Naming the Problem: Publishing Trends within in Urology on Race, Health Disparities and Structural Racism

Area of Science:

• Urology
• Health Disparities Research
• Bibliometrics

Background:

• Race is a known determinant of health, yet its role in health disparities is often oversimplified in medical literature.
• Societal inequities and structural biases are frequently the root causes of health disparities, rather than race itself.
• The urology literature's approach to discussing race and health disparities requires examination.

Purpose of the Study:

• To assess publishing trends concerning societal systems and their contribution to health disparities in urology.
• To analyze how race and racial disparities are discussed in top urology journals.
• To identify trends in the explicit naming of structural racism as a driver of disparities.

Main Methods:

• A bibliometric analysis was conducted on articles published between 2000-2021 in the top 15 urology journals.
• Articles were reviewed for mentions of race, racial health disparities, and disparities linked to structural biases.
• Logistic regression was used to analyze trends and the odds of publishing on disparities over time.

Main Results:

• Of 934 reviewed articles, 52% mentioned race as a demographic, and 12% noted racial health disparities.
• Only 2 articles explicitly implicated racism as a cause of disparities.
• Discussion of disparities increased significantly over time, with an 11% annual increase in the likelihood of disparity publishing.

Conclusions:

• The urology literature frequently uses race as a covariate but rarely names structural racism as the underlying cause of health disparities.
• Despite increased discussion of disparities, explicit acknowledgment of structural racism remains infrequent.
• Clearer language in publishing is necessary to address systemic biases and improve understanding of health inequities in urology.