WHAT DOES (AND SHOULD) ANTIRACISM WORK IN INJURY AND VIOLENCE PREVENTION LOOK (OR NOT LOOK) LIKE?

Statement of Purpose

The SAVIR document Conference Presenter Guidelines to Address Health Inequity and Racism, outlines guidance for using the race variable in research studies. Specifically, how not examining effect measure modification (EMM) could lead to a ‘cover-up of underlying structural racism.’ We examined how the prior injury and violence prevention (IVP) literature reflects this guidance.

Methods/Approach

We reviewed all manuscripts, excluding postscripts, electronic pages, editorials, policy forums, and SAVIR opinion pieces, that were published in the journal Injury Prevention from 2018–2020. We analyzed the manuscripts for inclusion of variables including race, ethnicity, caste, aboriginal status, and nationality (referred to hereafter as race). Where race data were available, we determined if and how the data were used. Similar analysis of research published in the journal Injury Epidemiology is underway.

Results

From 2018–2020, 283 research articles were published in Injury Prevention. Of those, 80 (28.3%) used datasets where race was available, and 55 (19.4%) used race in the published research. The 55 manuscripts included, 6 protocols, one systematic review, one instrument development study, and 47 studies that used race as either a descriptor (n=44; 93.6%), confounder (n=14; 29.8%), EMM (n=14; 29.8%), or combination of those. Nine studies (19.1%) used race as a confounder but did not examine EMM, 15 (31.9%) discussed racial disparities, and only five (10.6%) discussed the role of racism or bias.

Conclusions

One in five research studies inappropriately used race as a confounder, one in three discuss racial disparities, and one in 10 discuss the role of systematic racism or bias in their studies.

Significance

Overall, the results show a large, missed opportunity for examining and preventing systemic racism in IVP. This work, in combination with the SAVIR presenter guidelines, will lead to recommendations for improving the science of IVP and eliminating racial inequities.