Addressing racism as a driver of racial disparities in surgical literature: A scoping review

Since 2020, recognition of racism as a driver of health disparities has increased, yet the surgical literature lags in explicitly addressing its impact, limiting opportunities for advancing health equity. We conducted a scoping review of five high-impact U.S.-based general surgical journals using Google Scholar's H5-index, searching for original studies explicitly linking racism to surgical outcomes with the terms "racism," "surgery," and "surgical." Of 67 publications, 15 met inclusion criteria. Across studies, structural racism was consistently identified as a driver of advanced disease presentation and worse outcomes for Black patients. Surgical Oncology was the most studied field, with studies primarily addressing breast and colorectal cancer; Acute Care Surgery was the second most-studied. Several studies used geospatial analyses to reveal the lasting effects of historical redlining on surgical outcomes. Despite these findings, explicit investigations remain limited. Expanding research that examines racism within surgical practice and identifying ways to counteract its effects is essential to achieving meaningful health equity.