Kapri: 0:44

Hello, good people and welcome. I'm your host, Kapri, and I hope you had a great week and that an even better weekend is in store for you. So today we'll explore how psychological science can play a crucial role in promoting racial equity. In today's episode, we're diving deep into how psychology the science of understanding human behavior and thought can help dismantle systemic barriers and foster equity. In 2021, the American Psychological Association, or APA, issued a public apology for perpetuating racial inequities. Even in the science itself, the field has long been complicit in systemic racism, sometimes providing evidence that upheld oppressive systems. However, psychology as a discipline has grown and evolved, and now we're at a turning point where psychological insights can actively be used to promote justice and equity. So today we'll unpack what that looks like in practice and why it matters. Let's start by acknowledging the context of this work. For psychology to support racial equity, it has to confront the ways it's been used to justify stereotypes and biases. Historically, this field has participated in the perpetuation, maintenance and reproduction of racial systems, but today, psychologists are more aware of the social impact of their work and, through that awareness, they're finding new ways to approach issues of bias and discrimination. So what does this even mean practically Well. By studying these processes scientifically, psychologists are able to identify patterns that contribute to discrimination and then create targeted interventions to disrupt them. It's like shining a light into the unconscious corners of our mind and addressing what we find.

Kapri: 2:26

A major area where psychological science is making strides in racial equity is in the workplace. Now let's think about that for a moment. Think about the workplace as an environment. Many of us are spending so much of our lives at work, and it is a key space for social interaction. It's also a key place for social systems and hierarchies. Psychological studies tell us that workplaces often reinforce the status quo because it's comfortable or familiar, but holding on to comfort often means leaving existing biases unchallenged. It also often means leaving some people behind. Here's where psychology can offer solutions.

Kapri: 3:03

Research shows that promoting equity in the workplace isn't just about checking off boxes on a diversity report or meeting quotas. It has real, tangible benefits and even though there are a lot of folks saying, oh, we want to get rid of all this woke stuff, including people and culture is always the right thing to do. For instance, studies published in the Academy of Management Proceedings revealed that teams with deep-level diversity which means differences in knowledge, skills, values are actually more creative and innovative. But here's the catch For this creativity to thrive, the environment must be inclusive and supportive. And I just want to caveat and say that when I talk about diversity, many people often think well, you just mean racial or ethnic diversity. Well, no, actually, what I mean is diversity of all things, whether it's race, ethnicity, gender orientation, neurodivergency, cognitive ability, any ability, people and culture having cultural competence to embrace people, create spaces and places where people feel that they belong and that these are truly genuine environments where we're all working together, regardless of our socioeconomic background, our race, the color of our skin, our hair, the way we look, the way we dress, what kind of cars we drive, creating environments that are inclusive and supportive. That is diversity at its center, at its core and at its true level. So, if we think about an example of deep level diversity in the workplace, think about a team that's in a brainstorming session. When everyone in the room has a similar background, the ideas that are generated often are limited and reflect a very narrow perspective. But when a team includes people from all walks of life, like I just described so that's racial, cultural, educational backgrounds, et cetera they bring new ideas and ways of thinking that others might not have considered. This is not a bad thing. This diversity has driven innovation. I've seen it firsthand in the corporations and spaces where I've worked, and it can also help a team develop unique, powerful solutions, but only if the environment encourages all voices to be heard and for people to be seen. This is where inclusive practices make a big difference. So let's pause for a moment. When we refer to inclusive practices, we're not simply discussing diversity training events that last a day or two.

Kapri: 5:22

My research and experience as an executive in Fortune 500 companies actually indicates that brief training sessions and mandates have not effectively combated deep-seated biases. These often performative sessions can backfire, potentially reinforcing the biases they aim to mitigate. So genuine inclusion necessitates structural changes, embedding equity into an organization's core and everyday practices. So what does meaningful, lasting change look like in an organization? In my experience, a key strategy is to engage leadership, especially managers, as active participants in promoting diversity, equity, inclusion and accessibility. When managers participate in initiatives like recruitment programs for diverse talent or mentoring relationships with employees, and including those from neurodivergent and underrepresented backgrounds, they start to see themselves as advocates. This isn't just theoretical. It's backed by psychological research showing that leaders who advocate for these causes can help create more inclusive productive teams. Also, creating spaces for meaningful interaction between all organizational groups can reduce bias. This approach is grounded in what is known as contact theory, and it's been popularized by a social psychologist, dr Susan Fisk. However, contact theory suggests that, under the right conditions, interaction between groups can reduce prejudice and promote empathy.

