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'Every Part of the Engine'
Panel Opens Dialogue on Ethnic Diversity in Medical Research

By Carla Garnett

Photos: Bill Branson

On the Front Page...

Stop your Y2K preparations for a moment. Think farther into the future and consider human resources: Is NIH ready for 2050? Seems like a long way away, but in just a couple of generations from now, demographers forecast that the United States will cease to have a majority population. Will the NIH workforce reflect the diversity of the nation's population and be able to meet the health needs of such a people? Are those even relevant or reachable goals? Those were the main questions posed by a Feb. 11 panel discussion, "Ethnic Diversity in the Biomedical Research Community: Why is it important? How can it be achieved?"

Continued...

HEO President Larry Salas

Cosponsored by the NIH Black Scientists Association, the NIH Hispanic Employee Organization, the Office of Equal Opportunity and the National Institute of Neurological Disorders and Stroke, the forum brought together nearly a dozen panelists representing NIH's Black, Hispanic, Native American and Asian and Pacific Islander communities to discuss achieving ethnic diversity at NIH. In addition, Dr. Elizabeth Dean-Clower, vice-chair of the NIH employees concerned with disabilities committee, spoke about the importance of a more accessible and inclusive NIH. "Disability is pan-ethnic," she said.

Early on, panel moderator Dr. John Ruffin, NIH associate director for research on minority health, suggested a different way of thinking. "We need to look at NIH the way we would look at an engine," he said. "We need to ensure that the engine has diverse parts on all levels so the engine can run the way we want it to run. The wheels must be diverse. The pistons and spark plugs and every part of the engine that makes it move must be diverse. At NIH, all areas must be considered. This is not just about K through 12 and getting more students into the pipeline and improving our training programs. We need to go beyond that. We need to talk about how we get more HSAs [health scientist administrators], more institute directors, more scientific directors, more people at the study section level and the council level [from underrepresented minority populations]. These are the policymakers. We must talk about diversification in its broadest application."

Strength in Diversity

Continuing the automotive theme, Dr. Harold Slavkin, director of the National Institute of Dental and Craniofacial Research and NIH representative on an intergovernmental committee on enhancing diversity in biomedical research, gave a four-point rationale for diversifying the workforce.

"Without diversity you don't have a democracy," he said, drawing upon data from census estimates and developing global trends. "It's really that simple. Clearly, if you get diversity right, you have more fuel to drive the economic agenda. If you're competing in a global economy, the energy you need is embedded in human resources."

Diversity, he continued, enriches educational and work experiences, promotes personal growth, strengthens the workplace and enhances economic competitiveness.

"It is absolutely imperative that every child in this country be science literate, math literate, technology literate and health literate — if we're going to be competitive in the 21st century. Therefore there is no one who calls himself or herself an American who should not own the issue of diversity."

Offering a preview of recommendations his committee will deliver to NIH director Dr. Harold Varmus and other federal decisionmakers in the scientific community, Slavkin enumerated 6 ways to begin to change the demographics: expand support for graduate education; increase science, technology and engineering faculty and ensure that the faculty represents the diversity of the country; expand recruitment efforts at all levels; identify and remove barriers to full participation; challenge private industry to support undergraduate and graduate-level education in science technology for individuals who are less represented; and continuously study and evaluate diversity efforts.

"This is not a warm and fuzzy issue," emphasized Slavkin, who also chairs the committee for the recruitment of a diverse workforce in medical research. That committee — an NIH-wide panel consisting largely of institute directors and deputy directors — was charged by Varmus to develop immediate strategies to see that the agency's workforce in 5-10 years will be sufficient to address health disparities in the nation. "This is a very pragmatic issue. Our country is currently completely ill-prepared or ill-equipped to engage all Americans in the science, technology, mathematic, health agenda for the 21st century. Although we have made modest progress in some of these areas, we are woefully underutilizing the full talent pool of this great nation. The country will not be successful in the 21st century if we don't get this right."

Dr. Arlyn Garcia-Perez, assistant director of NIH's Office of Intramural Research, who described herself as "very much a product of NIH," said she can think of at least one barrier beyond funding and recruitment efforts that may be discouraging minorities and women from coming to NIH.

"It seems to me that NIH is perceived as an unfriendly environment," she said, recounting comments she has heard in her travels during the course of her 14-year association with the agency. Her undergraduate and graduate school careers were supported in large part by NIH programs, and an NIH grant brought her here as a postdoctoral fellow. NIH's intramural program via NHLBI then supported her throughout her career path to tenured senior investigator and section chief. She said her training made her view diversity as a scientist would: "Evolutionarily, the strongest organisms are those whose genome is most diverse...We must find a way to make the NIH environment attractive to a more diverse population."

Workforce Status Quo

NIH's intramural recruitment statistics over the last couple of years are not encouraging, according to information presented by HEO President Larry Salas and Dr. Milton Hernandez, director of NIAID's Office of Special Populations and Research Training.

"We believe that our workforce should be representative of the society in which we live," Salas said, noting that in recent years the number of underrepresented minorities in tenure-track positions has decreased from 8.3 percent to 6.3 percent and out of 103 vacancies for tenure-track investigators, only 20 women were selected and no underrepresented minorities. "This is very troubling to us."

