The Role of Clinical Trials in Public Health

Data is shaping the future of healthcare, including ways to improve population or public health. Chronic conditions are costly, but most are preventable. Public health professionals are on the frontlines of efforts nationwide to prevent and manage chronic disease. In addition, their profession is essential to researching responses to potential future epidemics using in-depth analysis of community health and risk factors.

Why Do Public Health Professionals Need Data?

Public health professionals are vital to maintaining community health — regardless of the population they serve. By filling the gaps, they often relieve some of the healthcare system’s burden by getting to the root of the problem. For example, they may help with disease prevention, community health education, chronic illness prevention or management. In addition, they may identify and remove barriers people face in finding affordable food, places to live and opportunities for fresh air and physical activity.

Armed with data from clinical trials, public health professionals can develop and share evidence-based approaches to healthy living in various populations. Additionally, they have a cyclical relationship with clinical trials. They use information gained from clinical trials to adjust their health promotion and intervention methods while providing valuable data to researchers conducting clinical trials.

What Are Clinical Trials?

According to the National Institute on Minority Health and Health Disparities (NIMHD), clinical trials “evaluate the efficacy, safety, and effectiveness of clinical treatments and devices, including drugs, surgeries, diets, behavioral approaches, and lifestyle interventions seeking to improve individual and community health.” Public health research aims to improve overall population health by understanding risk factors and effective interventions.

How Do Clinical Trials Impact Public Health?

Public health professionals use clinical trial data or evidence on several areas of population health to better understand public health demographics. They consider various elements including the following examples:

  • Prevalence of population health events (cancer and heart disease)
  • Factors that influence population health (environmental, genetic, social and cultural)
  • Risk factors for poor outcomes (access to care, social determinants of health, readmissions, missed appointments and medication adherence)
  • Mortality risk (suicide and delayed diagnosis)

In addition, they may develop trials to assess public health needs, develop programs or improve public health policies and education.

What is a Real-World Example of Public Health Research?

Clinical trials may provide data on the front end (identifying a need) or the back end (determining the outcomes of current health initiatives). Take the following example from a real-world study:

San Antonio, Texas, has an unusually high rate of childhood obesity. Since local statistics on childhood obesity were limited, researchers sought to better understand the issue. They analyzed data about body mass index, socioeconomic status and food consumption trends for children to determine which factors may be influencing the rate of childhood obesity.

The researchers found that children living in areas where food is less accessible were less likely to consume fresh produce. Using the data from this research, public health professionals partnered with a local nonprofit organization to address the lack of fresh produce in specific neighborhoods. They were able to work directly with already established food stores to provide reduced-cost fresh produce to the public.

A follow-up to this real-world example would be an impact assessment of the food access intervention on obesity rates in San Antonio over several years. Clinical trials must assess the efficacy of program outcomes addressing public health concerns to impact the continuity and potential program replication for changes in other communities. Also, public health professionals can analyze current health initiatives and make recommendations to nonprofit and governmental bodies regarding funding.

How Can Public Health Professionals Improve Clinical Trials?

Just as clinical trial data can influence public health initiatives, public health professionals can improve clinical trials. Perhaps one of their most important contributions is advocating for diversity and inclusion in clinical trials to promote health equity.

The NIMHD emphasizes that clinical trials “must be appropriately inclusive of racial and ethnic minority groups, as well as other populations experiencing health disparities, including sexual and gender minority or socioeconomically disadvantaged populations.” Historically, a lack of diverse participants creates gaps in better understanding risk factors and effective interventions for underrepresented populations.

While the FDA just mandated new legal requirements for clinical trial diversity, these only apply to drugs, not public health interventions. Without diversity, these inequity shortcomings can impede quality healthcare and hinder future clinical trials.

The Eastern Washington University (EWU) online Master of Public Health (MPH) program incorporates an integrated learning experience to match theory with real-world application. Students will create a Biostats toolkit to use in the field for research studies to help them understand which statistical tool can interpret and analyze data most effectively. Graduates of the online MPH program at EWU are able to examine the sociological perspective of healthcare inequities and develop the means to improve them.

Learn more about Eastern Washington University’s online MPH – General program.

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