Responsibility of Medical Journals in Addressing Racism in Health Care
Authors: Gbenga Ogedegbe
Journal: JAMA Network Open (2020)

2][3] However, while racial and ethnic health disparities have been the subject of research for decades, racism has received comparatively little attention in research published in medical journals.Recent protests across the US and beyond in response to the horrific death of George Floyd, an unarmed Black man, at the hands of a police officer in Minneapolis, have drawn renewed attention to the consequences of systemic racism on the health of Black, Hispanic, indigenous, and other people of color.Defined as a "system of structures, policies, practices, and norms that construct opportunities and assigns values based on one's phenotype," 4 racism was identified 30 years ago as an underlying cause of health inequities. 5Since then, the role of structural pillars of racism such as employment discrimination, mass incarceration, redlining, substandard public education, exposure to environmental hazards, differential treatment in health care settings, and poor access to quality health care have been extensively documented as social determinants of health.These structural pillars of racism foster an insidious and pervasive environment that promotes the persisting racial gap in morbidity and mortality.Given this context, it is important to reassess the role of medical journals in addressing the health effects of systemic racism. Racism as a Social Determinant of HealthRecently, many professional societies 6-8 representing physicians have made public declarations denouncing racist police brutality and racially motivated violence, with some affirming how racism contributes to social determinants of health.These statements should be a call to action for the medical community to promote research on the role of structural racism in public health.Some statements suggest the role medical journals can play not only communicating research findings but also in providing a platform for constructive dialogue.For example, the American Academy of Pediatrics stated that "systemic violence requires systemic response." 9This aptly highlights the requirement that to address the larger social ills of structural racism, all institutions must be accountable, and all must contribute to eliminating the deeply embedded racism that is woven throughout the fabric of US society.The profession of medicine and its medical institutions cannot remain complacent or complicit in the scourge of police brutality, a very visible form of structural racism; police shootings claim a disproportionate number of Black individuals yearly, a rate 2.5-fold higher than for White individuals. 10In 2015, the number of deaths per 1 million was 12 for White individuals, 22 for Hispanic individuals, and 30 for Black individuals. 10The practice of medicine must be reimagined to contextualize the social, structural, political and legal environment within which disease occurs if we are to uphold the sacred oath of "first do no harm." 11 Why Should Medical Journals Respond Now?One way that the medical establishment can lend its voice is through medical journals, an important platform for advances in clinical sciences and health care.There are several reasons for this importance.First, medical journals remain a critical source of rapid response efforts for acknowledging the severity of emerging public health issues and providing effective measures to address them.For example, we witnessed in the first half of this year the capacity of medical