Racial Representation Research Articles

The Effect of Racial Concordance on Patient Trust in Online Videos About Prostate Cancer

Black men have a higher risk of prostate cancer compared with White men, but Black adults are underrepresented in online content about prostate cancer. Across racial groups, the internet is a popular source of health information; Black adults are more likely to trust online health information, yet have more medical mistrust than White adults. To evaluate the association between racial representation in online content about prostate cancer and trust in the content and identify factors that influence trust. A randomized clinical trial was conducted from August 18, 2021, to January 7, 2022, consisting of a 1-time online survey. Participants included US men and women aged 40 years and older. Data were analyzed from January 2022 to June 2023. Participants were randomized to watch the same video script about either prostate cancer screening or clinical trials presented by 1 of 4 speakers: a Black physician, a Black patient, a White physician, or a White patient, followed by a questionnaire. The primary outcome was a published scale for trust in the information. χ2 tests and multivariable logistic regression were used to compare trust according to the video's speaker and topic. Among 2904 participants, 1801 (62%) were men, and the median (IQR) age was 59 (47-69) years. Among 1703 Black adults, a greater proportion had high trust in videos with Black speakers vs White speakers (72.7% vs 64.3%; adjusted odds ratio [aOR], 1.62; 95% CI, 1.28-2.05; P < .001); less trust with patient vs physician presenter (64.6% vs 72.5%; aOR, 0.63; 95% CI, 0.49-0.80; P < .001) and about clinical trials vs screening (66.3% vs 70.7%; aOR, 0.78; 95% CI, 0.62-0.99; P = .04). Among White adults, a lower proportion had high trust in videos featuring a patient vs physician (72.0% vs 78.6%; aOR, 0.71; 95% CI, 0.54-0.95; P = .02) and clinical trials vs screening (71.4% vs 79.1%; aOR, 0.57; 95% CI, 0.42-0.76; P < .001), but no difference for Black vs White presenters (76.8% vs 73.7%; aOR, 1.11; 95% CI, 0.83-1.48; P = .49). In this randomized clinical trial, prostate cancer information was considered more trustworthy when delivered by a physician, but racial concordance was significantly associated with trust only among Black adults. These results highlight the importance of physician participation and increasing racial diversity in public dissemination of health information and an ongoing need for public education about clinical trials. ClinicalTrials.gov Identifier: NCT05886751.

Racial Representation and Diversity on Non-Elected Transit Advisory Bodies

Non-elected advisory and planning bodies of transit agencies help planners determine the agency’s service, operations, and future developments. The Federal Transit Administration (FTA) requires reporting of the racial and ethnic makeup of those bodies to receive federal funding. This paper collects those data and compares them with the service area demographics of those agencies. This paper is an attempt to determine if those bodies are representative of the people they serve. This paper sets forth possible metrics to judge representation by and finds that most bodies in the United States are not representative, and instead over-represent the white population. This implication suggests that people of color in the United States are not being represented in the decision-making and planning processes of the transit agencies that serve them.

Post-9/11 American Hegemonic (Imperial) Narratives: A Typical Version of Neo-Orientalism or an Alternative to Domination?

ABSTRACT Hegemonic narratives have developed considerations of several perspectives on engaging with post-9/11 American imperialism and its system of power. This article deals with post-9/11 American novel, a version of neo-orientalist discourse that is inspired primarily by the American imperial ambitions and politics and the current public debates on Islamic terrorism, aggression, and backwardness. Employing insights from contemporary discussions around post-9/11 American hegemonic narratives and from contemporary hegemonic literature on the Middle East, the study examines narrative discourse to detect literary incitement to typological and racial representations. Analysis provides an examination of different perspectives concerning the origin of Islam in the 7th century in Arab peninsula, focusing on the first generation of Muslims’ intolerance towards non-Muslims and the Islamic heritage landscape as receptacle of the Middle East backward ideology and a place where radical ideology propagates the destruction of the west. Applying the notion of hegemonic literature as an exclusivist discourse, this study finds that pot-9/11 narratives and hegemony are symbiotic, reflecting the aspirations of the American policy in the Middle East region.

