Why Racial Justice Matters in Radiation Oncology

Abstract

Recent events have reaffirmed that racism is a pervasive disease plaguing the United States and infiltrating the fabric of this nation. As health care professionals dedicated to understanding and alleviating disease, many radiation oncologists have failed to acknowledge how structural racism affects the health and well-being of the patients we aim to serve. The literature is full of descriptive statistics showing the higher incidence and mortality experienced by the Black population for health conditions ranging from infant mortality to infectious disease, including coronavirus disease 2019 . Acknowledgment that the root of health disparities experienced by Black people in this country are based in racism is essential to moving the nation and the field of radiation oncology forward. With this lens, a brief overview of structural and institutional racism shapes a discussion of what radiation oncologists and the organizations that represent them can do to address this scourge. As members of a technological field, we often harness the power of data to advance human health and approach challenging diseases with optimism that multidisciplinary effort can produce cure. A few principles to mitigate the longstanding issues of Black marginalization within the field have been recommended via the ATIP (Acknowledgment, Transparency, Intentionality, and rePresentation) and LEADS (Learn, Engage, Advocate, Defend, Support) approaches. However, additional introspection is encouraged. Just as individuals, practices, and organizations rallied to determine how best to address the issues related to the COVID-19 pandemic, the same investigational fervor must be applied to the issue of racism to combat this sinister and often deadly disease.

Residency Match Trends, Racial Disparity, and Matching Amid a Pandemic

“…Racial concordance between physician and patient has been shown to improve information exchange and patient participation 11 . By failing to recruit a diverse physician population, our field contributes to the systemic racism that promotes healthcare disparities 12,13 . NHBs have the highest rate of cancer mortality despite having a lower incidence of cancer compared to Non-Hispanic whites, and their disproportionate marginalization in clinical trials is a continuing area of concern 9,10 .…”

“…Structural racism has excluded NHB applicants within the medical field and urgent action is needed to increase Black physicians in radiation oncology, as exclusion of any exceptional candidate is a loss of intellect, ideas, and innovation within our field. NHB representation is paramount within the workforce to pioneer the dissolution of systemic racism and to increase the intellectual breadth brought only by a diverse workforce 12,13 There is already an underlying concern for filling the available radiation oncology residency positions. Current trends show both US and international graduates are applying and interviewing at more programs, and the number of contiguously ranked radiation oncology programs has increased since 2009 from 10.3 to 14.0 in J o u r n a l P r e -p r o o f 2020 1,14 .…”

In Response to Comment On: Why Racial Justice Matters in Radiation Oncology

“…As Audre Lorde states, “we do not live single-issue lives,” 1 and every co-author on this Advances article advocates on a range of issues that benefit others. In our Advances article, 2 we speak our truth. For this moment and for this time, the nation has paused to listen to a clarion call that has been made continually for 400 years, yet only audible when their way of life is disrupted by a sanitation workers strike, bus boycott, and now by the images of another Black man whose life was extinguished as they all watched—the stillness of the COVID pandemic allowing them some time to reflect.…”

Lessons From COVID-19: Addressing Health Equity in Cancer Care

“…8 With the recent murder of George Floyd, a conversation about the economic system of structural racism and importance of social justice is advancing in our speciality. 9 However, anti-Black racism is just one form of injustice that leads to inequitable care. Radiation oncologists have historically focused on advancements in radiobiology and technology to improve cancer care for our patients.…”