A look at the increasing demographic representation within behavioral medicine

Abstract

Meeting the behavioral medicine research and clinical needs of an increasingly diverse United States population is an issue of national concern. We examine the trends in the demographic representation of the behavioral medicine scientific workforce through an analysis of the training grants funded by National Institutes of Health for the field of behavioral medicine from 1980 to 2018. We report the topics of these training grants, and we depict the demographic representation of the training leaders. We provide the demographic representation of the trainees, and of the first authors of publications reported within those training grants. Finally, we report the topics addressed in these behavioral medicine publications, to determine if topic diversity increased as the behavioral medicine scientific workforce diversified. Visualizations are presented that tell a story of how we have, and have not, advanced representation within the field of behavioral medicine. Best practices for launching future successful behavioral medicine scientists are then presented, to ensure optimal representation and diversification occurs in our workforce, our science, and our delivery of our clinical care.

Keywords: Behavioral medicine workforce; Demographics; Diversity; Representation; Trainees; Training topics.

Figure 1.

Topics of All Behavioral Medicine National Institutes of Medicine T32 Training Awards from 1975–2018. Note: The word cloud summarizes topics of all T32 traning grants. Size of a word reflects response frequency of the word/phrases. ‘Cardiovascular’ is predominantly followed by ‘Drug’, ‘Prevention, Abuse’, ‘Interdisciplinary’ and ‘Aging.’

Figure 2.

Demographic representation of the Behavioral Medicine’s National Institutes of Health T32 Training Directors from 1975–2018. Note: A human icon represents each director of a different T32 training award (shape by sex, color by race). Vertical position of a human icon and a circle (Y-axis) indicate a start-year and an end-year of an award. A dotted line represents a length of each award. For example, a black female director, who is a pioneer of behavioral medicine, has led behavioral medicine over 40 years. Five white males and one white female have lead behavioral medicine over 30 years.

Figure 3.

Predicted Sex, Race, and Ethnicity of First Authors of the 4302 Trainee Publications attributed to National Institute of Health T32 Grants. Note: The stream graph displays chronological volume changes of predicted demographic information of first authors (N=4302) from T32 grants. Overall, the stream volume is predominantly comprised of White male (56.2%) over the past four decades. As large volume of the first authors (over 400 authors per year) has flowed into the stream of the first authors during the past decade, increased volume of minority first authors has drascally entered into the stream of the first authors of T32 grants.

Figure 4.

Proportion of 4302 Trainee Publications attributed to National Institute of Health T32 Grants that focus on Race and Ethnicity Note: The stream graph displays chronological volume changes of topics on race and ethnicity among 4302 publications attributed to T32 grants. Total 7.9% of 4302 publications reports topics on race and ethnicity. The subtopics consist of race/ethnicity (3.7%), African American/Black (2.2%), Hispanics (1.4%), culture/multicultural (0.4%) and Asian (0.3%). The volume of topics on African American/Black and race/ethnicity has rapidly increased over the past five years.

Figure 5.

Proportion of 4302 Trainee Publications attributed to National Institute of Health T32 Grants that focus on Gender Note: The stream graph displays chronological volume changes on gender topics among 4302 publications attributed to T32 grants. Total 10.2% of 4302 publications contributes topics on gender. The subtopics consist of women (7%), LGBT/gay/lesbian/bisexual/homosexual (1.7%), gender (1.3%) and transgender (0.2%). The volume of topics on women and LGBT/gay/lesbian/bisexual/homosexual has abrubtly increased over the past decade.

Figure 6.

Proportion of 4302 Trainee Publications attributed to National Institute of Health T32 Grants that focus on of Social Determinants of Health Note: The stream graph displays chronological volume changes of topics on social determinants of health among 4302 publications attributed to T32 grants. Total 19.7% of 4302 publications reports topics on social determinants of health. The subtopics consist of children (11.7%), age (5.2%), aging (0.7%), elderly (0.7%), socio-economic (0.5%), bias (0.3%), low literacy (0.1%) and disability (0.2%). The volume of topics on children and age has rapidly increased over the past decade.