Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis
Abstract Throughout the COVID-19 pandemic, underserved populations, such as racial and ethnic minority communities, were disproportionately impacted by illness and death. Ensuring people from diverse backgrounds have the ability to participate in clinical trials is key to advancing health equity. We...
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BMC
2025-01-01
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| Series: | International Journal for Equity in Health |
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| Online Access: | https://doi.org/10.1186/s12939-024-02360-8 |
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| author | Raphael Cuomo Tiana McMann Qing Xu Zhuoran Li Joshua Yang Julie Hsieh Christine Lee Milena Lolic Richardae Araojo Tim Mackey |
| author_facet | Raphael Cuomo Tiana McMann Qing Xu Zhuoran Li Joshua Yang Julie Hsieh Christine Lee Milena Lolic Richardae Araojo Tim Mackey |
| author_sort | Raphael Cuomo |
| collection | DOAJ |
| description | Abstract Throughout the COVID-19 pandemic, underserved populations, such as racial and ethnic minority communities, were disproportionately impacted by illness and death. Ensuring people from diverse backgrounds have the ability to participate in clinical trials is key to advancing health equity. We sought to analyze the spatial variability in locations of COVID-19 trials sites and to test associations with demographic correlates. All available and searchable COVID-19 studies listed on ClinicalTrials.gov until 04/04/2022 and conducted in the United States were extracted at the trial-level, and locations were geocoded using the Microsoft Bing API. Publicly available demographic data were available at the county level for national analysis and the census tract level for local analysis. Independent variables included eight racial and ethnic covariates, both sexes, and twelve age categories, all of which were population-normalized. The county-level, population-normalized count of study site locations, by type, was used as the outcome for national analysis, thereby enabling the determination of demographic associations with geospatial availability to enroll as a participant in a COVID-19 study. Z-scores of the Getis-Ord Gi statistic were used as the outcome for local analysis in order to account for areas close to those with clinical study sites. For both national (p < 0.001) and local analysis (p = 0.006 for Los Angeles, p = 0.030 for New York), areas with greater proportions of men had significantly fewer studies. Sites were more likely to be found in counties with higher proportions of Asian (p < 0.001) and American Indian or Alaska Native residents (p < 0.001). Areas with greater concentrations of Black or African American residents had significantly lower concentrations of observational (p < 0.001) and government-sponsored COVID-19 studies (p = 0.003) in national analysis and significantly fewer concentrations of study sites in both Los Angeles (p < 0.001) and New York (p = 0.007). Though there appear to be a large number of COVID-19 studies that commenced in the US, they are distributed unevenly, both nationally and locally. |
| format | Article |
| id | doaj-art-af5ec7b86718477cb4b18c0a4af99f45 |
| institution | Kabale University |
| issn | 1475-9276 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj-art-af5ec7b86718477cb4b18c0a4af99f452025-01-26T12:20:49ZengBMCInternational Journal for Equity in Health1475-92762025-01-0124111110.1186/s12939-024-02360-8Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysisRaphael Cuomo0Tiana McMann1Qing Xu2Zhuoran Li3Joshua Yang4Julie Hsieh5Christine Lee6Milena Lolic7Richardae Araojo8Tim Mackey9School of Medicine, University of CaliforniaGlobal Health Policy and Data InstituteS-3 ResearchDepartment of Anthropology, University of CaliforniaDepartment of Public Health, California State UniversityOffice of Minority Health and Health Equity, U.S. Food and Drug AdministrationOffice of Minority Health and Health Equity, U.S. Food and Drug AdministrationOffice of Minority Health and Health Equity, U.S. Food and Drug AdministrationOffice of Minority Health and Health Equity, U.S. Food and Drug AdministrationGlobal Health Policy and Data InstituteAbstract Throughout the COVID-19 pandemic, underserved populations, such as racial and ethnic minority communities, were disproportionately impacted by illness and death. Ensuring people from diverse backgrounds have the ability to participate in clinical trials is key to advancing health equity. We sought to analyze the spatial variability in locations of COVID-19 trials sites and to test associations with demographic correlates. All available and searchable COVID-19 studies listed on ClinicalTrials.gov until 04/04/2022 and conducted in the United States were extracted at the trial-level, and locations were geocoded using the Microsoft Bing API. Publicly available demographic data were available at the county level for national analysis and the census tract level for local analysis. Independent variables included eight racial and ethnic covariates, both sexes, and twelve age categories, all of which were population-normalized. The county-level, population-normalized count of study site locations, by type, was used as the outcome for national analysis, thereby enabling the determination of demographic associations with geospatial availability to enroll as a participant in a COVID-19 study. Z-scores of the Getis-Ord Gi statistic were used as the outcome for local analysis in order to account for areas close to those with clinical study sites. For both national (p < 0.001) and local analysis (p = 0.006 for Los Angeles, p = 0.030 for New York), areas with greater proportions of men had significantly fewer studies. Sites were more likely to be found in counties with higher proportions of Asian (p < 0.001) and American Indian or Alaska Native residents (p < 0.001). Areas with greater concentrations of Black or African American residents had significantly lower concentrations of observational (p < 0.001) and government-sponsored COVID-19 studies (p = 0.003) in national analysis and significantly fewer concentrations of study sites in both Los Angeles (p < 0.001) and New York (p = 0.007). Though there appear to be a large number of COVID-19 studies that commenced in the US, they are distributed unevenly, both nationally and locally.https://doi.org/10.1186/s12939-024-02360-8COVID-19Geospatial analysisDemographicsHealth equityClinical trials |
| spellingShingle | Raphael Cuomo Tiana McMann Qing Xu Zhuoran Li Joshua Yang Julie Hsieh Christine Lee Milena Lolic Richardae Araojo Tim Mackey Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis International Journal for Equity in Health COVID-19 Geospatial analysis Demographics Health equity Clinical trials |
| title | Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis |
| title_full | Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis |
| title_fullStr | Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis |
| title_full_unstemmed | Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis |
| title_short | Demographic disparities in access to COVID-19 clinical trial sites across the United States: a geospatial analysis |
| title_sort | demographic disparities in access to covid 19 clinical trial sites across the united states a geospatial analysis |
| topic | COVID-19 Geospatial analysis Demographics Health equity Clinical trials |
| url | https://doi.org/10.1186/s12939-024-02360-8 |
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