Black lives matter in haematology

Abstract

The death of George Floyd at the hands of police in Minneapolis on May 25, 2020 has rightly sparked an outpouring of rage which is reverberating around the world. Racism costs lives, from disproportionate danger for Black people in the USA to systemic unfairness in other spheres of life around the world for many ethnic minorities, such as access to healthcare and opportunities for career advancement in acadaemia. Sadly, there are plenty of examples of inequality and inequity in haematology. As highlighted in our first Diversity and inclusion in haematology column, a diverse workforce that practices culturally competent medicine is essential from the standpoint of patient care; however, pay gaps and career advancement gaps, particularly in leadership roles, remain for Black people and other minority groups. Haematologists treat various conditions that disproportionately affect Black patients, such as sickle cell disease. Black and ethnic minority patients are less likely to be recruited into clinical trials in the haematology–oncology setting, which denies them access to potentially transformative treatments. It is more difficult for Black and other ethnic minority patients who require allogeneic stem cell transplantations to find a matched donor from a registry; the same issue arises for blood transfusion for which there are fewer Black blood donors. We must not blame these communities for not participating, but remove the obstacles that are stopping them from doing so. As has been highlighted by the editorial in The Lancet, medical journals have a role to play in the current dialogue. We made a commitment to achieve gender equity and to increase diversity among our authors, reviewers, and board members, and will continue to work towards those goals. We will add our voice to those calling for change, because standing up to racism is something in which we must all participate. Addressing bias towards patients with sickle cell diseaseStudies done in the USA suggest that many health-care providers have an unconscious preference for white patients and negative attitudes toward people of colour. Despite being contrary to our consciously-held egalitarian principles, these insentient beliefs can still filter their way into the clinical setting, manifesting as domineering language and speech, poor communication, negative patient-perceived interactions, mistrust in the patient–physician relationship, stigmatizing language in the medical record, and substandard treatment recommendations. Full-Text PDF