Visualising Afro-Cultural Identities in Contemporary Argentina: The Case of Antepasados. Los afroporteños en la cultura nacional

Antepasados. Los afroporteños en la cultura nacional [Ancestors: Afroporteños in National Culture] was one of the most comprehensive museum exhibits to address the cultural heritage of Afro-descendants from Buenos Aires – known as afroporteños. It was open to the public from April to June 2016 at the Museo del Libro y de la Lengua [Museum of Books and Language]. The primary purpose of Antepasados was to recapture afroporteños’ cultural heritage and fill what scholars, curators, and the government saw as a “regrettable absence” in narratives about national identity. This study examines how Antepasados (2016) articulated the logic of whiteness in Argentina and the politics of race representation in museums and public history while recognising the erasure of Afro-descendants in official discourse. This exhibit acknowledges the contribution of afroporteños to national culture and identity, and shows how Argentine society is dealing with its racial reckoning, albeit with certain contradictions. Finally, this study inscribes the case of afroporteños into broader discussions about race in Latin America by reframing national identity and cultural heritage discourses in more inclusive terms within a country where an emphasis on whiteness has been predominant.

Representation of the population in need for pivotal clinical trials in lymphomas

AbstractDespite the advances in cancer outcomes, significant health disparities persist. Several new agents have been recently approved for treatment of lymphomas, leading to improved outcomes. Extending the benefits of these new agents starts by adequate enrollment of all affected patient populations. This study aimed to evaluate the extent to which randomized controlled trials (RCTs) match the demographic and geographic diversity of the population affected by lymphoma. Two Food and Drug Administration databases, clinicaltrials.gov, and relevant primary manuscripts were reviewed for drug approval data and demographic representation in RCTs for classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma. Maps showing the distribution and frequency of trial participation relative to disease burden, insurance status, and racial representation were created. Black, Hispanic, and female patients were significantly underrepresented in the RCTs for lymphoma compared with that for the disease burden (3.6% [95% confidence interval (CI), 2.8-5.4] vs 14.6% [95% CI, 13.8-15.3]; 6.7% [95% CI, 5.5-7.9] vs 16.3% [95% CI, 15.5-17.1]; and 39.1% [95% CI, 37.3-40.9] vs 42.7% [95% CI, 42.3-43.1], respectively). White and male patients were overrepresented. More counties with higher mortality rates and racial minority representation had low access to the trials, particularly for cHL in the southern region of the United States. There are significant racial misrepresentations in pivotal RCTs in the United States, and geographic distribution of these trials may not provide easy access to all patients in need. Disparities in enrollment should be corrected to make results applicable to all populations.

DE03 Using the British Association of Dermatologists’ medical student app to promote a better representation of skin of colour in undergraduate education

Abstract It was exactly 10 years ago, in Liverpool, that the ‘BAD medical student app’ was launched. At a time when digital learning was becoming popular, a platform that is accessible globally, on your phone, which provides evidenced-based information to aid medical students’ educational needs in undergraduate dermatology, was born. In the wake of the need for promoting fair medical education, the General Medical Council, in their ‘2021–25 corporate strategy’, stipulated a requirement for an increased focus on equality, diversity and inclusion in medical education. Furthermore, medical students lack training on how skin disease presents differently in patients who have darker skin tones (Adelekun A. Skin color in dermatology textbooks: an updated evaluation and analysis. J Am Acad Dermatol 2021; 84:194–6). A 2018 study of general medicine texts found that &amp;lt; 5% of images included dark skin tones. Louie and Wilkes (Louie P, Wilkes R. Representations of race and skin tone in medical textbook imagery. Soc Sci Med 2018; 202:38–42) discovered that in general medicine texts commonly used by medical students, &amp;lt; 5% of the images included darker skin tones. The effects of the COVID-19 pandemic and the semipermanent transition to using virtual learning methods have required medical students to become more autonomous in supplementing what is learnt in lectures. Furthermore, the under-representation of skin of colour in primary medical texts will lead to students connecting diagnosis with a one-dimensional presentation and, in turn, hesitation in diagnosing skin diseases in darker skin tones. Understanding the existence of this limitation and recognizing the value of using the British Association of Dermatologists’ medical student app to reach out to medical students, we embarked upon a project to diversify education on cutaneous diseases in darker skin tones. The app, which contains didactic clinical information, as well as picture quizzes designed to challenge a student’s ability to make a spot diagnosis, has been expanded to include a larger proportion of images of darker skin tones. Where cutaneous diseases present significantly differently in lighter and darker skin tones, we have included contrasting images to illustrate this. We hope these structural changes to the app will complement higher initiatives to improve equity in skin-of-colour image representation in undergraduate medical education on cutaneous diseases.

