Addressing structural racism within institutional bodies regulating research.

Abstract

Invited EditorialAddressing structural racism within institutional bodies regulating researchSonnet S. Jonker, Cirila Estela Vasquez Guzman, and Belinda H. McCullySonnet S. JonkerCenter for Developmental Health, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OregonCorrespondence: S. S. Jonker ([email protected]).Search for more papers by this author, Cirila Estela Vasquez GuzmanDepartment of Family Medicine, School of Medicine, Oregon Health & Science University, Portland, OregonSearch for more papers by this author, and Belinda H. McCullyDepartment of Surgery, Oregon Health & Science University, Portland, OregonSearch for more papers by this authorPublished Online:02 Jun 2021https://doi.org/10.1152/japplphysiol.00853.2020This is the final version - click for previous versionMoreSectionsPDF (289 KB)Download PDFDownload PDFPlus ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInEmail INTRODUCTIONInstitutionalized racism impairs recruitment, training, and advancement of minoritized scholars in the biological sciences, degrading their experience and driving them to leave science in disproportionate numbers. Most discussions of necessary anti-racism efforts to advance equity in research have directly focused on academic faculty and their leadership. An expanded view of essential anti-racism efforts within institutions is necessary to effectively change academic institutional culture. To address this need, an approach to setting an anti-racism agenda within the role of institutional committees who serve as research gatekeepers, the Institutional Review Board and the Institutional Animal Care and Use Committee, is described. This approach could apply equally to other academic support units, such as department leadership, awards administration, medical education programs, and information technology.AN ANTI-RACISM AGENDAStructural racism is a “system in which public policies, institutional practices, cultural representations, and other norms work in various, often reinforcing ways to perpetuate racial group inequity […]. Structural racism is not something that a few people or institutions choose to practice. Instead it has been a feature of the social, economic and political systems in which we all exist” (1). Although interpersonal or personally mediated racism stands in contrast to structural racism, individuals have responsibility for perpetuating or changing the systems which contribute to it. A component of privilege is the luxury of not examining the social systems that contribute to privilege (2), and therefore, many white people and others with whiteness privilege are unaware of how structural racism selectively contributes to their success. Awareness of systemic racism makes it possible for us to address the structures and practices that enforce inequities within the biological and medical sciences (3, 4).Relative to their white colleagues, Black, Indigenous, and People of Color (BIPOC) are progressively more underrepresented at each training and career stage in science and engineering (5–7). For those who are able to break through social barriers to pursue careers in science (5), BIPOC professionals at all levels continue to face discrimination that impairs their training and advancement. Despite sustained efforts to increase the number of underrepresented minorities training in science careers and receiving National Institute of Health (NIH) funding, progress has been limited. Persistent underrepresentation of BIPOC faculty indicates that despite incentive programs, structural racism steadily eliminates diversity at each stage by making success more difficult for minorities.As a scientific community, we must take action to break these barriers and build inclusive environments that promote the growth and advancement of our BIPOC colleagues. To address this need, institutions across the country are taking initial steps to promote equity in academic departments. These commendable efforts are largely focused on promoting recruitment and retention of BIPOC faculty and students and educating members of academic departments about racism. Our efforts must go beyond academic departments: the role for anti-racism within the supporting bodies of academic institutions must be addressed, particularly within the regulatory committees responsible for research ethics.Although ethics regarding study subjects are the primary objective of the Institutional Review Board (IRB) and Institutional Animal Care and Use Committee (IACUC), very few scholars have engaged specifically with structural racism and whiteness in the domain of IRB and IACUC jurisdiction (8, 9). This is despite the fact that IRBs exist as a response to gross racially centered ethical failures in human subjects research (10), that health disparities have driven the beginning of a conversation about the importance of inclusiveness in research study subject groups (11–13), and that the Food and Drug Administration (FDA) requires that the IRB membership include consideration of “race, gender, cultural backgrounds, and sensitivity to such issues as community attitudes” (14). The IRB and IACUC are powerful institutional bodies that can deeply impact research productivity, creating a “gatekeeping” effect. Consequently, who is included in the membership and how these committees impact the work of the BIPOC scientists they regulate are pertinent issues.Inequity degrades our scientific community and our academic research mission. Our goal is to address this problem by suggesting steps that the IRB and IACUC can take to address this issue within their domain of influence. No one needs to lose opportunity by undertaking these steps; this is not an “us versus them” challenge. Rather, this opportunity for self-reflection and review within the IRB and IACUC only risks improving the access and support for all scientists engaged in human and animal