Health Inequities are the Symptoms, Racism is the Disease

Historically, corporate philanthropy within the pharmaceutical and biotechnology sectors has focused on patient outreach and education, addressing health inequities through increased access to care and treatment. While critically important, we believe that to truly make progress in advancing health equity, and to ensure our medicines can do the most good for the most people, we need to go beyond managing the symptoms to treat the disease – investing our resources in both the prevention of illness as well as on efforts that address systemic and structural barriers to health care equity, inclusive research, and a more diverse and multicultural health care and scientific workforce. That means acknowledging and facing head on the root causes of health inequities, and the first step is being willing to put a name to the most fundamental of these causes: racism.

Racism prohibits access to the building blocks of health and well-being, from safe neighborhoods and environments to educational and economic opportunity. It is also a deeply rooted driver of inequity in health care delivery, manifesting for example as provider bias and false narratives about different populations that lead to poorer quality care. Lack of diversity in the scientific and medical workforce – itself a result of systemic racism impacting pathways to STEM education and careers – compounds the problem, inhibiting our field’s ability to recognize and respond to these forces of oppression and provide empathetic and effective care.

Genentech and Genentech Foundation's Health Equity and Diversity in STEM Fund was established in 2019 to get at the root of these problems by tackling long standing inequities in both our healthcare and education systems. To do this, the Fund provides catalytic support to individuals and organizations that are:

  1. Pioneering new approaches to remove barriers to high-quality care and inclusive research for people of color. This includes initiatives addressing systemic racism within clinical trial research and care delivery and, more specifically, approaches that deepen accountability for health equity through collaboration between communities and health systems.
  2. Transforming pathways to STEM careers, at the undergraduate and graduate levels and beyond. Because we cannot fully address health inequities without building a more diverse scientific and medical workforce, the Fund will support efforts that advance training, recruitment, retainment, and advancement of students, researchers, and leaders from communities of color.

As a biotech company and corporate funder, we have a responsibility to act intentionally not only in terms of what we support, but also who we support. That’s why we designed the Innovation Fund to invest in initiatives that are led by people of color and that direct resources and decision-making power to communities, patients, and students. In 2020, 70 percent of Innovation Fund program teams were led by people of color. We also know that endeavoring to address challenges of this magnitude and complexity can be isolating, which is why we bring together Fund recipients to ideate, problem solve, build community, and advance field-wide learning through the Innovation Fund Learning Cohort. This approach supports our aim of ensuring the people and projects we fund are sustained long term – critically, the majority of our grantees report that the award has enabled them to strengthen related institutional capacity and systems at their institutions.

We also see this work as an important mechanism for advancing Genentech's ambitious Diversity & Inclusion goals and as a manifestation of our commitment to transform society.

I’m thrilled that we’re able to offer this biennial funding initiative, which has made possible groundbreaking work by innovators who are already chipping away at long standing drivers of inequity. I invite you to learn more in the following profiles of five prior grant recipients with whom we have been so proud to partner.

ENSURING REPRESENTATION IN CLINICAL TRIALS

Black women are 41 percent more likely to die of breast cancer than white women, but they are vastly underrepresented in treatment research. As a result, they are missing out on access to newly emerging and often life-extending treatments. This is in part due to deeply rooted concerns and justifiable mistrust of the medical system. With support from our Health Equity & Diversity in STEM Innovation Fund, TOUCH, The Black Breast Cancer Alliance, Breastcancer.org, and others launched the groundbreaking #BlackDataMatters study to dig deep, get real, and better understand the barriers that prevent Black women from participating in trials. The results of this study are now informing the equally innovative and unprecedented When We Tri(al) movement to engage more Black women in clinical research.

“The current drugs are not working hard enough for Black women. I'm on a mission to empower our community with the necessary knowledge to advocate for ourselves within a medical system that too often fails us. We must advance the science. Our When We Tri(al) initiative will serve as a moment to hear firsthand how clinical trials can change the game for breast cancer and Black women." -- Ricki Fairley, CEO and founder of TOUCH, The Black Breast Cancer Alliance.

