On behalf of the American Society for Radiation Oncology (ASTRO) Board of Directors, I thank Dr Chapman and her colleagues for their article in this edition of Advances in Radiation Oncology discussing racism in radiation oncology. The ASTRO Board of Directors stands resolutely with the authors against anti-Black violence and racism and welcomes the recommendations put forward in the article.
We must confront the fact that structural racism has long existed, including in health care and in our own specialty. Unaddressed, it will continue to threaten the health and welfare of the patients we serve in the Black community, and it is anathema to us. We are called to eradicate racism as an inviolable part of our social contract as physicians.
We must also acknowledge that structural racism directly affects the professional lives of ASTRO’s Black members. The effects are many, including a less vital and effective organization, and ASTRO must do more to fully realize our commitment to diversity, equity, and inclusion, including in senior leadership positions of ASTRO. Moving forward with a pledge to achieve equity, the voices and perspectives of our Black members, especially during priority-setting and resource allocation, will better inform and drive ASTRO’s agenda to improve the lives of patients with cancer, thereby reducing health inequity.
We are grateful for the difficult and important conversations that are happening and that will guide our efforts to listen and to act, including those by Chapman et al. These conversations inspire us to take advantage of this unique time in history to forcefully take intentional actions. As an example, it is well recognized that the pipeline of Black medical students into our field is very low. What is less well-known is that the trend has been worsening, according to recently collected data (Deville et al, unpublished data, June 2020). Given that all residents in our field must matriculate into academic residency training programs, ASTRO will engage the Association of Black Radiation Oncologists, the Society of Chairs of Academic Radiation Oncology Programs, the Association for Directors of Radiation Oncology Programs, the Association of Residents in Radiation Oncology, and our Committee on Health Equity, Diversity, and Inclusion in a coordinated effort to understand our present state, identify barriers for recruitment of Black residents and retention of Black faculty, and provide tangible solutions to improve. Increasing our recruitment of Black resident physicians is foundational to our ability to drive greater equity and thereby reduce our nation’s health inequity. We need to rally our society’s leaders to provide a collective voice of engagement and change throughout radiation oncology.
The ASTRO Board of Directors will be meeting just as this commentary is being published, and these topics on race will be key to that agenda. Much introspection and reflection by the board is going to be required, as will facilitated discussion and the acknowledgment, transparency, intentionality, representation and learn, engage, advocate, defend, support approaches noted by Chapman et al, to provide concrete examples of starting points. We will also develop a strategic vision on the topic of racism along with a corresponding plan of action. ASTRO will require partnership with all of its members, including those in the Committee on Health Equity, Diversity, and Inclusion, to make meaningful, lasting progress that ultimately affects academic, research, and community practices.
We believe this is a critical issue for ASTRO, and it is a moral imperative that we act. In that spirit, we, the ASTRO Board of Directors, embrace the opportunity before us to engage in the work necessary to understand and address the racism in our field that has so dramatically disadvantaged Black patients and communities as well as our Black colleagues.