research.ACKNOWLEDGMENTThe first step in fixing a problem is acknowledging that a problem might exist. Because of white privilege, understanding structural racism is an effort that white scientists are not forced to make. As a scientific community, we each must make a conscious decision to be anti-racist, and intentionally create IRB and IACUC committees that explicitly support and include scientists of all backgrounds.Recommendations for acknowledging the problem include: Draft and share an explicit statement that represents the committee’s position with regard to diversity, equity, and inclusion. Include a specific commitment by the members to anti-racism and anti-discrimination, and standards of expected behavior.Create accountability for the IRB and IACUC to deliver on equity building, by making diversity, equity, and inclusion performance goals in job evaluations of IRB and IACUC administrators.Partner with the university office, official, or committee tasked with diversity, equity, and inclusion initiatives.However, acknowledging something that’s always been true is only the start to creating equity (15).INFORMATION GATHERINGThere is currently scant information on influence of effects of racial diversity or structural racism within IRBs and IACUCs. A lack of information is not evidence that a problem does not exist, but rather suggests a crucial oversight in the ethical obligations of these guardians. We have found that programmatic areas requiring attention might not be obvious; thus, critical inspection of IRB and IACUC programs, and solicitation of perspectives from stakeholders, are necessary to have the data needed to understand and address discrimination issues. This effort is expected to be ongoing and iterative to build on new perspectives and structural changes achieved by previous work. To that end, we recommend that the IRB and IACUC routinely solicit information about racism related to the IRB and IACUC. All conclusions should be reported to stakeholders and used to revise the program.Recommendations for gathering information include:Draw on institutional surveys designed to track the diversity, equity, and inclusion and climate of racism. Consider that the IRB and IACUC contribute to the university climate, and that these surveys also reflect people’s experiences with the IRB and IACUC.Create open-ended and regular solicitations for feedback from scientists, trainees, and staff about the IRB and IACUC:Include an explicit statement that the IRB and IACUC are committed to equity to encourage feedback.Invite all scientists, trainees, and staff, especially those with BIPOC backgrounds, to provide feedback on their experiences engaging with the IRB and IACUC.Ask IRB and IACUC members to share their perspective on how these committees impact BIPOC scientists and trainees.Solicit feedback from BIPOC scientists about programmatic changes intended to address structural racism on a regular basis.EASING THE BURDENStructural racism increases the effort required by BIPOC individuals to complete the tasks by prejudicially increasing the difficulty of the task or limiting the tools they can use. Dealing with covert and overt incidences of discrimination and harassment are also draining for BIPOC workers. These factors create a chilly or even hostile work environment that imposes emotional and intellectual burdens, and limit productivity of BIPOC scientists, trainees, and staff (16). Administrative burden itself is recognized by the NIH as a serious drain on research productivity (17), and, importantly, in other contexts, it has been found that administrative burdens are not neutrally enforced across racial groups (18). As such, it must be the goal of the IRB and IACUC to ease the burden as much as possible within the context of ensuring humane and lawful research. Special attention must be directed toward addressing policies, processes, and practices that unequally burden BIPOC scientists, trainees, and staff.Recommendations for easing the burden include:Awareness of unconscious bias does not necessarily change outcomes, and enacting sweeping cultural changes may be difficult and expensive, thus “engineering controls” or “bias interrupters” that do not depend on insightful behavior by individuals may yield better results (19, 20). These approaches must be evidence-based or generate evidence of effectiveness.Implement fair and consistent enforcement of rules related to the IRB and IACUC. Information about policies and rules should be easy for all to find, to facilitate compliance. Response to violations should include education and access to resources for correction. The consequences of violations, and escalation for repeat violations, should be clear and equitably enforced.Create expectations and implement practices to increase cultural and communication competencies of committee staff and members. Examples include expectations and resources for learning, remembering, and using correct pronunciation of people’s names; using the terms of identification that individuals provide for themselves (in writing this, we have used terms currently considered inclusive and respectful, but intend to include the many people burdened by institutional racism that identify differently); and skills for working through discomfort to arrive at understanding.Actively assist scientists in preparing protocols and modifications and teach them why requirements exist and how to meet them. Frequently advise scientists, trainees, and staff that this service is available.Increase transparency about the IRB and IACUC by holding open houses staffed by members of the program, by sharing information on how protocol review works (with reference to laws and rules), by being open about how decisions are made (such as appointment to the committee), how compliance inspections occur (including sharing an inspection checklist, if used), and by being open about the process for generating standard procedures and policies.Ensure