The recent review article by Stevens and colleagues (February 28) (1) explores the genomic, epigenomic, and transcriptomic signatures of prostate cancer in racialized groups. We agree that racial inequities in prostate cancer incidence and outcome need to be described and urgently addressed in order to achieve health equity. However, we have several concerns regarding the methods used and the possible implications of inherent genetic racial differences. We recognize that the appropriate use of race in research is complicated and that we are all learning to do this better with the shared goal of reducing health disparities.
Since racial categories are socio-political constructs and poor proxies for human genetic variation (2, 3), the rationale for the use of these categories must be clearly explained in the methods to avoid inadvertently perpetuating the myth of race as an inherent biological category.
Anemia is a significant health concern worldwide and can be the result of nutritional, environmental, social, and infectious etiologies. We estimated the prevalence of anemia in 336 pre-school children and 132 adults in the rural Central Plateau of Haiti and assessed associations with age, sex, household size, water source, sanitation, and Helicobacter pylori seroreactivity using logistic regression analysis; 80.1% (269/336) of children and 63.6% (84/132) of adults were anemic. Among children, younger age was associated with increased prevalence of anemia (adjusted odds ratio [aOR] = 4.1, 95% confidence interval [CI] = 1.5–11.1 for children 6–11 months compared with children 48–59 months). Among adults, 50.8% were H. pylori-seropositive, and seropositivity was inversely associated with anemia (aOR = 0.4, 95% CI = 0.2–0.9). Anemia prevalence in this region of Haiti is very high and not attributable to sanitary conditions or a high prevalence of H. pylori infection.
by
Vanessa E Van Doren;
Mark L Spencer;
Daniel Resnick;
Shub Agrawal;
Mackenzie LW Garcia;
Krisha Desai;
Amara Fazal;
Raha Sadjadi;
Francois Rollin;
Tracey Henry
Background: Inadequate support for underrepresented-in-medicine physicians, lack of physician knowledge about structural drivers of health, and biased patient care and research widen US health disparities. Despite stating the importance of health equity and diversity, national physician education organizations have not yet prioritized these goals. Aim: To develop a comprehensive set of Health Justice Standards within our residency program to address structural drivers of inequity. Setting: The J. Willis Hurst Internal Medicine Residency Program of Emory University is an academic internal medicine residency program located in Atlanta, Georgia. Participants: This initiative was led by the resident-founded Churchwell Diversity and Inclusion Collective, modified by Emory IM leadership, and presented to Emory IM residents. Program Description: We used an iterative process to develop and implement these Standards and shared our progress with our coresidents to evaluate impact. Program Evaluation: In the year since their development, we have made demonstrable progress in each domain. Presentation of our work significantly correlated with increased resident interest in advocacy (p<0.001). Discussion: A visionary, actionable health justice framework can be used to generate changes in residency programs’ policies and should be developed on a national level.