Flying Blind: Why Canadian Health Research Fails to Reflect the Population It Serves

Canada's health research enterprise operates under a troubling paradox. For over a decade, federal mandates have required researchers to consider sex, gender, and diversity in their studies—yet no one has systematically verified whether these requirements translate into practice. The result is a system that may be producing research fundamentally misaligned with the population it claims to serve. When clinical trials and health studies fail to include representative samples, the treatments and interventions they validate may work differently—or not at all—for excluded groups. This is not merely an equity concern; it is a validity crisis that undermines the scientific foundation of Canadian healthcare. Our assessment of global health datasets and Canadian research infrastructure reveals that this problem stems not from researcher indifference, but from a critical gap between policy aspirations and operational capacity. Institutions lack the digital tools to measure diversity, leaving them unable to identify—let alone correct—systematic exclusions. Addressing this requires moving beyond compliance narratives toward investment in auditing infrastructure that can objectively verify representativeness.