Racism and Capitalism: A Contingent or Necessary Relationship?

Abstract Anti-racist debate today remains polarised between ‘class reductionist’ (any attempt to address racial disparities reinforces capitalist class relations) and ‘liberal identity’ (disparities in racial representation can be resolved without questioning class inequality) politics. Both positions share a common perspective – racial oppression and class exploitation are the products of distinctive social dynamics whose relationship is historically contingent. This essay is an initial step toward characterising a structurally necessary relationship between capitalism and racial oppression. The essay draws upon Anwar Shaikh and Howard Botwinick’s elaboration of Marx’s political economy, and Ellen Wood’s analysis of the specificity of capitalist imperialism.

Gender and Racial Representation of Invited Speakers From The Aesthetic Society Annual Meetings Over a 5-Year Period.

Increased representation from both women and non-White ethnicities remains a topic of discussion in plastic surgery. Speakers at academic conferences are a form of visual representation of diversity within the field. This study determined the current demographic landscape of aesthetic plastic surgery and evaluated whether underrepresented populations receive equal opportunities to be invited speakers at The Aesthetic Society meetings. Invited speaker's names, roles, and allotted time for presentation were extracted from the 2017 to 2021 meeting programs. Perceived gender and ethnicity were determined by visual analysis of photographs, whereas parameters of academic productivity and professorship were collected from Doximity, LinkedIn, Scopus, and institutional profiles. Differences in opportunities to present and academic credentials were compared between groups. Of the 1447 invited speakers between 2017 and 2021, 20% (n = 294) were women and 23% (n = 316) belonged to a non-White ethnicity. Representation from women significantly increased between 2017 and 2021 (14% vs 30%, P < 0.001), whereas the proportion of non-White speakers did not (25% vs 25%, P > 0.050) despite comparable h-indexes (15.3 vs 17.2) and publications (54.9 vs 75.9) to White speakers. Non-White speakers oftentimes had more academic titles, significant in 2019 ( P < 0.020). The proportion of female invited speakers has increased, with room for further improvement. Representation from non-White speakers has not changed. However, significantly more non-White speakers holding assistant professor titles may indicate increased ethnicity diversity in years to come. Future efforts should focus on improving diversity in positions of leadership while promoting functions that target young minority career individuals.

Gender and Racial Diversity Among Colon and Rectal Surgery Trainees and Leaders.

