Juneteenth reflections and our path forward from
Ashley C Moultrie, CCRP
, senior director of DEI and community engagement
On behalf of everyone here at Javara, I wish to extend a very Happy Juneteenth to all! While this federal holiday is a day of celebration, it is also one of reflection and appreciation. today I think of the hard-fought emancipation of enslaved African Americans 159 years ago, and the trials, tribulations, and triumphs that led us here today. But as I do, I lift my head up with purpose and determination, looking forward to all the work still left to be done.
As a professional in the clinical research space, this work is plagued with the faults of a clinical research industry & healthcare system historically prejudiced against the African American community. My question to you today, is, how can we position ourselves to change the trajectory of this story for the future? It is no secret that our journey with healthcare has been a long and difficult one. Enslaved and regarded as only 3/5 human, those before us were left to die, or worse, killed at the hand of other living beings. No standard of care. No care at all. A lack of access and vastly inferior care through Reconstruction and the Jim Crow eras manifested only as a struggle that continued through the Civil Rights movement and remains deeply embedded in the healthcare inequities we face today.
In clinical research, we often point to the history books – such as Tuskegee and Henrietta Lacks – as examples of medical racial bias, of which, there are many. But it is no secret that to this day, such history is still being written in many ways. As healthcare leaders, we have concrete solutions. We have the knowledge, and the understanding of our complex system, and the deeply rooted biases within. These biases directly impact peoples’ lives, and that must end. If we have the will, we can finish the work. Health equity is not just a dream – it is achievable. It is our future. But we cannot give up.
Here at Javara, we’re working toward health equity with a mission to make clinical research accessible to all. I’m honored to serve in the company’s first diversity, equity, and inclusion (DEI) position, created this year, to bring greater alignment to both internal and external initiatives, challenging the industry to address historical biases, obstacles to access, and failed inclusion critically and relentlessly.
- Internal processes to elevate engagement – As an organization, our vision is to truly embody DEI and all that it stands for. Currently, we are working to increase efficiency for reaching underserved communities on a broad scale including updating processes across teams in 7 states with a focus on our HR practices, handbook, and training for our learning and development teams. We’ve also set community engagement targets for all Javara team members, with quarterly goals for service in our communities.
- Community needs assessments – To change the demographics of clinical trials, we’re collecting and interpreting data about the populations in the areas we serve, including racial and ethnic makeup, disease prevalence, economic status, insurance, and language needs. We also work closely with community-based organizations to gain a deeper understanding of culture, and respective challenges and potential barriers to participation. Once complete, we can ensure Javara is always ready to initiate new studies with a diverse cohort that reflects our communities.
- Diversity action plans – Javara’s diversity action plans were established to provide the details needed to support a sponsor in making the critical decision of whether to work with Javara. For example, if a sponsor wants to do a study with Dr. Smith that has significant African American participation, we show them that Dr. Smith’s city is 47% African American and given the demographics and location of the health system, we have a 17% African American study population. That number might be higher or lower than the sponsor’s goals, but it is the actionable reality on the ground, which is far more beneficial for evaluating right-fit trials and actionable next steps than a mere guess or goal that might not be met.
- Diverse team building – I always say we build trust by face, by faith, or by fun. In order to build rapport with our patient populations, it is important that we also take representation into account when employing our own Javara staff. Ensuring our team members reflect the communities in which they serve – from their physical identity to their faith or core belief system – is an invaluable way to recruit participants through trusted sources.
Equitable representation in clinical trials ensures the quality of the study, the quality of the drug or device, and ultimately the quality of patients’ health. Conversely, inequitable study participation has meant treatments are optimized for white patients, consistently leading to suffering by major segments of the population—a global health crisis.
Please join me and all of Javara this Juneteenth as we both reflect on the histories that led us here and recommit ourselves – and our work – to a future in which health equity is a reality for all. We’ve come far, but we still have so far to go. We cannot stop now.
