Evaluating Minority Representation in the All of Us Research Program: Progress and Ongoing Challenges

Area of Science:

• Public Health
• Genomics
• Health Equity

Background:

• The All of Us (AoU) Research Program aims to build a diverse dataset for precision medicine.
• Understanding racial and ethnic representation is crucial for ensuring generalizability of findings.

Purpose of the Study:

• To evaluate trends in racial and ethnic diversity within the AoU Research Program from 2017 to 2023.
• To assess regional disparities in representation compared to US Census benchmarks.

Main Methods:

• Utilized the AoU data repository and 2020 US Census data for comparison.
• Calculated odds ratios (ORs) to quantify underrepresentation by demographic group and region.

Main Results:

• Non-Hispanic White individuals comprised 56.3% of participants; Non-Hispanic Blacks (15.9%), Hispanics (14.9%), Asians (3.5%), and Multiracial/Other (9.4%).
• Asians and Hispanics were consistently underrepresented across the study period.
• Significant regional disparities were observed, with lowest Asian representation in the West (OR=0.48) and most pronounced Hispanic underrepresentation in the South (OR=0.54).

Conclusions:

• Persistent underrepresentation of Asian and Hispanic participants indicates ongoing recruitment challenges in the AoU program.
• Addressing these gaps is essential for achieving the program's scientific and ethical objectives in precision medicine.
• Equitable participation is key to advancing precision medicine research for all populations.