Despite recent changes in women and underrepresented minorities in medicine, there still exists large gender and racial gaps in surgical training and leadership. We hypothesize that gender and racial representation have improved among general and colorectal surgical trainees and leadership over the past 20 years. This cross-sectional study examines gender and racial representation of general and colorectal surgery residents, colorectal faculty members, and the American Society of Colon and Rectal Surgeons Executive Council. We extracted data from the Journal of the American Medical Association Graduate Medical Education yearly reports for information on surgical residents. We used the American Society of Colon and Rectal Surgeons website and publicly available practice websites to obtain information regarding colon and rectal surgery residents, faculty members, and the American Society of Colon and Rectal Surgeons Executive Council. We primarily focused on the gender and underrepresented minority breakdowns of general surgery residents, colorectal surgery residents, and the American Society of Colon and Rectal Surgeons Executive Council. We found that between 2001 and 2021, the number of women and people identifying as underrepresented minorities increased within general surgery programs. In addition, there has been a similar increase in underrepresented minorities and women entering colorectal surgery residency programs. Finally, there has been a steady, significant increase in women representation in the American Society of Colon and Rectal Surgeons Executive Council, with a slower increase in underrepresented minorities on the council. The study is limited by using previously collected data and relying on publicly available profiles for gender and race information. General and colon and rectal surgery have significantly increased gender and racial diversity at the training and leadership levels. ANTECEDENTES: A pesar de los cambios recientes en las mujeres y las minorías subrepresentadas en la medicina, todavía existen grandes brechas de género y raza en la capacitación y el liderazgo quirúrgico.OBJETIVO: Presumimos que la representación racial y de género ha mejorado entre los pasantes y el liderazgo en cirugía general y colorrectal en los últimos 20 años.DISEÑO: Este es un estudio transversal que examina la representación racial y de género de los residentes de cirugía general y colorrectal, miembros de la facultad colorrectal y el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto.CONFIGURACIÓN: Extrajimos datos de los informes anuales de Educación Médica para Graduados del Journal of the American Medical Association para obtener información sobre los residentes quirúrgicos. Utilizamos el sitio web de la Sociedad Estadounidense de Cirujanos de Colon y Recto, así como los sitios web de práctica disponibles públicamente para obtener información sobre los residentes de cirugía de colon y recto, miembros de la facultad y el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto.MEDIDAS PRINCIPALES DE RESULTADO: Nos enfocamos principalmente en los desgloses de género y minorías subrepresentadas de residentes de cirugía general, residentes de cirugía colorrectal y el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto.RESULTADOS: Encontramos que entre 2001 y 2021, la cantidad de mujeres y personas que se identificaron como minorías subrepresentadas aumentó dentro de los programas de cirugía general. Además, ha habido un aumento similar en minorías subrepresentadas y mujeres que ingresan a programas de residencia en cirugía colorrectal. Finalmente, ha habido un aumento constante y significativo en la representación de mujeres en el Consejo Ejecutivo de la Sociedad Estadounidense de Cirujanos de Colon y Recto con un aumento más lento en las minorías subrepresentadas en el consejo.LIMITACIONES: El estudio está limitado por el uso de datos recopilados previamente y por confiar en perfiles disponibles públicamente para la información de género y raza.CONCLUSIONES: La cirugía general y de colon y recto han hecho algunos avances significativos en el aumento de la diversidad racial y de género en los niveles de formación y liderazgo. (Traducción-Yesenia.Rojas-Khalil ).

Compliance with Public Health Orders: The Role of Trust, Representation, and Expertise

Governments rely on citizen compliance to implement policies. Yet, in the current climate where citizens express low levels of trust in government, gaining compliance can prove challenging. Scholarship suggests other factors that might promote compliance even in the absence of trust. We examine two: expertise and descriptive representation across race, gender, and partisanship. We experimentally activate general (dis)trust in government and use a conjoint experiment to examine multiple factors that might shape citizens’ willingness to comply with and trust government guidance related to COVID-19. We find that shared partisanship and consultation with experts have the largest effects. We also see an effect of shared racial identity on compliance for Black Americans, at least when trust is relatively low. As we consider the role of trust, expertise, and descriptive representation across race, gender, and partisanship simultaneously, the results offer important insights into factors that underpin citizens’ willingness to comply with government mandates. Our results have important real-world implications, highlighting the importance of bipartisan responses to crises as well as ensuring racial representation in government. They also demonstrate that explicitly involving experts in decision-making processes increases citizens’ willingness to comply with policy.

“On a Risky Slope of Democracy”: Racialized Logics Embedded in Community–School Board Interactions

As school board meetings are integral sites of local education policymaking, scholars must consider how structural racism manifests in these spaces across various district contexts. We examine how racialized institutional logics undergird the interactions between majority-Black district leadership and a local Black community during school board meetings. Through an ethnographic case study of school board meetings over the 2019–2020 school year, we find that racialized pressures led predominantly Black school board members and district administrators to uphold policies and practices that limited two-way authentic interactions with their Black constituents. In conclusion, we argue that racial representation in educational politics may be important, but is not sufficient unless accompanied by changes to policies and practices that privilege Whiteness and reproduce racism.

