R. Dipp1, J. Hong2, A.H. Stephen1, S. Chao2,3, D.S. Heffernan1 1Brown University School Of Medicine, Division Of Trauma And Surgical Critical Care, Department Of Surgery, Providence, RI, USA 2New York Presbyterian Hospital, Department Of General Surgery, New York, NY, USA 3Weill Cornell Medical College, Department Of General Surgery, New York, NY, USA
Introduction: The journals Surgery and Journal of Surgical Research, representing the SUS and AAS respectively (and the Academic Surgical Congress collectively), are among the highest regarded academic surgical journals. Manuscripts within Surgery and JSR often define the optimal care of the surgical patient. The reporting of race within clinical manuscripts is increasingly important to uncover potential, and correctable, race-based barrier to accessing surgical care. However, currently there is no standard for reporting race within clinical manuscripts. With the increasing awareness of the importance of appreciating diversity and inclusion, we reviewed the rate of race and ethnicity reporting within JSR and Surgery.
Methods: The journals Surgery and JSR were reviewed for clinical based manuscripts from July 2023 to July 2024. Basic science, translational, review articles and meta-analyses were excluded. Manuscripts were reviewed for whether race or ethnicity was reported and if reported how many times specific races (e.g. White, Black, Hispanic, Asian, Pacific Islander, Native American or “other”) were reported. Articles were also reviewed for the total number of patients, primary sub-specialty of the disease, and the geographic location of the senior author.
Results: Overall, 585 manuscripts were reviewed, 146 (27.8%) of which were international (Non-US) constituting a total of 35,435,206 patients. Only 49.9% of manuscripts reported any race or ethnicity. However, there was a significant discrepancy of reporting race between US and International based manuscripts (65.2% versus 2.7%;p<0.001). Within US based manuscripts, race was most commonly reported among manuscripts originating from SouthWest states (78%) and was least likely to be reported from manuscripts from California (45%) (p<0.01). There was no difference in reporting of race between the NorthEast (71.6%) and SouthEast (69.1%) regions. Race was most likely to be reported in Oncology related manuscripts (76.1%) and least likely reported in Trauma/Acute Care related manuscripts (59.7%) (p<0.01). When race was reported, White was most often noted (98.6%) followed by Black (84.7%). Hispanic (61.1%) Asian (51%) race. Only 20% of manuscripts reported Native Americans, and 14.2% reported Pacific Islander (p<0.01). Overall, 10.5% of manuscripts that reported race noted White race with no other sub-categories.
Conclusion: Despite an increased awareness of diversity, inclusivity, and representation within healthcare, there is real paucity of reporting of race and ethnicity within the leading surgical literature. Further, race is very rarely reported in studies undertaken outside of the US. This work should be a call to action for leading, influential journals to establish standards and measure adherence to guidelines advocating the reporting of race or ethnicity, to achieve better inclusivity of all populations.