Disparities in healthcare are one of the biggest problems facing America’s Black and Brown population today, from soaring costs to lack of adequate medical coverage. This is especially true within the realm of medical research, where a vast majority of the testing for new pharmaceuticals and experimental therapies is focused almost entirely on white volunteers. Thankfully, a new company called Acclinate has set out to fight the problem by increasing the involvement of minority populations in clinical testing and helping to even the playing field to ensure that a diverse and inclusive population is fully represented in all aspects of emerging medical research and development.
For anybody with even a passing knowledge of the healthcare industry, it’s likely not surprising to hear that disparities in medicine have existed for decades. Using data from the National Center for Health Statistics, researchers in 200 found that the mortality rate for Black men and women was 1.6 times higher than it was for white individuals — a rate that hadn’t changed significantly in more than fifty years.
Things are just as grim today. In a 2020 study conducted at the University of Michigan, researchers were able to compile numerous current studies showing the ongoing and glaring health disparities that exist between Black and white Americans. In addition to higher rates of hypertension, diabetes, obesity, some forms of cancer and greater levels of cognitive decline in old age compared to white people, the study also revealed that Black people had less access to health care, received lower payouts from Medicare after dying and were more likely to suffer from some form of food insecurity. In a blog post about the study, Melissa Creary, Ph.D., assistant professor of health management and policy at the U-M School of Public Health, wrote “We see an undeniable burden of disease in the Black population. It’s this disproportionate amount that is worrisome. The underlying issue to why we see so many is actually attributed to structural inequity.”
Even in clinical trials, where representation and inclusion are essential to ensure the development of a drug or procedure works for people of all races, these sorts of disparities remain an ongoing concern for physicians and scientists. From research into the treatment of gout to the development of COVID-19 vaccines, Black and Brown individuals simply aren’t as involved.
Enter Acclinate. Created by Dr. Delmonize “Del” Smith, an IT and healthcare guru, and Tiffany Whitlow, who has spent more than 15 years working in healthcare management and community engagement, Acclinate bills itself as a company committed to increasing diversity in clinical trials, improving recruitment of minority volunteers and ensuring inclusive representation throughout all aspects of ongoing medical research.
Acclinate was also recently selected by Cox Enterprises (No. 17 on The DiversityInc Top 50 Companies for Diversity list in 2020) as one of ten startups currently participating in the “Cox Social Impact Accelerator powered by Techstars” program. The Techstars program spotlights startups that have a focus on creating solutions to curb social injustice or that will otherwise beneficially impact the lives of diverse communities. The program provides all of the founders with capital investment, executive mentoring and networking opportunities to help them achieve their goals faster. Acclinate is currently using the opportunities and mentorship they received as part of the program to push even further toward their goal of helping to eliminate racial disparities in healthcare, especially as it relates to clinical testing.
In a recent Zoom conversation with Acclinate founders Dr. Smith and Whitlow, DiversityInc was able to learn more about how the company was formed and what they see as the future of healthcare in America.
What follows is a look at that conversation, edited lightly for both clarity and readability.
DiversityInc: Thanks so much for taking the time to talk with us today! Could you tell us a bit more about your background, how you got started working together, and how Acclinate came about?
Dr. Del Smith: Sure, absolutely. So, I think it’s important to note that we were here pre-COVID-19 and pre-civil and social unrest too — we’ve been at this a while. About a year and a half ago, Tiffany and I really solidified our current business model, spending time trying to figure out how we can get the attention of the industry to let them know that we were here and can help them to work against racial disparities in their research. Then, all of a sudden, COVID-19 happened. And of course, civil and social unrest spiked as well, which really put a spotlight on health inequalities and other social justice issues.
Since then, Acclinate has really taken off. We’re very excited about the opportunity that’s in front of us despite the fact that what really led to the opportunity was this terrible pandemic. We were finally looking at issues of health, inequalities and health disparities, which we think is a good thing for our country and our company.
Right, definitely! For people who don’t know how medical studies work and how research trials are put together, can you talk through why representation of all groups is so important?
Tiffany Whitlow: Del and I usually use our personal stories when we’re talking about this, so I’ll let Del share his. Mine is that I was actually given up for adoption because I’m biracial, so I was never really able to make good health decisions early in my life. When I became a mom myself and had to make decisions for my son who was hospitalized due to his asthma, I wanted to learn everything I could to make those good decisions. And that’s when I found out that one of the medications he was being given — Albuterol, which is the most commonly prescribed drug for asthma — was less effective for 47% of African Americans and 67% of Puerto Ricans. Learning that, learning that these drugs that we are depending on to save our lives really inspired me to start working in this field.
Dr. Smith: So much of what we’re doing is about making sure that our communities of color are empowered about their health. For me, my personal story is when I was younger, my mom contracted tuberculosis. She was a health care worker and of course, they gave her drug after drug after drug to see which one would actually work to help her recover. Unfortunately, she passed away as a result. We now know that if they’d done genotype testing on her, they could have determined which one of those three drugs would have had the greatest effect on her. Maybe the outcome would have been different.
When my mom passed away, I went searching for my biological father, only to find that he’d passed away a year earlier. I also discovered that every single male on his side of the family passed away from cancer before the age of 50. So, all of a sudden, I was faced with this new information about my own propensity for cancer. I’ve got three sons and that obviously became a front-and-center concern for them as well too.
