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Do the Skin Colors Depicted in Orthopedic Literature Reflect the Population?
Orthopedics
|July 3, 2025
Summary
Orthopedic literature underrepresents darker skin tones compared to the general population. While representation has slightly improved, it remains significantly lacking, particularly in non-US publications.
Area of Science:
- Orthopedic research and medical illustration diversity.
- Health equity in medical publishing.
Background:
- Previous studies noted skin color misrepresentation in medical journals.
- Orthopedic literature's depiction of skin tones has not been previously assessed.
Purpose of the Study:
- To evaluate if orthopedic literature accurately reflects population skin color diversity.
- To determine if skin tone representation in orthopedic journals has changed over time.
Main Methods:
- Analysis of patient images from four major orthopedic journals in 2010 and 2020.
- Categorization of images using Fitzpatrick skin phototypes (I-III lighter, IV-VI darker).
- Comparison of depicted skin tones against 2020 US Census data.
Main Results:
- Only 13% of images depicted darker skin tones (Fitzpatrick IV-VI).
- Darker skin tones were significantly underrepresented (13% vs. 38% US population).
- Representation saw a slight, non-significant increase from 2010 (11%) to 2020 (16%).
Conclusions:
- Orthopedic literature significantly underrepresents darker skin tones.
- A mild improvement in diversity was observed, but disparities persist.
- Further efforts are needed to ensure equitable representation in medical publishing.
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