Kapri: 6:49

In a Fortune 500 company that I used to work in, where most senior executives and CEOs were white men, I had an opportunity to serve as the chief diversity, equity and inclusion officer and face the challenge of addressing the stark inequities that impacted not only my career trajectory but those of other employees and people of color. As a part of my role, I developed initiatives to increase workforce representation and foster authentic inclusion at all company levels. I drew from my experiences navigating corporate America, where race, gender and identity often intersected in complex ways, to shape the organization's inclusion and belonging strategy. Recognizing the limitations of traditional DEIA training, I decided to implement a new approach grounded in contact theory. The most impactful moments in my career came from meaningful, sustained interactions with colleagues from different racial and cultural backgrounds, not from one-off workshops or compliance-based mandated training. To achieve this, I introduced a program called Courageous Conversations where executives and middle management of diverse racial and cultural identities participated in a series of structured dialogue.

Kapri: 7:58

Over a year, I paired two employees both were high-level vice presidents or VPs One we'll call Joe, a white man who had been with the company for over 20 years, and Renra, a newly promoted black woman. During their first session, joe seemed skeptical and I couldn't help but notice the discomfort in his posture and tone. However, as they started to share their personal stories and professional journeys, something shifted. Rhaenyra spoke about the barriers she faced as a black woman in a predominantly white male industry, the microaggressions, the constant need to prove herself and the invisible load she carried daily. Joe listened intently. His skepticism gradually replaced by a quiet understanding. In the subsequent meetings, joe shared his own story a privileged upbringing where race was never a barrier but a shield. He spoke about his unconscious bias, which he had never fully confronted before, and Renea listened with empathy but did not let him off the hook. She challenged him with pointed questions, drawing connections between his experiences and the systemic issues that she faced.

Kapri: 8:59

Over time, the structured interactions that I facilitated became deeper and more genuine. Joe began to actively advocate for changes in hiring practices and mentorship programs, using his influence to open doors that had long been closed to executives like Rennera. He admitted in one session that he had never realized how isolating it could be to be the only one in the room, a perspective that Rennera lived with daily. I watched this transformation unfold with a sense of quiet satisfaction. The program wasn't just about increasing diversity quotas. No one wants to be a diversity hire. No one wants to be hired for the color of their skin. People want to be hired, respected and brought in because they have the qualifications, credential and skill to do the job. So this was about creating genuine human connections that broke down preconceived notions and built empathy by facilitating sustained, meaningful contact between employees who would have otherwise remained strangers. I leveraged contact theory to foster an environment where differences became the starting point for collaboration rather than a source of division.

Kapri: 10:05

More than teaching DEIA concepts is needed. A real change comes from creating the conditions for relationships that challenge bias, break down stereotypes and reimagine what's possible in the corporate world. In the end, joe and Rene's relationship became a model for others in the company, demonstrating that when barriers to contact were removed, empathy and understanding could emerge, transforming both individual perceptions and the entire organizational culture. Picture a workplace where people from different racial backgrounds are encouraged to collaborate on projects. They're forced to communicate, problem solve and rely on one another as they work together. This breaks down stereotypes and helps people view each other as individuals with unique strengths rather than as members of a group defined by race or ethnicity. This approach requires the right conditions. Simply putting people together is not enough. There has to be a shared goal, a mutual respect and equality in roles to benefit from this approach. After a short break, we'll come back and continue our conversation about how diverse racial and ethnic representation in clinical trials is important. More in a minute.

Announcement: 11:11

Are you ready to make a difference in your community? In our Speak Out Advocacy series, we're here to empower you to use your voice for change. Whether improving access to mental health care, reducing stigma or shaping important social policies, this series provides the tools to create a lasting impact. If advocating for better care, breaking down barriers or transforming mental health services speaks to your heart, this is the perfect space to learn and take action. Do you have a topic you're passionate about or need support advocating for yourself or others? We'd love to hear from you. Text the show to share your thoughts. Just check the details in the show notes. Together, let's build a community that fosters change. Keep enjoying reframing the membrane.

