A Call to Action to Enhance Justice, Equity, Diversity, and Inclusion in the Journal of Gerontology Series A: Medical Sciences

Since the killing of Ahmaud Arbery, Breonna Taylor, George Floyd, and many others, there has been an increased awareness of racism, discrimination, and lack of diversity and inclusion in the United States. There is longstanding evidence that racist acts have disproportionately harmed members of the Black community, Indigenous people, and People of Color (BIPOC), among others. Racism remains a sustained and persistent part of many aspects of American society. Racism represents how multiple sectors function jointly to influence the allocation of resources to impact health and well-being of racial and ethnic groups, particularly African Americans compared with Whites (1–6). Racism and discrimination affect health across the life-course (6). For example, there is a growing body of literature that suggests that discrimination is linked to all-cause mortality (7), physical (8–10) and mental health (11–14) outcomes among older adults. In addition, racism is a fundamental determinant of health that impacts a number of risk factors and health outcomes, and is identified as a public health issue by the National Institutes of Health (NIH) and Center for Disease Control (CDC). Despite these unfortunate realities, racism is often unrecognized, denied, or ignored by members of our society, including those working in medical and scientific professions who are responsible for promoting the health and welfare of all people, regardless of their age, race, ethnicity, religion, sexual orientation, gender identity, or beliefs.

Furthermore, there are relatively few underrepresented scholars in the biomedical workforce. These professionals are more likely to conduct health disparities and minority health research in the United States (15,16), and research studies on these topics are less likely to be funded by the NIH when compared with other biomedical topics (17). Moreover, even when topic choice is accounted for, Black scientists remain less likely to be funded compared with their White peers (17). On top of this, the burden of translating research findings into interventions to improve the well-being of communities of color disproportionately falls on the shoulders of public health professionals from underrepresented backgrounds. This burden and other expectations contribute to the minority tax, or the additional responsibilities placed on BIPOC professionals to educate those around them and serve as liaisons to underrepresented students, patients, and communities (18–20). These inequities are evident in academic publishing where there is: (i) a lack of diversity in editorial board members, (ii) a lack of diversity and expertise in the review pool to adequately review manuscripts focusing on health disparities, minority health, and racism, (iii) a paucity of published content focused on racism as a driver of health disparities, and (iv) a lack of people of color in leadership positions (Editor in Chief, Deputy Editor in Chief, Associate Editors) at Journals (21).

Medical Sciences section of the Journal of Gerontology Series A (JGMS) recognizes that structural racism has the potential to impact the scientific enterprise, the conduct and translation of research to benefit diverse populations, and the advancement of scholars of color. We recognize that systemic bias, discrimination, and inequity have played a role in the lack of diversity in JGMS. In response, as the Editor in Chief and as Associate Editors of JGMS, we aim to guide the Journal toward addressing racism and building an anti-racist, anti-oppressive, and inclusive culture. We recognize that examining older adults from different racial and ethnic groups using a life course perspective will elucidate a plethora of life experiences that will help contextualize research findings and provide valuable data that can be translated into more equitable and just social and health policies. Our goal is to promote scholarship focused on the heterogeneity of the aging process and life experiences. We encourage studies that seek to advance our understanding of how a variety of social factors such as individual discrimination, racism, segregation, education, housing, neighborhoods, and transportation may impact disease, function, and other health outcomes for people of different backgrounds.

Below are some actionable steps that JGMS will take moving forward.

1. We will recognize interindividual and structural racism and discrimination as important drivers of health inequities and encourage research on these topics.

2. We will include Minority Health Issues as a permanent section in JGMS.

3. We will devote future special issue(s) to the topics of health disparities across the life course, minority aging, discrimination, racism, and minority health.

4. We will strive to achieve more diversity on the editorial board with regard to race, ethnicity, gender identity, sexual orientation, nationality, and institution.

5. We will work to achieve more diversity in the reviewer pool.

6. We will ask authors to use inclusive person-centered language, which places an individual’s role as a person (adult, individual) before their condition. For example, we will characterize people as “older adults with diabetes” instead of “diabetics.” Although we also recognize that some individuals prefer identity-first language that places their condition first, such as Deaf people, (https://ncdj.org/style-guide/), we will advocate for the language preferred by the individuals being described.

7. We will ask that race/ethnicity categories be collected and reported for a study, and that the source of classification be included in the methods (eg, self-report, electronic health record, etc.).

8. We will require authors to capitalize the names of races, ethnicities, and tribes, and to use racial and ethnic terms as adjectives instead of nouns. For example, Black older adults instead of older Blacks. (https://jamanetwork.com/journals/jama/fullarticle/2776936 has a similar rule, for reference) (21)

9. For analyses that include race/ethnicity as a variable, we will ask authors to specify the conceptualization of this variable. For example, “We adjusted for race/ethnicity to account for unequal social conditions of different racial/ethnic groups in the United States.”

10. We will ask authors to acknowledge lack of representation of study populations in the limitations section when appropriate.

Taken together, we believe that these actions will promote fair, equitable, and just publishing policies, and reduce inequities that disadvantage people from other underrepresented backgrounds. Further, this call to action will help promote scholars of color and thereby enhance the caliber of science in JGMS. We intend to report our progress on an annual basis. We aim to support and extend the Gerontological Society of America’s principal mission “to promote the study of aging and disseminate information to scientists, decision makers, and the general public” by making that information relevant, translatable, and accessible to all people in a just and equitable manner.