Women and non-white people among Lasker Award recipients from 1946 to 2022: cross sectional study

Principal findings

The number of women and non-white people in academic medicine and biomedical research continues to increase,414 yet the proportion among Lasker Award recipients has not changed in more than 70 years, and lag times do not appear to fully account for the observed inequities. Moreover, the proportions have not changed among Lasker Award recipients despite public proclamation of the importance of diversity, equity, and inclusion by the Lasker Foundation.

Women have received just 5% of Lasker Awards for research, but 20% of public service awards. These data suggest that women are more likely to receive non-research awards, reflecting potential implicit biases or adherence to historical gender norms.101516 This gender inequity is magnified when considering women with intersectional identities that focus on overlapping identity characteristics which may increase levels of discrimination (eg, gender and race combined) because one non-white woman was identified as having received a Lasker Award over the course of seven decades. These findings are consistent with previous research suggesting bias against these groups.16

Perhaps one of the most telling findings is that of the 12 Nobel laureates in Physiology or Medicine who were women (this award has shown important gender inequities5), 33.3% (4/12) have not received a Lasker Award. This inequity was most pronounced in 1947 when Carl Cori and Gerti Cori shared the Nobel Prize in Physiology or Medicine for their discovery of the catalytic conversion of glycogen;12 however, in the previous year, the Lasker Award for the same contributions was awarded only to Carl Cori.

Policy and societal implications

The anonymity of the nomination process precludes the ability to assess if women and non-white people are being nominated at equitable rates, and once nominated, if they are receiving awards equitably based on the composition of nominees. Thus, we propose the entire award process be made transparent, from the call for award nominations to review, selection, and conferral. It would be beneficial to know the methods used for the award process, including the language used in the call for the award. Furthermore, understanding the personal characteristics of those involved in the awards is paramount to allow for analysis of potential inequities at all award stages. The people involved include those who are nominating candidates for awards, members of the review and selection committees, and the award nominee cohorts themselves. Moreover, detailing how review and award selection committee members are chosen would help ensure these committees have diverse members.

Furthermore, establishing a database of demographic and other relevant personal data for award recipients, award nominees, and the pool of potential award candidates overall would allow temporal analysis of the gender ratio among award recipients compared with the gender ratio among suitable candidates. This process of temporally tracking award nominees and recipients by gender would allow researchers and the public to independently assess the impact of diversity, equity, and inclusion initiatives, and ensure the Foundation is held accountable.

In addition to these initiatives, transparency about academic metrics and award criteria is critical for rectifying inequities. Academic metrics, while important for award recognition, must be evaluated carefully because many of these metrics could be manipulated. Therefore, it is crucial to understand the importance placed upon specific quantifiable award metrics, such as the number of publications, Hirsch index (H index), and research funding. However, perhaps more important is understanding how award selection committees define unquantifiable metrics, and to what extent emphasis is placed upon them, such as importance of discoveries, major contributions, and groundbreaking work. These are important considerations because previous studies have shown that women are not equitably represented when considering these metrics, which likely contribute to inequities among recognition awards, including the Lasker Award. For example, studies show that women are credited less than men in research,1718 men might tend to overstate the importance of their research,19 and this lack of restraint could lead to perceived bias about their contributions to science.20 These findings suggest that women, if producing research that is considered similarly impactful as that being produced by men, are less likely to be recognized and cited. Furthermore, some authors have suggested that women must reach higher levels of scholarly achievement than men to achieve similar career success.21

Finally, while this study focused on inequities among recipients of a prestigious biomedical award, the implications transcend recognition awards. We have established the need for further investigation into the myriad of potential factors that might hinder women and members of historically minoritized groups from advancing in biomedical science and academic medicine. These factors include recruiting pathways, available mentors, resources, implicit biases, stereotypes, and external structural biases, among others.

Strengths and limitations

This observational study could not assess causation, and we do not assert any one factor as the sole cause because inequities are often multifactorial. Another limitation is potential mischaracterization of personal characteristics. While all methods of identifying personal characteristics are subject to limitations, perception by others is believed to be important because it could affect bias.10 Furthermore, our methods have previously been used.1 We acknowledge that race and ethnicity are social constructs and all forms of categorization have known limitations. Binary forms such as racialized, visible minority, and non-white have all been used quite extensively. In our analysis we selected the term racialized because it has recently been gaining favor in the literature.

The proportion of non-white people in biomedicine was not calculated as it was for women because the number of active non-white scholars in biomedicine is unknown. These data are no longer collected by many institutions by law, and it is impossible to estimate this figure algorithmically from scholars’ last names.

Finally, we acknowledge that the true denominator or the population from which recipients of the Lasker Award are selected is unknown. While we attempted to account for the time required from the beginning of a scholar’s research career to recognition by the Lasker Foundation, for all practical purposes, only the highest achieving researchers (and not all researchers) make up the population to which the awards are bestowed. Unfortunately, identifying this high achieving population is fraught with challenges. While one could theoretically calculate the proportion of women and men among the 5% of researchers with the highest H index for example, this does not necessarily reflect the appropriate denominator because those involved in clinical medicine and public health are unlikely to fall into this population. Furthermore, and potentially more concerning, is that these metrics are already inherently flawed. As previously mentioned, several studies have shown that women tend to be credited less than men for their research,1718 and must attain greater achievement than men to reach similar success in their academic career.21 Therefore, using metrics that are already inherently inequitable would only further contribute to these inequities.

Conclusions

In summary, the Lasker Awards are prestigious biomedical awards, and while the number of women and non-white people in academic medicine and biomedical research continues to increase, the proportion of women among recipients has not changed in more than 70 years. The proportions of white men among recent award recipients remain high, which is difficult to reconcile given the ever increasing number of qualified scientists from diverse backgrounds. Moving forward, offering support at every level to enable people to excel not only remains important, but continuing to interact with institutions conferring awards to maintain accountability and equitable representation among selection committees should also be emphasized. These trends show that continued diversity, equity, and inclusion efforts are required. However, researchers and advocates must hold organizations responsible for outcomes because our findings highlight that simply publicizing commitment to diversity, equity, and inclusion initiatives does not necessarily guarantee change or equitable practice.