Announcement: 11:56

Did you know contact theory isn't just about race or ethnicity? It applies to many groups that are excluded from everyday activities and spaces. Think about homelessness. People often look away, treating people experiencing homelessness like they're invisible, or consider age discrimination, religious divides, socioeconomic status or even neurodivergent individuals. The theory even extends to social hierarchies, like the caste system in India. Fostering positive interactions between outgroups and ingroups can help us understand and reduce conflict. Want to learn more and explore real-world examples? Text the show now to get resources and actionable tips for practicing positive contact theory in your community.

Kapri: 12:39

So let's dive into a critical topic that's at the intersection of health equity and medical innovation diversity in clinical trials. Whether it's a new drug, a groundbreaking therapy or a medical device, clinical trials are the backbone of health advancement. But if the participants in these trials don't represent the diverse population that will ultimately use these treatments, we run the risk of creating disparities that could widen health gaps rather than close them. Today, let's explore why diversity in clinical trials is more than just a checkbox. It's a necessity for ensuring equitable health outcomes for all. We'll discuss the current challenges, the role of systemic barriers and promising initiatives that aim to increase diverse representation. So let's get started. Clinical trials are an essential step in determining whether medical products like drugs, vaccines or devices are safe and effective. Yet not all bodies react the same way to treatments. Factors such as age, gender, race and ethnicity can influence how individuals respond to medications, due to differences in genetics, underlying health conditions and environmental exposures. Historically, clinical trials have relied heavily on white male participants, which has left us with significant knowledge gaps about how treatments work for other groups. For instance, research shows that Black, hispanic, asian and Indigenous populations are often underrepresented in trials, even when these groups face a higher burden of certain diseases. This lack of diversity can result in less effective or even harmful treatment outcomes for these underrepresented groups. Consider the racial bias found in pulse oximeters, which measure blood oxygen levels. During the COVID-19 pandemic, studies revealed that these devices were less accurate for people with darker skin tones, leading to delays in critical care. This example underscores the broader issue care. This example underscores the broader issue. When clinical trials don't include diverse participants, we risk developing tools and treatments that fail to serve everyone equitably.

Kapri: 14:35

Let's delve into why diverse participation in clinical trials remains so challenging. Several factors contribute to the underrepresentation of people of color, women and low-income individuals in clinical research. First, structural barriers play a significant role. Many clinical trials are conducted at well-funded academic medical centers, which are often far from under-resourced communities. This creates logistical hurdles, such as transportation issues, making it difficult for those who would benefit most to participate. Additionally, exclusion criteria based on comorbidities, like hypertension and diabetes, disproportionately disqualify older adults and people of color. Then there's the issue of mistrust, which I talked about before. Rooted in a legacy of unethical medical practices, the US Public Health Service syphilis study at Tuskegee and the unauthorized use of genetic samples from the Havasupai tribe are stark reminders of how medical research has exploited communities of color. These historical abuses have left deep scars, fostering a persistent skepticism towards the healthcare system.

Announcement: 15:40

The Reframing the Membrane Crossing Boundaries podcast is provided solely for informational and entertainment purposes. It is not intended to replace professional medical or mental health advice, diagnosis or treatment, nor does it substitute for a relationship with a licensed mental health clinician. Always consult your physician before deciding about your physical or mental health.

Kapri: 16:02

Finally, knowledge gaps and a lack of culturally sensitive outreach further hinder participation. Research shows that physicians are less likely to discuss clinical trial opportunities with patients of color. Without awareness and education, many potential participants remain unaware of these opportunities, highlighting the need for better communication and engagement strategies. Despite these challenges, there are promising efforts underway to improve diversity in clinical trials. In my work in the biopharmaceutical industry, there has been an introduction of guidelines to increase representation of underrepresented groups. For example, the FDA's diversity action plans now require researchers to outline strategies to ensure that trial participants reflect the demographics of the intended user population. During the COVID-19 pandemic, for example, companies like Pfizer and Moderna took steps to increase diverse enrollment by partnering with historically Black colleges and universities or HBCUs and community organizations, and so this helped to build some trust and demonstrated a commitment to equity, ultimately leading to better data on vaccine efficacy across different racial and ethnic groups. Another noteworthy initiative is the Equitable Breakthroughs in Medicine Development, which is led by PhRMA. This program collaborates with community health centers serving predominantly low-income and racially diverse populations, making clinical trials more accessible and ensuring that the gathered data better represents the broader population. So there are a number of implications of inadequate representation, so let's talk about the consequences of underrepresentation in clinical trials, which is far-reaching.

