Race, Ethnicity, and Disparities in Rheumatology Educational Materials

Area of Science:

• Rheumatology
• Medical Education
• Dermatology

Background:

• Clinical images are crucial for rheumatology training.
• Representation of diverse skin tones in medical education is essential for equitable patient care.
• Previous studies have highlighted disparities in medical image representation.

Purpose of the Study:

• To assess the representation of dark skin tones in major rheumatology training resources.
• To compare the depiction of dark skin in rheumatology images with US demographic data and lupus patient populations.

Main Methods:

• Images from key rheumatology resources (ACR Image Library, UpToDate, NEJM, Kelley's Textbook) were analyzed.
• Fitzpatrick's skin phototypes were used to classify skin color as light, dark, or indeterminate.
• Image representation was compared against US Census data and national lupus case studies.

Main Results:

• Only 13.4% of 1,043 analyzed images depicted dark skin.
• Dark skin was significantly underrepresented compared to the US population (13.4% vs. 20.6%) and lupus patient data (22.6% vs. 44.2%).

Conclusions:

• Major rheumatology educational image banks show a significant underrepresentation of darker skin tones.
• Enhanced representation of racial and ethnic minorities in training materials is needed to improve diagnosis of cutaneous manifestations in diverse patients.