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Quantification and optimization of travel time for ethnic minority populations in cancer clinical trials

Lee, H.; Trevino, J. G.; Terry, M. B.; Winkfield, K.; Janowitz, T.

2024-05-29 epidemiology
10.1101/2024.05.29.24308033 medRxiv
Show abstract

Of all minority racial and ethnic groups, Hispanic populations are most under-represented in trials compared to the general US population. Transportation and socioeconomic burdens are two important inter-related quantifiable and modifiable variables associated with decreased clinical trial participation for underrepresented populations. In this study, Hispanic population sizes and socioeconomic deprivation indices of catchment areas within simulated 30-minute driving distances from all major U.S. cancer trial sites (N=78) and all U.S. hospitals (N=7,623) were calculated using OpenStreetMap and U.S. census data. In the proximity of major trial sites Hispanic ethnicity representation varied across a wide range (64% to 2%) and Hispanic populations were underrepresented compared to the national average in almost 2/3 of the sites (n=50). The cities with the highest number of hospitals identified with catchment populations of >60%, >40% or >20% Hispanic representation were San Antonio TX, Houston TX, and New York NY respectively. Data-driven analyses can quantify and optimize measurable factors associated with decreased clinical trial participation for under-represented populations and may aid selection of trial sites to enable participation.

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