Kapri: 17:44

When certain groups are not adequately included, it can lead to disparities in treatment outcomes and access. So let's consider a few real-world examples. Recently, there was a drug approved for Alzheimer's and it was priced at about $26,500 a year, although this was covered by Medicare. Many older Black and Hispanic adults, who experience higher rates of dementia and have lower average incomes, face significant out-of-pocket costs. This is a financial barrier that highlights a broader issue of equity and access to life-saving treatments, and it's worth noting that the $26,500 is a reduction from what was double the price before it was slashed in half to 26,500. Then, when we think about gene therapies for sickle cell disease, for example, a condition that disproportionately affects Black and Hispanic populations, offered a one-time cure, but it came with a price tag of over $2 million.

Kapri: 18:38

Without comprehensive coverage and financial assistance, these groundbreaking treatments remain out of reach for many of the people who need them most. Obesity medications also demonstrate disparities in access. Although obesity rates are higher among people of color, limited coverage and high costs make these treatments inaccessible for many, perpetuating existing health inequities. Moreover, biases in clinical decision-making tools and algorithms can exacerbate these disparities. We've seen. Algorithms that are trained on data that lack diversity, yield biased recommendations, and so this can lead to a sub optimal or even harmful treatment decisions for minority patients. So, as we move toward inclusive and equitable clinical trials, what can be done to address these issues? So let's talk about some strategies that could make a significant impact after a short break.

Announcement: 19:27

Are you ready to make a difference in your community? In our Speak Out Advocacy series, we're here to empower you to use your voice for change. Whether improving access to mental health care, reducing stigma or shaping important social policies, this series provides the tools to create a lasting impact. If advocating for better care, breaking down barriers or transforming mental health services speaks to your heart, this is the perfect space to learn and take action. Do you have a topic you're passionate about or need support advocating for yourself or others? We'd love to hear from you. Text the show to share your thoughts. Just check the details in the show notes. Together, let's build a community that fosters change. Keep enjoying reframing the membrane.

Kapri: 20:12

One strategy is community engagement. Building trust with historically marginalized communities is essential. Researchers can collaborate with community leaders and organizations to design studies that reflect the needs and concerns of the population. This approach helps ensure that the voices of those most affected by health disparities are heard and valued. Then there's policy reform. So legislation like the Food and Drug Omnibus Reform Act requires clinical trials to include diversity action plans setting a new standard for accountability and research. Such policies can be crucial for addressing the historical underrepresentation of certain groups. And expanded coverage is another area where we could improve. So expanding Medicare and Medicaid coverage, for example for new drugs and therapies, can help to mitigate some financial barriers.

Kapri: 21:01

Ensuring that all patients, regardless of income, have access to innovative treatments is a vital step toward health equity In transparent data reporting. Accurate and transparent reporting of demographic data in clinical trials is necessary to address and assess progress and hold researchers accountable. By disaggregating data by race, ethnicity, gender and socioeconomic status, we can identify gaps and develop targeted solutions. So when we think about a path forward, the journey toward inclusive and equitable clinical trials is a challenging one, but it's a journey we must undertake. Achieving diverse representation is not a checkbox activity. It's about conducting better science, improving patient outcomes and creating a healthcare system that works for everyone.

Kapri: 21:47

So thank you for tuning in to today's episode. If you found this discussion informative, please share with your friends in your network, leave us a review and follow our podcast. In our next episode, we're going to dive more into the topics of trauma-informed care, the art of reframing and letting go, and implications for mental health treatment across different communities. Don't forget to subscribe and follow and join our conversations by texting the show. Let's keep crossing boundaries and reframing the way we think about health, equity and the world around us. Until next time, good people, be well, stay safe.