The Participatory Action for Access to Clinical Trials (PAACT) program, another Genentech grantee, is also working to make sure cancer clinical trial participants reflect the patient population – including Black Detroiters. PAACT is a collaboration between researchers at the Henry Ford Health System and the University of Michigan Detroit Community-Academic Urban Research Center and is guided by a Steering Committee composed of eight community organizations representing Caribbean, African, and African American populations in Detroit and surrounding communities. Researchers and community members of the Steering Committee have been meeting monthly to guide collection of data from community members and health care providers to gain an increased understanding of issues related to participation in cancer clinical trials and to jointly develop a community engagement plan to increase enrollment of Black cancer patients in Henry Ford trials.

For Zachary Rowe, executive director of the Detroit community group Friends of Parkside, the PAACT approach has been a refreshing change of pace. “They’re listening to what we’re saying: If you want to have more African American folks involved in research, don’t bring us in at the end,” he said. “It’s really simple. No research on us without us.”

BUILDING CLINICIAN EMPATHY THROUGH VIRTUAL REALITY EXPERIENCES

Studies suggest virtual reality can increase empathy, and cognitive science research has found that unconscious thought processes can be acted upon to ameliorate clinician biases that may contribute to racial disparities in health care. With this in mind and with Genentech support, Dr. Kelly Taylor and her team at University of California San Francisco is leading the Combating Unequal Treatment in Health Care Through Virtual Awareness and Training in Empathy (CULTIVATE) project to evaluate virtual reality learning modules as a way to build empathy among health care providers. The modules allow providers to experience the healthcare system from the perspective of a middle-aged Black woman and Spanish speaking Latinx man – including provider interactions that feel disrespectful, scary, and uncomfortable – or someone whose language and culture are not well understood.

“They get to see what it’s like to feel dismissed, or to have their clinician approach them with cultural humility – it’s an opportunity to walk a mile in someone else’s shoes in a very tangible way,” said Dr. Taylor. “Increasing this sort of understanding gives them a chance to provide better, more patient-centered care.”

CHAMPIONING EQUITABLE FUNDING FOR BLACK PRINCIPAL INVESTIGATORS

Black Principal Investigators (PIs) are awarded funding at roughly half the rate of white PIs with comparable academic achievement – a significant barrier to the success of Black faculty that can negatively impact their tenure1. That is why Dr. Omolola Eniola-Adefeso (University of Michigan) and her co-PI Dr. Kelly Stevens (University of Washington) assembled a group of 250+ women faculty members in departments across the country to champion more equitable research funding, including specific calls for action by federal agencies to address racism within their funding practices. With Genentech support, they have been able to provide funding and mentorship to Black PIs previously denied federal funding for their work, allowing them to pursue critical cutting edge biomedical research.

“One of the biggest pain points is not being able to compete fairly for federal funds,” Dr. Eniola-Adefeso has said. “Genentech’s support to the University of Michigan is helping to close the racial gap in NIH research funding. This is innovative leadership.”

ADVANCING SOLUTIONS DESIGNED WITH AND FOR THE COMMUNITY

The San Joaquin Valley has some of the most polluted air in the country, contributing to high asthma rates, particularly among children. That is why Dr. Rosa Manzo (University of California, Merced) has focused her research on improving health outcomes in the region, where she herself grew up. And it is why she has partnered with the people she knows are experts on what the local population really needs – promotoras, lay health workers who also serve as cultural and linguistic brokers for their communities. With Genentech support, Dr. Manzo has been able to launch a program through which promotoras work with pre-health undergraduate students and medical students who are also from the area to deliver asthma-management education to Valley residents in a culturally sensitive, language-appropriate and engaging way.

“Different approaches that may seem very simple can have a lot of impact,” Dr. Manzo has said. “Rather than coming to them with a problem we’ve identified, we ask [the promotoras], what are the needs in the community?”