Many Medications Don’t Work for People of Color and This is Why
When we think of racism in healthcare we often initially gravitate towards the interpersonal relationships of providers and patients. We discuss provider bias when prescribing medications and the lack of communicating information in ways that patients fully understand when, how and why they are taking what they are taking.
Despite these encounters full trust is given to the doctor’s when a medication is prescribed because a pill does not hold these racial bias’. Right? Wrong. There is major inequity even in the way that these pills are created.
Black and Brown people have often been a part of foundationless, manipulative and unscientific experiments mostly to support the concept of eugenics, but we see huge gaps in research that actually supports the wellness of these groups.
96% of modern genetic research has been done on White people. Meaning the foundation of where we even understand the human genome comes from a small portion of the population. We use genetics as the basis to understanding disease and use this understanding to create medications to prevent disease from worsening.
Once a drug reaches the trial phase we continue to see inequities in the underrepresentation of people of color. Although Latino and Black people make up 30% of the U.S. population, they only comprise of 6% of clinical trial participants and less than 2% of clinical trials have been done on Asian people since the year 1993. Therefore, we are essentially using a one size fits all approach when it comes to our understanding of the effectiveness of prescribed medications. We survey a few and expect that the methods help all, when in actuality it only supports that few. You can clearly see the effects of this one size fits all model in the example of asthma.
Uncontrolled asthma largely affects African American and Latino youth. In urban classrooms across America you can hear the murmurs of wheezing as the teacher instructs the class. In fact, African Americans are 3 times more likely to die from asthma than their White counterparts. Albuterol, a medication that increases airflow in the lungs, is often prescribed for its low cost and accessibility. Although the burden of the diseases mostly impacts people of color, 50% of African Americans in the first round of albuterol do not respond to the treatment. This number is an astonishing 67% in Puerto Ricans and only 20% in White people.
A few years ago the State Attorney General of Hawaii had to sue Plavix, a medication that prevents platelets in your blood from sticking together, because the medication was not effective in his people. And it was not effective because 75% of the population carry a genetic trait that makes them poor responders to this blood thinner.
Who your ancestors are effects your response to medications.
There have been big pushes to increase research in various ethnic and racial backgrounds recently spearheaded by the Obama administration and the National Institute of Health, naming this a priority area. But we may not see the effects of this in at least 15–20 years based on the FDA and big pharma processes.