that anti-racism initiatives receive sufficient oversight and resources to be successful through reporting and accountability. This must include follow-up on reports or findings of racism, timely communication with stakeholders, and visible follow-through on announced programmatic changes.CREATING OPPORTUNITYExclusion and discrimination limit opportunity for BIPOC scientists, trainees, and staff, even in the absence of overtly racist behavior (6). Service on the IRB and IACUC can advance faculty careers, whereas having BIPOC people in the committees can create more equitable protocol review for minoritized scientists, and result in better, more ethical, scientific studies (21). A survey of IRB and IACUC office staff and members found that just 5%–6% identified as Hispanic/Latino (including from Spain), 3% identified as American Indian or Alaskan Native (including all Original Peoples of the Americas), and only 1%–6% as Black or African American (including Africa and Caribbean) (22, 23). This clearly does not reflect the population diversity of the United States, which is the appropriate target to effect positive change in the biomedical workforce (24). Furthermore, we must go beyond the concept of “a seat at the table” and do the work to promote diverse “voices at the table” (9). This may require active leadership to prevent silencing of minority voices by those with “loud voices” (8).Recommendations for creating opportunity include:BIPOC faculty should be actively recruited for consideration of membership on the IRB and IACUC to build committees that go beyond “checkbox” levels of diversity.Advertise leadership and administrative staff openings with government designated minority-serving institutions, including Historically Black Colleges and Universities (HBCU), Hispanic-Serving Institutions (HSI), and Tribal Controlled Colleges and Universities (TCCU), Alaska Native- and Native Hawaiian-Serving Institutions (ANNHI), and Asian American Native American Pacific Islander-Serving Institutions (AANAPISI).Nonscientific and nonaffiliated IRB and IACUC members are, by definition, minority members of the committee. Do not exclude consideration of BIPOC people for these positions, but do not compound their minoritized status by relying on these positions exclusively for diversity and inclusions on the IRB and IACUC.SELF-EDUCATIONEducating ourselves about how racism manifests itself in academic institutions and how it impacts BIPOC scientists, trainees, and staff is critical, but we put this last because it is too often the only step taken. Change must be informed in order for it to be effective. Because learning is repetition, and because skills for discussing racism must be reinforced with regular practice, we recommend that the IRB and IACUC routinely participate in anti-racism training. The discussion component is essential, as white passivity is integral to maintaining structural racism (2). Training should be guided by current best practice of educational curriculum and modalities found to reduce racist behaviors, and to facilitate anti-racist behaviors.Recommendations for educating ourselves include:Improve communication skills to engage in conversations about race in productive and respectful ways. Understand the meanings of key words and phrases such as (but not limited to) explicit/unconscious bias, anti-racism, oppression, and institutional racism.Understand and respect cultural differences in concepts of professionalism. For instance, professional self-expression in hair style, jewelry or clothing, or task-management approaches prioritizing relationship building (25, 26).Address institutional racism, and identify how it differs from “isolated” incidences of overt racism. Discuss how we as individuals can confront racism in the institutional systems in which we work.Require IRB and IACUC members to enroll in explicit/unconscious bias training.Regularly incorporate discussion of diversity, equity, and inclusion into the meeting agenda.Understand how the history of racism in local and scientific communities impacts current experiences of BIPOC scientists, trainees, and staff at your institution. Contextualize inequities within social-political historical frameworks.These recommendations are a starting point to examining the role of the IRB and IACUC as institutional programs capable of perpetuating covert discrimination that impedes the careers of BIPOC people within our research community. It is expected that the process of discovery, and revision of program practices, will lead to an evolution in perspectives and challenges to be faced.These steps equally could apply to other academic support units, such as department leadership, medical education programs, awards administration, and information technology, but we have focused on the IRB and IACUC deliberately. In an emergency, it is common for people to panic and freeze. In first-aid training, you learn never to just say, “Someone call 911!” No one will do it, because everyone thinks someone else will do it. Instead, you point at a specific person, and command, “You! Call 911!”This is our finger and voice, commanding IRBs and IACUCs into action.DISCLOSURESNo conflicts of interest, financial or otherwise, are declared by the authors.AUTHOR CONTRIBUTIONSS.S.J. drafted manuscript; S.S.J., C.E.V.G., and B.H.M. edited and revised manuscript; S.S.J., C.E.V.G., and B.H.M. approved final version of manuscript.REFERENCES1. 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Previous Back to Top Next FiguresReferencesRelatedInformation More from this issue > Volume 130Issue 6June 2021Pages 1668-1671 Crossmark Copyright & PermissionsCopyright © 2021 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.00853.2020PubMed33856259History Received 8 October 2020 Accepted 8 April 2021 Published online 2 June 2021 Published in print 1 June 2021 Keywordsadministrationcareerdiversityracismunderrepresented minorities Metrics Downloaded 1,032 times