Representation of age, race and ethnicity in real-world evidence (RWE), randomized clinical trial (RCT), and Surveillance, Epidemiology, and End Results (SEER) cancer patient registry data in advanced renal cell carcinoma (aRCC).

e18672 Background: Representation of key demographic characteristics in real-world settings and clinical trial environments is medically necessary to address evidentiary gaps and disparities in clinical outcomes among patients with advanced renal cell carcinoma (aRCC). We characterized age, race, and ethnicity in patients with aRCC in real-world evidence (RWE), corresponding randomized controlled trials (RCTs), and Surveillance, Epidemiology, and End Results (SEER) data during contemporaneous periods spanning 2017-2022. Methods: Demographic characteristics were assessed from one RWE chart review study, two RCTs (Checkmate 214 and Keynote 426), and a SEER cohort based on RCT/RWE eligibility criteria and compared across data sources using 2-sided chi-square or t-tests. Results: Age, race and ethnicity were collected for 4,821 patients (RWE: n = 635, 13.2%; RCT: Checkmate 214 n = 1,096 and Keynote 426 n = 861, 40.6% across both RCTs; SEER: n = 2,229, 46.2%). RCT participants were younger at metastatic diagnosis (60.9 vs 65.1 years) and at 1L therapy initiation (60.9 vs 65.7 years) compared to patients in RWE and SEER, respectively (both p &lt; 0.0001). Black patients accounted for 17.2% in RWE, 1.6% in RCT, and 4.8% in SEER data, and Asian patients accounted for 6.3% in RWE, 11.8% in RCT, and 6.0% in SEER data. Hispanic representation was significantly higher in RWE studies than RCT studies, (15.0% vs 3.4%), P&lt; .001. A significantly greater proportion of white patients was observed in RCTs than RWE (84.5% vs 71.7%) and greater representation of non-Hispanic white patients was observed in SEER vs RWE (67.5% vs 60.3%), P&lt; .001 (Table 1). Conclusions: This study describes existing disparities in representation of age, race, and ethnicity among patients with aRCC in research. RCTs had lower representation of older, Black, and Hispanic patients with aRCC compared to SEER and RWE studies. Despite limitations including sparse data available among Hispanics in RCTs, RWE studies can provide greater visibility to traditionally medically underrepresented patients with aRCC. [Table: see text]

Comparison of diversity across real-world evidence, randomized clinical trial, and Surveillance, Epidemiology, and End Results (SEER) data in patients with metastatic breast cancer.

e18670 Background: Compared with patients in typical care settings, participants in randomized clinical trials (RCTs) tend to be younger and less diverse. We compared representation of age, race, and ethnicity at initiation of first-line (1L) therapy for metastatic breast cancer across real-world evidence (RWE), RCT, and Surveillance, Epidemiology, and End Results (SEER) registry data. Methods: RWE and SEER inclusion criteria were based on corresponding RCTs. We compared age, race, and ethnicity at initiation of 1L therapy among female patients with metastatic breast cancer across 2 RWE chart review studies (completed between 2019-2021), 4 RCTs with similar eligibility (reported between 2014–2021), and the latest SEER registry data (2017–2019) using t-tests and 2-sided chi-square tests. Results: We collected demographics of 57,479 patients (RWE: n = 860, 1.5%; RCT: n = 2,707, 4.7%; SEER: n = 53,912, 93.8%). Mean age at 1L therapy initiation was significantly higher in RWE than RCT studies (61.8 vs 56.0 years) and representation of Black patients was significantly higher in RWE than RCT studies (25.3% vs 2.9%), both P&lt; .001. Mean age at metastatic diagnosis in SEER was 59.0 years; age at 1L initiation was not reported. SEER included 13.4% Non-Hispanic Black patients. Hispanic representation was 11.2% in RWE, not reported in RCT, and 15.9% in SEER studies (Table). Conclusions: Decisions about treatment choices among clinicians and payers are primarily driven by RCT results, yet they may not be representative of real-world populations. We found that RCTs had lower representation of older and Black patients than both SEER and RWE studies. Limitations included varying study periods, lack of Hispanic ethnicity reporting in RCTs, differential SEER participation by US region, and potential patient overlap. Well-conducted RWE studies may fill gaps left by RCTs for improving representation and generalizability to patients with metastatic breast cancer. [Table: see text]

