Ignorance is neither neutral nor benign, especially when it cloaks evidence of harm. And when ignorance is produced and entrenched by gatekeeper medical institutions, as has been the case with obfuscation of at least 200 years of knowledge about racism and health, the damage is compounded. The racialized inequities exposed this past year—involving COVID-19, police brutality, environmental injustice, attacks on democratic governance, and more—have sparked mainstream awareness of structural racism and heightened scrutiny of the roles of scientific institutions in perpetuating ignorance about how racism harms health.
Sometimes ignorance and denial is so stark and galling you can only conclude it is at least intentional, if not complicit.
In particular, the ways the world’s leading gatekeeper medical journals produce ignorance about racism and health are ripe for review. In our analysis, we build on prior scholarship, including the 2018 study by Hardeman et al that focused on articles published between 2002-2015 in the 50 highest-impact public health journals and found that only 25 named institutionalized racism in their title or abstract. Our novel contribution is three-fold: (1) we extend the analysis to include articles from 1990-2020, thereby expanding the time frame and capturing the past year of increased explicit discourse and action about racism and health; (2) we distinguish between articles that present viewpoints versus empirical scientific investigations; and (3) we deliberately focus on the world’s four leading medical journals, as well as bringing in selected comparators.