Call for Papers on Prevention and the Effects of Systemic Racism in Health
Authors: Frederick P. Rivara, Stephan D. Fihn
Journal: JAMA Network Open (2020)

Health, as defined by the World Health Organization, "is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." 1 It is a simple concept but embodies the effects of multiple forces acting from before conception to the end of life.Although massive local and global disparities in health have been recognized for decades, there is now an emerging consensus that systemic racism, defined as a "system of structures, policies, practices, and norms that construct opportunities and assigns values based on one's phenotype" is one of the strongest forces. 2(p9) In JAMA Network Open, we have published many articles evaluating health outcomes associated with systemic racism, including neighborhood-based social determinants of health associated with premature mortality, 3 discrimination in health care, especially among African American individuals, 4 racial bias of clinicians toward African American women during allocation of advanced heart therapies, 5 disparity in access to trauma centers for Black communities, 6 fear generated by electoral politics on premature births among Latina women, 7 fewer positive effects on health with higher parental education among Hispanic youths, 8 and the projected estimates of African American medical graduates of closed historically Black medical schools. 91][12] Emblematic of these concerns has been the heightened visibility of the use of excessive force by police on minority populations, which has sparked protests in the US and elsewhere around the world.Addressing these long-standing inequities requires action in many elements of society including the entire health care system encompassing the financing and delivery of health care services, recruitment and training of health professionals, and medical research.Desperately needed is a better understanding of how systemic racism and other social determinants affect health and the interventions that can lower risks and improve outcomes.JAMA Network Open is therefore issuing a call for papers that contribute to the evidence base on prevention and the effects of systemic racism on health and health care.We are interested in papers that apply rigorous science to examine who is affected, the mechanisms of how racism translates into poor health and health care, and how racism and its effects can be addressed at the primary, secondary, and tertiary levels of prevention.Studies that use rigorous science, including randomized and nonrandomized clinical trials that assess interventions, observational studies, and systematic reviews and meta-analyses are needed to make progress in this area.Progress must also include changes in health care systems, from the national and local policies that govern the health care sector, to the selection and education of health care professionals, to financing that eliminates restrictions on access, to the provision of high quality health care as defined by the US National Academy of Medicine-"care that is safe, effective, patient-centered, timely, efficient, and equitable." 13(pp5-6) Interested authors should consult our Instructions for Authors 14 on the study designs and reporting requirements for articles suitable for JAMA Network Open.