Enrollment representation of age, race, and ethnicity in ovarian cancer registrational clinical trials (2010-2020): An evaluation by the U.S. Food and Drug Administration.

e18527 Background: Ovarian cancer is the fifth leading cause of cancer mortality among U.S. women. Because clinical trials have historically not been demographically representative of real-world patients, an understanding of the extent of disparities is an important step in addressing them. We aimed to evaluate the representation of older adults and racial and ethnic minorities in trials for ovarian cancer drugs. Methods: We conducted a pooled analysis of all trials that were submitted to the U.S. Food and Drug Administration (FDA) from January 1, 2010 to December 31, 2020 in support of marketing applications for epithelial ovarian, fallopian tube, or primary peritoneal indications. Demographic data (age, race, and ethnicity) for adult participants were analyzed alongside incident ovarian cancer case data (diagnosis between 2010 and 2019) from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Enrollment to Incidence Ratio (EIR) is reported and defined as the percentage of participants divided by percentage of U.S. incident ovarian cancer cases. An EIR between 0.80-1.20 indicates adequate representation; &lt;0.80 or &gt;1.20 indicates underrepresentation or overrepresentation, respectively. Participants with race or ethnicity categories reported as unknown or missing, or insufficient for calculation were not included in this analysis. A sensitivity analysis was conducted to evaluate the exclusion of trials enrolling only BRCA+ participants. Results: The analysis included 8,211 participants enrolled across 15 clinical trials. Age was available for all participants; race/ethnicity was not reported for 16.3% of participants. With increasing age, EIR decreased (Table). Non-Hispanic (NH) White participants had the highest EIR of all racial/ethnic groups, while NH Black and Hispanic participants had the lowest EIR. Results were similar when excluding trials enrolling only BRCA+ participants. Conclusions: Adults aged ≥75, NH Black, and Hispanic participants were underrepresented in registrational trials for new ovarian cancer therapies. To enhance understanding of the correlation between age, race, and ethnicity, further analyses are necessary. Prospective measures are essential, as discussed in recent FDA guidances, to enroll an adequately representative population in ovarian cancer clinical trials.[Table: see text]

Unpeeling the banana dance: The quare fugitivity of Joséphine Baker

Unpeeling the banana dance: The quare fugitivity of Joséphine Baker

RWD95 Comparing Representativeness of Race and Ethnicity in Real-World Evidence, Randomized Clinical Trial, and Surveillance, Epidemiology, and End Results (SEER) Cancer Patient Data

In the United States (US), randomized clinical trial (RCT) participants tend to be younger, healthier, less racially/ethnically diverse, and predominantly male compared with their real-world patient counterparts. Using contemporaneous time periods spanning 2017–2022, we assessed representation of race and ethnicity of patients with advanced melanoma, breast, lung, liver, or kidney cancer in real-world evidence (RWE) chart reviews, corresponding RCTs, and the Surveillance, Epidemiology, and End Results (SEER) database, which represents cancer diagnoses in the US irrespective of treatment.

Analysis and optimization of equitable US cancer clinical trial center access by travel time.

