity and minority health.

Thankfully, Dr. Ramirez’s Salud America! program at UT Health San Antonio is creating Latino-focused recruitment strategies and systems for cancer and Alzheimer’s clinical trials. This work is supported by a grant from Genentech, a member of the Roche Group.

“Our new project will allow us to use culturally relevant digital health communications, advocacy networks, and clinical partnerships to promote health equity and advance clinical trials for cancer treatment and Alzheimer’s disease among Latinos,” she said.

How Else Can We Help Latinos?

Systemic racism and bias continue to hurt Latinos in healthcare. But we can help make a difference.

One way is through examining our own biases.

Download the free Salud America! “Find Out If You Have Implicit Bias and What to Do Next” Action Pack. This will guide you to see if you have implicit bias, reflect and learn from others who have overcome their own implicit bias, and encourage others to learn about implicit bias, too.

Another way we can address system racism is by asking our city to declare racism a public health crisis.

Download the free Salud America! “Get Your City to Declare Racism a Public Health Crisis Action Pack”!

The Action Pack will help you gain feedback from local social justice groups and advocates of color. It will also help you start a conversation with city leaders for a resolution to declare racism a public health issue along with a commitment to take action to change policies and practices. It will also help build local support.

GET THE ACTION PACK!