Addressing the Impact of Systemic Racism in Radiation Oncology

Langston Hughes,¹ the great Harlem Renaissance writer, juxtaposed the idea of America as a “shining city upon a hill” with the experience of the Black men and women in his poem “Let America Be America Again.” Hughes wrote, “America never was America to me … there’s never been equality for me, nor freedom in this ‘homeland of the free.’”

Those words were published 85 years ago. In 2020, our families, friends, colleagues, patients, and neighbors continue to viscerally feel this pain, continue to viscerally feel the fear of being stopped by an officer, or worse, continue to feel their voices and lives are of “less value.” Institutionalized racism runs throughout every aspect of American society, pervading our judicial system, health care, and education. Black people are exhausted. They are exhausted by the lack of progress on eliminating racism. They are exhausted by the burden to end racism being placed predominantly on their shoulders by educating non-Black people across the United States and even globally. They are exhausted by the murder of another Black life at the hands of police. They are exhausted by a Black man being murdered while jogging—daily exercise so routine the majority of us simply take for granted we will return home alive.

The past 2 weeks have seen protests expand across the nation—from small, rural towns to major US cities. The protests are among the largest and most diverse many of us have ever seen in our lifetimes, filled with the voices of others who are now too exhausted and demand change. For this issue, Drs Chapman, Gabeau, Pinnix, Deville, Gibbs, and Winkfield wrote, “Why Racial Justice Matters in Radiation Oncology.” They describe the impact of silence by the majority of the radiation oncology community on Black radiation oncologists and the gross underrepresentation of Black voices within the field. They outline steps that the community, through the American Society for Radiation Oncology, can take, including investment of funds, resources, mentorship, and overall commitment to eradicating anti-Black racism.

In response to calls for concrete action, we at Advances in Radiation Oncology say the following: We see you. We hear you. We are listening to you, we are educating ourselves, and we commit to taking concrete, actionable steps to address systemic, institutional racism within our own medical and academic community.1, 2, 3, 4 The burden is on us to amplify Black voices and research, actively work to diversify the field to better serve our patients and society, and provide the resources and sponsorship needed to move Black physicians and scientists into positions of leadership.

Advances in Radiation Oncology prides itself on being a progressive journal willing to tackle the most uncomfortable questions plaguing US society and the radiation oncology community. Without a doubt, systemic, institutionalized racism is a stain on the American conscience, and we cannot consider ourselves a moral, free, or just society while freedom and justice are denied to our friends, colleagues, and neighbors for no reason other than the color of their skin.

We believe silence is not an option. Although the protests have called us to action, it is up to the medical and academic community to take concrete steps to advance sustainable change, stand up to injustice, and continue to protect society for the long-term after the protests have wound down. Therefore, Advances in Radiation Oncology is taking the following initial steps to commit to eliminating racism in academic journal publishing:

• 1.Accountability: Assess and promote diversity in editorial boards, reviewers, and authors, and track progress toward creating a more equitable field and diverse academic community that mirrors the nation and patients we serve.
• 2.Advocacy: Encourage journals, including our sister journals, International Journal of Radiation Oncology Biology Physics and Practical Radiation Oncology, to expand their submission classifications to include terms such as health equity, diversity and inclusion, and health disparities. These omissions communicate value in subtle and implicit ways and subjugate important advances needed in our field.
• 3.Education: Promote research on health equity and disparities and diversity and inclusion: Curated features with special guest editors will highlight past and present publications and are intended to foster an ongoing dialogue around structural barriers and systemic biases within radiation oncology, physics, and biology research.
• 4.Engagement: We want to hear your ideas around impactful actions. What structural biases and systemic racism have you experienced through research and the publishing process?

We know that this is only a beginning and that much more is needed. Words without sustained action will be meaningless. The path forward to eliminate racism in scientific publishing will require all of us to participate in this effort. It will take diverse and inclusive teams, contrition of privilege, resources, and motivation. We look forward to your engagement, your actions, and your discourse.