6524 Background: Racially minoritized and socioeconomically disadvantaged populations are underrepresented in cancer clinical trials. Data-driven, quantitative approaches are required to address this inequity. Here, we systematically analyze the geographical distribution of self-identified racial and socioeconomic demographics within commuting distance to cancer clinical trial centers and all hospitals U.S.-wide. Methods: We calculate self-identified racial and socioeconomic demographics of populations living within 30-, 60-, and 120-minute one-way driving commute times from U.S. cancer clinical trial centers and all U.S. hospitals. Data sources include the U.S. 2020 census (for race and socioeconomic data), OpenStreetMaps (for calculation of commuting times), NCT trial registry (for cancer clinical trial quantification), NCI Designated Cancer Centers List, Nature Index of Cancer Research Health Institutions and National Homeland Infrastructure Foundation-Level Data (for U.S.-wide hospital and cancer clinical trial center identification). Data analysis was conducted in R, and Ggplot2 used for all data visualizations. Results: Analysis of clinical trial numbers between 2012–2022 identified 78 high-volume U.S. cancer trial centers. Compared to U.S. national averages, these centers are in areas with socioeconomically more affluent populations (+27.6K USD (95% CI +23.1 to 32.8K) median income unpaired mean difference; -0.073 (95% CI -0.063 to -0.084) deprivation index unpaired mean difference), with higher proportions of affluent self-identified White individuals (+10.1% unpaired mean difference (95% CI +6.8 to +13.7%)). The top 10th percentile of all U.S. hospitals (N=7,623) show a range of absolute sum difference from 2.4% to 35% from equal racial representation of White, Black/African American and Asian/Mixed/Other groups. For each U.S. city above 500,000 inhabitants, we compile map overlays that display all prospective hospitals within commutable distance to racially diverse and socioeconomically disadvantaged populations. These maps may inform the design of future clinical trials or investigations in enrollment and retention strategies for clinical trials. Conclusions: Our analysis identifies biases in the sociodemographics of populations living within commuting distance to U.S.-based cancer trial sites and enables the determination of more equitably commutable prospective satellite hospital sites that could be mobilized for enhanced racial and socioeconomic representation in clinical trials. Other recruitment barriers still need to be tackled to ensure racial and socioeconomic demographics within the geographical vicinity of a clinical site can translate to equitable trial participant representation.

Crossing the Line: Redrawing Legacies of Racial Representation in Watson and Holmes:

Abstract: The 2013 graphic novel Watson and Holmes: A Study in Black rewrites Arthur Conan Doyle’s A Study in Scarlet (1887) as the story of two young Black men solving crimes in modern-day New York City. The adaptation challenges traditional Victorian national borders by highlighting the interimperial, white supremacist connections Doyle’s works promote between Britain and the United States. Furthermore, it crosses Victorian temporal boundaries by evoking Doyle’s racialized theorization of a mind-body hierarchy and the impact of this broader Victorian dogma on contemporary experiences of lived blackness. The formal complexity of comics facilitates Study in Black ’s restaging and rejection of blackness as abject materiality in the Sherlock Holmes stories and their original illustrations. This self-conscious and densely allusive redrawing of Doyle’s novel presses upon readers the burden and insights of Black double consciousness, theorized at the ostensible end of the Victorian period.

Racial disparities and inequity in clinical trials of chimeric antigen receptor T-cell therapy.

e18515 Background: Chimeric antigen receptor (CAR) T-cell therapy is a paradigm-shifting advancement in hematologic malignancies with therapeutic futility. There is growing evidence that there are disparities affecting race and ethnicity for malignancy treatments as well as under-representation of minorities in clinical trials. We analyzed the racial representation in clinical trials of CAR-T products in the US. Methods: We searched all clinical trials in PubMed for six FDA-approved CAR-T therapy for all indications. We included all phase 2 and above published trials that were conducted in the US and recorded demographic data. Results: Out of total 64 studies; 16 were included for final analysis. A total of 1678 patients enrolled in the CAR-T therapy trials. The table shows indication and demographic data of the patient. Only 9 (56%) articles reported race and 8 (50%) articles reported ethnicity. We found only 47 (3%) African Americans, 47 (3%) Asian races, and 53 (3%) Hispanic ethnicity patients were enrolled in the trials. Conclusions: Our study highlights inadequate reporting of race/ethnicity and continued under-representation of minorities in clinical trials. This is the largest study examining the generalizability of CAR-T cell therapy RCTs at a population level. The underrepresentation in RCTs is an alarming finding as the incidence of many of the diseases is quite high in such minority populations thus exposing a significant disparity in health equity and healthcare access. More insights through research and policymaking are necessary to overcome barriers to delivering equitable healthcare, especially to underrepresented minorities.[Table: see text]

What are the Trends in Racial Diversity Among Orthopaedic Applicants, Residents, and Faculty?

What are the Trends in Racial Diversity Among Orthopaedic Applicants, Residents, and Faculty?