In 1994, Hernandez pointed out, Hispanics accounted for 219 of 13,899 permanent employees, or 1.6 percent of the workforce, at NIH. By 1997, the number had risen modestly to 287 of 13,288, or 2.2 percent. Only one Hispanic employee held the higher-paying rank of Senior Executive Service in 1994; by 1997, three Hispanic NIH'ers were paid at the SES level.

He briefly outlined three programs NIAID uses to help close workforce gaps: The Introduction to Biomedical Research Program, a 20-year-old program that brings college juniors and seniors here for a week of lectures, and mentoring on research careers. Many of these students return to NIH for summer research experiences and a significant number opt for careers in biomedical research. Next, the Bridging the Career Gap Program that has been held every other year since 1993 brings minority scientists funded on Research Supplements for Underrepresented Minorities (RSUMs) for a 2-day program of career advice and grantsmanship.

"These young scientists have a very high rate of success by any measure," Hernandez remarked.

Finally, he said, NIAID has also been very successful bringing postdocs to NIH's intramural laboratories "by recruiting from among our portfolio of young minority Ph.D.'s supported by RSUMs or minority predoctoral fellowships (F31's). Over the last few years we have been able to recruit 10 postdocs in this manner, and another one is probably coming in the summer."

'Life in the Trenches'

Dr. Hameed Khan, a health scientist administrator in NICHD's Division of Scientific Review who is also a former intramural scientist, spoke plainly about what he called "life in the trenches" — the intramural programs: "Ethnic diversity in biomedical research has failed in the intramural program" because NIH has not adequately addressed four major issues.

"The first question," Khan said, "concerns two false assumptions — that we're laid back and we lack the ability to communicate." Comparing people's work should determine who is laid back, he said, and as for lack of communication skills, "I think what they are saying is that we speak with an accent...I think they think women speak too softly and that prevents them from being leaders in the lab. Those are the assumptions, which are both false. Until those assumptions are removed, diversity in the lab will not take place and our contributions will be very small."

Dr. Clifton Poodry, director of NIGMS's Division of Minority Opportunities in Research, urges NIH to set an example for the rest of the country and adopt a "best practices" model in its recruiting, hiring and promotion policies.

Another reason diversity has failed, Khan continued, is that the diseases affecting some minority populations are not seen as scientifically interesting or significant to the research community in general. For example, he said, when AIDS appeared in the homosexual community, the disease quickly became a national emergency. "Massive amounts of money and manpower were released to combat the problem," Khan said. "Within 18 years, we have an exotic cocktail of drugs like AZT and proteases, and the death rate has dropped down to almost 50 percent. I can't say the same success is true of sickle cell anemia [which was discovered in 1957 and continues to affect millions of African Americans and their children]. What progress have we made? Hardly any."

The last two issues he said NIH needs to address are: What can NIH do to create diversity and what message is NIH sending to the biomedical world by its visiting scientists (who see the lack of diversity here and report back to their homelands that it must be acceptable in all biomedical centers in the world)? Khan proposed that NIH achieve ethnic diversity by selecting capable people, then training, promoting and trusting them, and by placing these people in positions where they could focus on diseases specific to them. Commenting on the last issue, he said visiting scientists should not judge America in haste, but that history has shown that when Americans find they have made a mistake, they do everything in their power to correct it.

"Two important things distinguish America from all other nations in the world," Khan concluded, explaining why he decided to come to a country he felt had a long history of discrimination and why he believes the country needs to play to its strength. "First, America is the land of opportunity. From the beginning it opened its gates to all peoples, regardless of race, religion or place of origin. Today the doors remain open and we still come, bringing our knowledge, our skills, our hopes and our dreams...This mass immigration has created the greatest ethnic diversity in this country — nowhere else can it be found. And this makes Americans the most tolerant people in the world."

In addition, he continued, the climate of freedom in America allows "new ideas and new technologies to flourish, and flourish they have. This has resulted in technological achievements in this country unmatched by any other nation on Earth and that makes America the greatest country in the world."

"I hope this is just the first forum of many," remarked Pedro Morales, deputy director of NIH's Office of Equal Opportunity. "This subject is critical, because as the data reflects, African Americans, Mexican Americans and Puerto Ricans in the mainland are severely underrepresented in science education and in tenure-track positions at NIH. Other minority groups are underrepresented at different levels of the science continuum. The data are instructive as to what are the priorities we must face today and the need to energize the community to develop a response that is within the reach of the NIH leadership to embrace. This is not an easy task. There are many controversial issues. There are legal as well as political issues. There are issues of trust and mistrust as well as competition."

BSA president Dr. Thomas Houze, IRTA postdoctoral fellow in NIAID's Laboratory of Molecular Microbiology, suggested that such differences be confronted head on.

"Conflict is not necessarily a bad thing, if it leads to an honest dialogue and has a constructive goal," he said, in introductory remarks. "These and all other elements are pretty much worthless unless we can create an environment of civility in which divergent ideas can be expressed without being seen as subversive and dangerous. In the next millennium, we as scientists must be totally aware of our social as well as our global obligations."