Research Beyond the Ivory Tower: Partnering with Safety-Net Health Systems for Equity

Safety-net health systems serve primarily low-income, racially/ethnically diverse patients who bear a disproportionate burden of disease and high social needs. Many safety-net institutions are publicly funded and are under-resourced to deliver high-quality and timely care. Further, little clinical and translational research includes safety-net populations due to lack of funding, structure to support research, and low prioritization. However, we argue that US health care as a whole will lose key insights across all levels of translational medicine—T1–T4 research, if safety-net health systems do not participate in research. Solutions such as targeted funds for safety-net research, consortium arrangements for research infrastructure, and increasing ways for clinician-researchers to have their primary home in safety-net settings are suggested to fill this gap. Achieving health equity in the U.S. is contingent upon safety-net inclusion in research to advance knowledge and develop, test, and evaluate innovations applicable across all patient populations.