Introduction.

Abstract

Introduction Stephen Olufemi Sodeke, PhD, MA (bio) The manuscripts in this Supplemental Issue of the Journal of Health Care for the Poor and the Underserved are from the Second Conference on Bioethics Issues in Minority Health and Health Disparities Research hosted by Tuskegee University at the Auburn Marriott Opelika Hotel and Conference Center, Opelika, Alabama, from January 23–25th, 2019. The conference theme was "Effective Health Care and Inclusion: Growing the Next Generation of Researchers for Bioethics, Behavioral, and Health Disparities Research." This conference was based on our belief that: (1) scholars ethically working to reduce cancer health disparities must be celebrated, (2) they must be given space to pass on enabling tools to the next generation of health scientists and researchers, and (3) that the new generation can anticipate, critically examine, and reflect on how to resolve ethical issues raised by their caring or research efforts. We expected them to emerge equipped to propose more effective, reasonable, and ethically defensible changes to methods and policies. In planning the conference, we reasoned that vulnerability is an ontological condition of our humanity and that inherent, situational, and pathogenic vulnerabilities exemplified as health inequalities, disparities, and inequities remain legitimate concerns.1 These factors reflect an injustice due to the unequal burden of suffering and preventable deaths experienced by minority populations.2,3 Furthermore, in view of efforts to confront the ethical challenges of the new personalized medicine initiatives, such as the All of Us Research Program, and the returning of genomic research results to patients for clinical care, the life-affirming field of bioethics should address these matters.4–10 Therefore, the Bioethics Shared Resource Core of the Morehouse School of Medicine/Tuskegee University/University of Alabama at Birmingham Comprehensive Cancer Center Partnership collaborated with the research community and adopted a holistic approach to create the necessary reflective space to address relevant ethical issues.11 The conference had three parts. The first part considered the philosophical accounts of vulnerability and ethical obligations in addition to why collaborative efforts from bioethics and public health matter in attempts to break the cycle of health inequities. We examined current intervention research on improving minority health, standards and models, and promises and perils. This first part concluded with discussions on the obligations and challenges of translating research findings into practice—from bench to bedside to the community and everything in-between. [End Page vi] Martha Albertson Fineman's paper, "Vulnerability in Law and Bioethics," set the tone of the conference. Fineman's insights represented a moral grounding for the subsequent discussions on health disparities and the obligation to achieve equity. The author opined that "recognition of universal vulnerability reveals the ways in which all human beings are inexorably dependent on social relationships and institutions throughout the life course." Winn and Milligan's work on the connection between health and place-living in neighborhoods (affluent versus poor) called attention to how ZIP code or neighborhood of association (ZNA) and immutable community history are relevant in the quest to break the cycle of inequities. The authors suggested that, unless we are vigilant, some communities could be overlooked and remain invisible, particularly in the era of big data and a personalized approach to medicine. Current intervention research on improving minority health included the work of Wilson and colleagues. The authors discussed their work with the Tuskegee/Macon County Diabetes Coalition as a case study for ethical community engagement to empower communities in an attempt to promote healthy living and habits in communities that suffer from this disease. Payne-Foster and colleagues conducted a survey on racial anxiety among medical residents. The authors found that participants scored less on their workplace skills and actions. They concluded that training programs for physicians must "incorporate more skill development around handling racial anxiety." They raised the ethical question of social accountability of medical schools in building a culturally competent workforce. Hernandez explored the concerns and needs related to maternal mental health with a population that is often stigmatized and inadvertently neglected. She noted that traditional institutional review board (IRB) forms and processes focus on individuals, but there is a need to include considerations of community; thus, she argued, researchers should use a community...