The year 2020 brought several extreme challenges to our communities, one of which was sharply increased attention to race-based disparities that exist in every aspect of our culture. As the AUA takes significant steps toward addressing and ultimately eliminating these disparities as they relate to urology, an important effort will be addressing racial, ethnic and gender disparities and underrepresentation in urologic research.

This call to action importantly acknowledges the realities and consequences of inequities in research activity across all biomedical disciplines and not uniquely urology. Disparities in research funding hinder opportunities for scientific advancement of researchers from ethnically diverse backgrounds. Funding statistics from the National Institutes of Health are revealing; a recent report documented funding award rates for Black principal investigators to be ˜55% that of white counterparts of similar academic achievement.¹ This hardship translates into barriers for academic promotion, leadership positions and overall professional livelihoods for underrepresented minority researchers.

Similarly, disparities exist with respect to the study of health conditions relevant for the wellness of diverse populations. A comparative analysis of public and private research funding in the United States brought to sickle cell disease and cystic fibrosis illustrates the point. For these genetic diseases, which display comparable epidemiology and morbidity for predominantly ethnic minority and non-minority individuals, respectively, the amount of research funding per person is three-fold less in minorities.² This disparity is all the more startling when philanthropic support is included, which then adjusts the funding difference to be eight-fold.² These findings would suggest the likelihood of unequal scientific progress for advancing medical care for those with sickle cell disease.

Understanding the importance of diversity in research to meet the needs of all patients is not new to AUA and Urology Care Foundation research programs. Over the past several years, the AUA’s Office of Research has worked toward increasing diversity in AUA and Urology Care Foundation scientific symposia, research workshops, research awards, and various advisory groups.^3,4 This has been part of the Office of Research mission to increase and maintain the workforce of urology physician-scientists and researchers. However, these efforts have recently been rightly and significantly increased, and targeted efforts have begun toward comprehensively transforming the AUA’s and our Foundation’s research programs, and ultimately the field of urologic research as a whole, into the vibrant, dynamic, diverse and inclusive support that is needed to ensure that the pipeline of new researchers reflects and includes the diversity that will create the most effective research workforce and outcomes.

Working in collaboration with the recently formed AUA Diversity and Inclusion Task Force, the Office of Research and the AUA Research Council and Committees are developing a new overarching Research Strategic Plan that includes increasing diversity in urologic research as a key goal. Under the guidance of AUA Research Council Chair, Aria Olumi, MD and Chair-elect Steven Kaplan, MD, this includes the establishment of a research-focused Diversity, Equity, and Inclusion (DEI) work group led by Margarett Shnorhavorian, MD, MPH and the AUA Office of Research’s Erik Siedow, MA, that will focus on enhancing DEI across all AUA and Urology Care Foundation research programs to build a better pipeline of physician scientists and researchers in a sustainable, purposeful manner. This includes nurturing interest in urology and urologic research as early as high school and undergraduate levels, transforming interest into passion and curiosity into commitment. Through its participation in the Health Research Alliance (https://www.healthra.org/), the AUA is hearing from organizations such as the V Foundation, the American Society for Hematology, the Burroughs Wellcome Fund, and the Alzheimer’s Association, among others, that have collectively invested tens of millions of dollars in diversity-targeted programs to advance the success of communities of investigators underrepresented in research and provide outcomes that demonstrate optimal approaches to this goal.

The plan to improve DEI will leave no stone unturned, ensuring that DEI is operationalized across AUA and Urology Care Foundation research program governance as well as research advocacy, investigator support programs such as research funding and mentoring, research program communications, scientific peer review, and research education such as scientific symposia, workshops, and courses. This work has already begun, with the establishment of five new awards that are targeted to improve gender, racial and ethnic diversity in urologic research. These awards are spread across clinical and postdoctoral fellow, resident and medical student research grant programs with sponsors including the Society of Urologic Oncology (Research Scholar), Bristol Myers Squibb (Research Scholar), Urovant Sciences (Residency Research Award) and the AUA New York Section (Summer Medical Student Fellowship). Over time, and as additional support is developed, the AUA, working with our Urology Care Foundation as well as partner organizations such as the R. Frank Jones Urological Society and many others, plans to play a major role in strengthening urologic research through a robust and sustainable workforce with equitable opportunity for all and diversity that reflects the urology patient community and urology as a whole.

Acknowledgment

We thank Carolyn J.M. Best, PhD, AUA Director of Research, for her contributions to this article.