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1 + 1 = 3 (or More): The Value of Collaborations for Diversity and Inclusion in Biomedicine

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2 years 10 months
04.17.18 By Hannah A. Valantine
An image of a pencil-drawn web, with multiple multi-colored rectangles with dark blue arrows pointing from each of them towards a central turquoise rectangle.

"Coming together is a beginning, staying together is progress, and working together is success." – Henry Ford

As has been articulated by many, team performance transcends individual strength. Certainly, this is the case for biomedical research, especially in the modern era. Team science draws together novel ideas and approaches, undergirding the value of workforce diversity for solving complex health challenges. Collaborations—across sectors and organizations—extend the concept even further. Such alliances are essential for achieving lasting health and economic impact from biomedical research, and for sustaining scientific workforce diversity, the engine that drives innovation from discovery to application.

Let me begin by reflecting on some examples of successful studies in biomedicine that involved collaborations. As a cardiologist, what comes to my mind immediately is the Framingham Heart Study and follow-on work. Its original goal, set in 1948 by what was then the National Heart Institute, was to identify common factors that contribute to cardiovascular disease. Through a longstanding collaboration with the Boston University School of Medicine and community members (the small town of Framingham, Massachusetts), the study researchers zeroed in on high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity as those factors. This research laid the groundwork for subsequent government-funded research, and collaborations, including between scientists Michael Brown and Joseph Goldstein and industry that yielded cholesterol-lowering statins. These drugs have prevented thousands of deaths from heart disease. The Framingham study and its many collaborations, including the Boston University School of Medicine, extend to this day, embracing the innovation of genomics and Big Data with its third generation of community participants. This model of leveraging collaborations with communities and industry has been extended to studies of cardiovascular disease in African-American communities (the Jackson Heart Study and the Atherosclerosis Risk in Communities Study, for example), setting the stage for broadening our understanding of cardiovascular health. Yet another example of a study involving collaborations is the Women’s Health Initiative, which was pivotal in answering the question of whether hormone-replacement therapy was beneficial in protecting women from cardiovascular death. Moreover, a follow-up analysis showed that this groundbreaking research involving collaborations resulted in 126,000 fewer breast cancer cases and a corresponding net economic return of $37.1 billion—$140 per dollar invested in the trial.

Can we adopt the leveraging power of a collaborative model for enhancing diversity and inclusion in the scientific workforce? Although collaborations already exist between government, academia, and industry to advance the delivery of health innovations to individuals and populations, few if any alliances have been forged in the context of workforce development. If we are to embark upon this model, an integrated approach will be vital. A good place to start in understanding the potential for collaboration is with professional societies that already provide to their memberships discipline-specific professional development, mentoring, sponsorship, and career advancement through job postings. Here are just a few examples:

I firmly believe that this existing and extensive investment of time and resources—which is buoyed by a strong will for change—has established a framework and broad nationwide reach through which NIH can further enhance and accelerate scientific workforce diversity. Seizing this hitherto missed collaborative opportunity could disseminate effective approaches for preparing the next generation of scientists to meet the needs of our increasingly diverse nation. It could also provide the engine to drive institutional culture change that is essential for sustaining a diverse scientific workforce.

In several previous blogs, I have articulated the need for a diverse and inclusive biomedical research workforce to promote excellence, innovation, creativity, broadening the research agenda, and offering the ability to ask new questions stemming from an individual’s life experiences. These goals are attainable if we pool from the U.S. intellectual capital that is rapidly becoming more diverse.

There are pockets of success in progress toward enhancing diversity at certain stages of the biomedical career trajectory: most notably the production of doctorates from underrepresented groups, including women. Most of these successes have been borne of collaborations between academic institutions that are recipients of federal funding from NIH and other federal agencies, such as the National Science Foundation and the Department of Energy.

Yet, in no sector of biomedicine has hiring into biomedical careers matched the diversity in trainee pool despite rapid expansion over the past 10 years. This is where the opportunity is the greatest. As I described earlier, NIH research enhanced by collaborations with communities and with industry has fueled a dramatic decrease (70 percent since 1969) in deaths due to heart disease, and contributed directly to a host of advances across the spectrum of health and disease. The fiscal impact of biomedical research has been similarly impressive. More than half of U.S. economic growth since World War II has come from science and technology resulting from scientists translating discoveries into products with the help of the private sector. As one striking example, the NIH-led Human Genome Project produced nearly $1 trillion of economic growth—a 178-fold return on investment—at a cost of only $2 per year for each U.S. resident. This multidisciplinary effort leveraged expertise and resources across fields and between government and industry.

Postdoctoral fellows performing a research experiment

NIH: Postdoctoral fellows Heba Diab (left) and Lu Sun (right) prepare cells for analysis and discuss their research project with principal investigator Rosa Puertollano Ph.D.

Beyond the pharmaceutical and biotechnology spaces, one area of great promise is information technology. Creative use of Big Data is ushering in new paradigms for biomedical research and its application to health care. Examples include mining data for patterns that can be developed into algorithms to individualize care, identifying and stratifying risk in vulnerable populations, and amassing virtual data through wearable technologies. We are on the brink of a revolution in biomedical research where discoveries at the bench can be rapidly translated into patient care and individualized with precision. Doing so requires a highly integrated approach between discovery and application, made possible by teams with diverse perspectives and novel tools, and yes, collaborations!

The current state of lack of diversity in the biomedical workforce pervades all sectors: biomedical academic faculty, the federal workforce, industry researchers, information technology, and the investment arena that funds all of these to some extent. Yet, we must reframe this problem as an opportunity. We have the trainees, and we have a national need for diverse input to solving health challenges and innovating products for our diverse nation. What’s needed is a vehicle to connect supply and demand. I envision that vehicle to be strategic collaborations that engage these sectors in an integrated fashion, designed with a laser focus on developing the scientific workforce for the range of career paths that are essential to support the U.S. biomedical research enterprise.

Over the past few years, I have been building a framework for an integrated approach to collaborations: "Hubs of Innovation" in scientific workforce development. Collaborations are at the core of this framework—between academia, industry, government, research-intensive and teaching institutions, and professional societies. Imagine a single "Hub" in which leaders from each of these sectors come together to design professional development models that prepare a scientist to move seamlessly into her/his sector of choice, with each collaborating institution implementing agreed-upon data-driven practices for creating institutional cultures of inclusion. The Hubs—aiming to be research-centric and evaluation-based—would initially target the career-transition step toward independence: not just into academia but into the many sectors where a highly trained diverse workforce is necessary to bring innovation to health and technology advances.

Our nation is presented with the unique opportunity of connecting an increasingly diverse talent pool of scientists with the full range of biomedicine careers encompassing basic discovery to health applications, a critical part of the NIH mission to advance human health. Effective collaborations across sectors are needed to connect the wealth of diverse STEM talent with careers that will enrich the nation’s highly diverse population. We must seize the opportunity to engage diversity of experiences and cultures across the many sectors of biomedical ecosystem to ensure that U.S. global preeminence in discovery and applied research is enhanced. In the words of Charles Darwin:

"It is the long history of humankind (and animal kind, too) that those who learned to collaborate and improvise most effectively have prevailed."

 

Hannah Valantine, M.D.

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