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Why we need diversity, equity and inclusion (DEI) in clinical and public health research

Diversity, equity, and inclusion (DEI) are essential in clinical and public health research, ensuring discoveries and interventions benefit all sections of society; and enhancing the quality, relevance, and impact of research. Ensuring that diverse populations are represented appropriately within research is a scientific necessity. By embedding DEI principles into research design and execution, researchers can generate findings that are broadly applicable across the population while also addressing long-standing health disparities.

DEI is needed in clinical and public health research because it improves the generalisability and relevance of research findings. Research outcomes must apply to the diverse populations they are intended to serve. By including participants from different racial, ethnic, gender, socioeconomic, and geographic backgrounds, studies can avoid biases that result from the narrower recruitment into research studies we often saw in the past. Without such diversity, research findings may only reflect outcomes relevant to a narrow segment of the population. For example, earlier research on cardiovascular disease often excluded women, resulting in treatment guidelines that were less relevant for them. 

DEI also plays a critical role in addressing health disparities. Under-represented populations, such as racial minorities and low-income groups, often experience worse health outcomes due to a lack of targeted research addressing their specific needs. Inclusive research helps identify population-specific health risks, barriers to care, and differential outcomes; thereby guiding the development of interventions that reduce disparities. 

Building community trust and engagement is another important outcome of DEI in research. When communities see themselves represented, they are more likely to trust the research process and participate actively. Higher participation rates lead to better data quality and more robust findings. Additionally, community engagement allows for the co-creation of solutions that reflect the unique needs and values of different populations, making health interventions more effective and sustainable. This approach has been particularly valuable in addressing vaccine hesitancy, where working closely with underrepresented communities has improved vaccination uptake and trust in public health efforts.

DEI also ensures that research accounts for biological and social differences that influence health outcomes. Biological and genetic variations, as well as differences in environmental and social factors, can significantly impact the effectiveness of treatments and interventions. Research that includes diverse populations can identify and address these differences, leading to more personalised and effective healthcare solutions. 

Beyond the practical benefits, DEI in research is also an ethical imperative. Every individual in our society, regardless of their background, deserves to benefit from the advances in scientific knowledge and healthcare.  Excluding certain groups from research not only perpetuates health disparities but also reinforces systemic injustices.  

Achieving DEI in research is challenging.  It requires a concerted effort to address issues such as recruitment and retention of diverse participants, cultural sensitivity in research design, and the need for inclusive research teams. This is why research organisations such as the US National Institutes for Health (NIH) and the English National Institute for Health and Care Research (NIHR) have mandatory sections on DEI in their application forms. 

In conclusion, diversity, equity, and inclusion (DEI) are not merely buzzwords. DEI contributes to improving the overall quality and validity of research data. Diverse and inclusive studies are less prone to selection bias and provide more comprehensive data, resulting in stronger, more reliable conclusions. The representative datasets from these studies enable researchers to develop evidence-based practices that guide clinical and public health initiatives globally.


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