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Revisiting Race, Ethnicity, and Disparities in Rheumatology Educational Materials: An Update Since 2020
Lisa Zickuhr1, Eric Roberts2, Tyler Daugherty1
1Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Arthritis Care & Research
|March 19, 2024
Summary
Awareness of underrepresentation of people with skin of color (P-SOC) in rheumatology education led to improvements. A 40.6% increase in P-SOC images in key materials between 2020 and 2024 demonstrates progress toward equitable representation.
Area of Science:
- Medical Education
- Rheumatology
- Health Equity
Background:
- Clinical images in rheumatology educational materials have historically underrepresented people with skin of color (P-SOC).
- A 2020 study highlighted this disparity, prompting publishers to address the issue.
Purpose of the Study:
- To investigate the change in representation of P-SOC in rheumatology educational materials following the 2020 awareness study.
- To quantify the improvement in the proportion of images depicting dark skin tones in key rheumatology resources.
Main Methods:
- Images from the American College of Rheumatology (ACR) Image Library, Kelley's Textbook of Rheumatology, New England Journal of Medicine (NEJM), and UpToDate were collected.
- Skin tones were categorized as 'light' or 'dark', and the proportional change in images depicting dark skin tones was calculated between 2020 and 2022/2024.
- One-sided Z-tests were used for statistical comparison.
Main Results:
- The overall proportion of images depicting dark skin tones increased by 40.6% (P < 0.0001).
- Kelley's Textbook of Rheumatology showed the most significant increase (90.1%, P = 0.0039).
- ACR Image Library, UpToDate, and NEJM also demonstrated enhanced representation (41.9%, 31.0%, and 28.2% increases, respectively).
Conclusions:
- Focused efforts by educational publishers can significantly improve the representation of P-SOC in rheumatology educational materials.
- Enhanced visual diversity in educational resources is crucial for improving the quality of foundational knowledge for rheumatology providers.
- This progress aims to enhance health experiences and outcomes for P-SOC with rheumatic diseases.
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