These stories and our personal backgrounds are also what fuels our passion as a company — our interest in ensuring that people are empowered, that communities of color take control of their health and learn more about their health and understand how they can be proactive, as Tiffany said. We want to help people learn about how they may be able to be part of clinical trials that could benefit them, regardless of whatever disease, state or situation they’re in.
Looking at the way Acclimate works, you set out to build a community of individuals who are open to being involved in research and then help them find studies that might apply to their specific health concerns. What’s your process like for educating people and building that community? How do you find people who are interested in participating?
Whitlow: We tap into trusted organizations and community partners as our primary data source. The industry forgot a long time ago that a lot of this is grassroots and that you have to have relationships with the communities you’re trying to serve — especially knowing the lack of trust that exists within the minority community based on past injustices within the healthcare system.
When we find people who are interested in working with us and who want to learn more about trials that might benefit them, they become part of a pool or group that we call the Now Included community. And once you’re a member of the Now Included community, you’re always a member of the Now Included community, regardless of your active participation in a trial or how many trials you’ve been a part of.
And then companies that are doing research can then come to you to find volunteers or people who might be interested in the research, ensuring they’re covering a broad and diverse swath of people with their trails. That’s a great model to have set up! Before Acclinate existed, what was this process like? Why was it so lopsided towards white individuals vs. people of color?
Dr. Smith: I wish I could say that the process was very systematic. A lot of times, these sites and these investigators are trying to entice people with incentives like $10 or $15 gift cards, encouraging them to be part of the trial. They’re going out into their most immediate community and network. We’ve even seen people go out with clipboards and stand on a street corner, trying to recruit people for clinical trials. You’d think that that’s not going on today, but it is. And again, it’s this first interaction of just dealing with people because you’re trying to get them into a trial where we feel like the industry is currently falling short. People want to know that you care about them first and foremost, as an individual and about their health. And they want to know that before you ask them to be part of some trial.
Your system sounds like a win-win for both individuals who are looking for new research or looking to address certain medical issues, as well as companies who are trying to ensure they’re serving all members of a community.
Dr. Smith: That was definitely our goal. We’ve developed a platform that allows us to identify which participants in our community network would be most likely to take part in a given trial if they were given the opportunity and that’s the way that we have made the system more efficient. At the end of the day, we’re decreasing the time it takes to recruit people for trials. We’re decreasing the costs that it takes to recruit people for trials and, more importantly, we’re increasing the diversity of the clinical trial participants themselves. That’s what we’re adding in terms of value to the current system.
Great! Is Acclinate primarily focused on drug research currently or are there other areas where the Now Included community are helping with inclusion as well?
Dr. Smith: We’re primarily dealing with disease states and drug research, but we have been approached recently about expanding our trials to other areas. For example, we have a particular pharmaceutical company that has a skincare line and they want to be able to test this new skincare line, particularly on people of color because of the rising demographics. Forty percent of our U.S. population is currently minority and growing, so being able to make products that are effective for everyone is a growing concern that we’re happy to assist with.
What kind of goals or benchmarks are you hoping to achieve in the coming years? What excites you about what you’re doing and how it can impact the future?
Whitlow: For me, the most important thing is helping the industry understand that they also need to be held accountable and they need to work harder to serve all communities. To do that, there needs to be a true disruption to the current process. That’s not going to feel good. It’s not going to feel comfortable. It’s not going to be what you’re used to. But ultimately it’s going to have the outcome that the industry wants to have. And it’s going to help companies develop more effective drugs that work in the larger population as a whole, which obviously drives their revenue and matters to them.
I’m excited that when big pharma is now looking at deploying new clinical trials, we are a part of that process. Diversity is now involved in these trials.
Dr. Smith: Tiffany’s right on. I think that the longer-term picture for us is that we would like to be seen and known as the most trusted source for health-related issues for the minority community. We know we’ve got other entities and people that are trying to do general healthcare-related information for the masses, but we are specifically focused on building a company that, if you are suffering from sickle cell or you just got a diagnosis of prostate cancer, can be a resource for individuals. If you’re trying to figure out where to go to deal with some condition or where you can get more information or where you can connect with people who look like you or find physicians that look like you, we want to be that resource. And we want our Now Included community to be there as a resource as well, providing support, acceptance and assistance.
Dr. Smith: I’ll sum it up this way: As a young company who believes that they’ve developed a unique solution to a problem that’s been around for a long time, we know that whoever has the best product is not necessarily the one that wins the business race. But what we’re most proud of is the fact that we’ve been very successful with getting the attention of the industry. And when we look at what’s coming down from the Biden administration, as it relates to health equity and health inequalities, and the strategies put in place, knowing there’s a good chance that we’re going to play a very active and significant role in that process — those are the things that we’re excited about.
For anyone who believes that they have a solution to have a positive impact on a problem, you don’t sleep well at night until you know that you’re fully realizing the potential, to get that solution out to as many people as possible and to make as big of a difference in the world as you can. And that’s what I think I’m most excited about when I put my head down on the pillow at night.
For more on Acclinate or to become a member of the Now Included community, click here.
For more on the Cox Enterprises Techstars program, click here.