Authors: Adrien Bernstein, Ruchika TalwarR, Cheyenne Williams, Andres Correa, Brandon MahalIntroduction: Health-outcome differences across racial and ethnic lines have been clearly demonstrated. The specific contribution of our societal systems on these disparities, however, is rarely explicitly addressed in the scientific literature. The extent to which these topics are described within urology has yet to be evaluated. To that end, we sought to assess publishing trends regarding race within the urology literature.
Methods: We performed a systematic literature review of the top 15 urology journals determined by impact and H factor, querying Web of Science, Pubmed, Ovid and Scopus for titles and abstracts with the term race or ethnicity between 2000 and 2021 (n=1206). Abstracts, reply to editors and non-US based literature were excluded (n=254). Articles were graded by the presence of (1) race (2) disparities secondary to race or (3) racial disparities secondary to structural biases.
Results: Our query returned 952 articles for review. In 450 (47%) articles, race was solely mentioned in the abstract as a demographic term or a covariate of an alternative outcome of interest. Of the remaining 505 articles which articulated racial differences in health, 116 (22%) utilized language to specify the difference as a health disparity and only 1 article used stronger language to implicate structural racism. Rates of more direct language varied significantly by journal and year of publication (figure). Discussion of health disparities increased overtime, ranging from 0% at the beginning of the study period to 24% of articles mentioning race in 2020.
Conclusions: Despite frequent use of race as a key covariate within the urologic literature, racial health disparities relating to structural biases are rarely explicitly named. While it is widely acknowledged that in the US race is a determinant of health, often race itself is ascribed the risk when societal inequities more often are at fault. In order to address the systemic biases that underpin these inequities, and in turn improve the health of our patients, increased awareness through clear language in publishing is needed.
Source of Funding: n/a