YSPH Senior Fellow Kaakpema Yelpaala urges greater diversity in clinical trials

Kaakpema “KP” Yelpaala, MPH ’06, lecturer and senior fellow in public health (health policy) at the Yale School of Public Health, advocated for greater diversity in clinical trials as a speaker at the Global Black Economic Forum (GBEF) during the 30^th ESSENCE Festival of Culture in New Orleans on July 7. The festival is the largest African American culture and music event in the United States.

Yelpaala made his remarks during a panel discussion about underrepresentation in clinical trials that was organized by the GBEF. Also on the panel were Dr. Aletha Maybank, MD, senior vice president of the American Medical Association, Wizdom Powell, director of the University of Connecticut’s Health Disparities Institute, and Adrelia Allen, director of clinical trial patient diversity at Merck.

The GBEF’s Public Convention during the ESSENCE Festival brings together world leaders, CEOs, entrepreneurs, and policymakers who participate in panel discussions aimed at elevating and advocating for Black and marginalized communities around the world.

More information is needed about the benefits of participating in clinical trials, said Yelpaala, who, as the faculty director of InnovateHealth Yale, supports the creation of innovative solutions to public health challenges and education for underserved communities in the United States and low-resource countries.

Yelpaala said it was important to increase diversity in clinical trials for several reasons: to ensure equitable health care outcomes, address medical mistrust in Black populations, and emphasize the importance of clinical research in personalized therapies. He cited the African American Heart Failure Trial (A-Heft), a clinical trial that included a large number of Black participants to evaluate the efficacy of a drug used to treat congestive heart failure, as an example of how diversity in trials can lead to tailored drug therapies for diverse populations. The trial resulted in treatment for hypertensive-driven congestive heart failure, which is more common in Black populations than their White counterparts.

A 2020 report by the U.S. Food and Drug Association (FDA) revealed that among the clinical trial participants for new drugs approved that year, 75% were white, 8% were Black, 6% were Asian, and 11% were Hispanic. According to Yelpaala, the underrepresentation of non-white populations in clinical trials can result in a lack of data on the safety and efficacy of treatments for these groups. This can contribute to health disparities, as different racial or ethnic groups may respond differently to certain medications. As well, genetic differences can influence how patients metabolize drugs, which can affect both the efficacy and side effects of medications.

“Part of our challenge in increasing diversity in clinical trials relates to a broken primary and preventative health care system,” Yelpaala said. “Ideally, Black Americans would have a long-term relationship with a trusted primary care physician. This foundational relationship with the health provider would be an important channel of information to learn about clinical trials. Currently, many people may learn about a clinical trial only when they are in a health crisis or from a provider they do not know well or trust,” he said.

The ESSENCE Festival and GBEF Public Convention featured conversations on topics ranging from voter education, health and wellness, and beauty trends to music, entertainment, entrepreneurship, and sustainability. This year’s festival attracted more than 3 million virtual and live attendees from July 4-7.