Leaders of the AAP’s flagship journal Pediatrics say they have seen progress in the use of race in the journal’s articles over the years, but there is room for improvement.
“As our understanding of inclusive language evolves, it is our responsibility as the medical and scientific community to ensure the responsible reporting and interpretation of race,” authors wrote in “Trends in Use and Discussion of Race in Pediatrics Articles Over 75 Years,” (Nama N, et al. Pediatrics. April 9, 2024). “It is important for researchers to understand the role race plays in health disparities, and to appropriately acknowledge race as a social and not biological construct.”
A team of Pediatrics editors and current and former members of the Pediatrics editorial board analyzed a sample of 375 articles that spanned 1948 to 2022. They found 39% of the articles included race as a variable. Most of the 137 U.S. studies that included race did so only to describe the study subjects.
Among 137 U.S. articles including race from 1948 to 2022,
- 7% described race as a social construct,
- 11% described race as biological,
- 20% included statements perceived as implicit bias,
- 5% included explicit bias,
- 9% compared subjects with dichotomous terms like white/non-white and
- 13% adjusted for race in prediction models, many of which used white as a reference group.
Authors also looked at articles from 2013 to 2022. About 53% of the articles from that period discussed race, mostly to describe the subjects.
Among 23 U.S. articles published in the last decade that included race,
- 13% described race a social construct,
- 4% described race as biological,
- 22% had statements that may reflect implicit bias,
- 0 included explicit bias and
- 13% compared subjects with dichotomous terms like white/non-white.
“Our findings overall demonstrate the need for continued improvement of specific guidelines, expectations and education surrounding reporting race and mitigating racial bias in the scientific literature,” authors wrote.
Pediatrics journal guidelines, which were updated in 2023, instruct authors to avoid nonspecific terms like minority, people of color and non-white. Authors should provide a rationale for including race and/or ethnicity in a manuscript as well as context.
“Results related to race and/or ethnicity should be interpreted in the context of racism (eg, interpersonal, institutional, or internalized) and histories of exclusion, mistreatment, and exploitation, rather than as behaviors or presumed deficits,” the guidelines state.
Resources
- Pediatrics guidelines on the use of race and/or ethnicity
- International Committee of Medical Journal Editor guidelines on preparing a manuscript
- AAP policy Eliminating Race-Based Medicine
- “AAP Perspective: Race-Based Medicine”
- AAP Equity Agenda
- Words Matter: AAP Guidance on Inclusive, Anti-biased Language
- AAP News story “AAP receives major grant to help eliminate race-based medicine”
