Concluding remarks to a PhD thesis written during two historic crises in the United States

I just finished a draft of my PhD thesis, and we are allowed to include a “Concluding Remarks” section, in which we offer some perspective on science based on our thesis training. Here is what I wrote:*

In the weeks I have taken to write this thesis, turmoil has raged across the United States surrounding two separate but related crises: the COVID-19 pandemic and systemic racism. While the protests of the hour center around the death of George Floyd and police brutality, these protests along with the disproportionate impact of the COVID-19 on minority communities (1) bring to light other aspects of American society that have resulted in long-standing and egregious disadvantages for racial and ethnic minority groups in the United States. Studies of public health disasters like Hurricane Harvey (the topic of my thesis) reveal that many health outcomes are influenced by the racial, ethnic, and socioeconomic characteristics of the impacted individuals (2,3). The current crises in our nation highlight the need to analyze and address the root causes of health disparities in the United States, including the higher all-cause mortality for non-white individuals, the higher risk of pregnancy-associated death for non-Hispanic Black and American Indian/Alaska Native mothers, and the higher infant mortality rate for non-Hispanic Black children, just to name a few (4-6). The US clinical and biomedical research system is also not immune to racial and ethnic bias, as the vast majority of studies have failed to include representative numbers of non-white individuals, leaving critical knowledge gaps for other races and ethnicities (7). While the turmoil of the hour is unprecedented in my lifetime, I am hopeful that this outrage at injustice will lead to lasting change and inspire an entire generation of doctors and scientists to study, identify, address, and eliminate the root causes of systemic injustice against minority communities in the US biomedical research and healthcare system.

*modified to eliminate unpublished results from my thesis work.

References

1. Center for Disease Control and Prevention. COVID-19 in Racial and Ethnic Minority Groups. (2020).

2. Chakraborty, J., Collins, T. W. & Grineski, S. E. Exploring the environmental justice implications of Hurricane Harvey flooding in greater Houston, Texas.Am. J. Public Health 109, 244–250 (2019).

3. Hamel, L., Wu, B., Brodie, M., Sim, S.-C. & Marks, E. Early Assessment of Hurricane Harvey’s Impact on Vulnerable Texans in the Gulf Coast Region: Their Voices and Priorities to Inform Rebuilding Efforts. (2017).

4. Centers for Disease Control and Prevention. CDC health disparities and inequalities report — U.S. 2013 Fact sheet. (2013).

5. Cunningham, T. J. et al. Vital signs: Racial disparities in age-specific mortality among blacks or African Americans — United States, 1999–2015. Morb. Mortal. Wkly. Rep. 66, 444–456 (2017).

6. Center for Disease Control and Prevention. Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths. (2019).

7. Oh, S. S. et al. Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled. PLoS Med. 12, 1–9 (2015).