Goldberg Julia E, Prabhu Vinay, Smereka Paul N, Hindman Nicole M
From the Department of Radiology, NYU Langone Health, 550 1st Ave, New York, NY 10016.
Radiographics. 2023 Feb;43(2):e220112. doi: 10.1148/rg.220112.
Current disparities in the access to diagnostic imaging for Black patients and the underrepresentation of Black physicians in radiology, relative to their representation in the general U.S. population, reflect contemporary consequences of historical anti-Black discrimination. These disparities have existed within the field of radiology and professional medical organizations since their inception. Explicit and implicit racism against Black patients and physicians was institutional policy in the early 20th century when radiology was being developed as a clinical medical field. Early radiology organizations also embraced this structural discrimination, creating strong barriers to professional Black radiologist involvement. Nevertheless, there were numerous pioneering Black radiologists who advanced scholarship, patient care, and diversity within medicine and radiology during the early 20th century. This work remains important in the present day, as race-based health care disparities persist and continue to decrease the quality of radiology-delivered patient care. There are also structural barriers within radiology affecting workforce diversity that negatively impact marginalized groups. Multiple opportunities exist today for antiracism work to improve quality of care and to apply standards of social justice and health equity to the field of radiology. An initial step is to expand education on the disparities in access to imaging and health care among Black patients. Institutional interventions include implementing community-based outreach and applying antibias methodology in artificial intelligence algorithms, while systemic interventions include identifying national race-based quality measures and ensuring imaging guidelines properly address the unique cancer risks in the Black patient population. These approaches reflect some of the strategies that may mutually serve to address health care disparities in radiology. RSNA, 2023 See the invited commentary by Scott in this issue. Quiz questions for this article are available in the supplemental material.
与美国普通人群中的比例相比，目前黑人患者在获得诊断性成像方面存在差距，且黑人医生在放射学领域的代表性不足，这反映了历史上反黑人歧视在当代的影响。自放射学和专业医学组织成立以来，这些差距就一直存在。在20世纪初放射学作为一个临床医学领域发展时，对黑人患者和医生的显性和隐性种族主义是机构政策。早期的放射学组织也接受了这种结构性歧视，为黑人放射科医生的职业参与制造了强大障碍。尽管如此，在20世纪初，仍有许多开创性的黑人放射科医生在医学和放射学领域推动了学术研究、患者护理和多元化。这项工作在当今仍然很重要，因为基于种族的医疗保健差距依然存在，并继续降低放射科提供的患者护理质量。放射学内部也存在影响劳动力多样性的结构性障碍，对边缘化群体产生了负面影响。如今，有多个机会开展反种族主义工作，以提高护理质量，并将社会正义和健康公平标准应用于放射学领域。第一步是扩大关于黑人患者在获得成像和医疗保健方面差距的教育。机构干预措施包括开展基于社区的宣传，并在人工智能算法中应用反偏见方法，而系统性干预措施包括确定基于种族的国家质量指标，并确保成像指南妥善解决黑人患者群体中独特的癌症风险。这些方法反映了一些可能共同有助于解决放射学中医疗保健差距的策略。RSNA，2023 见本期斯科特的特邀评论。本文的测试问题可在补充材料中获取。
