ARI SHAPIRO, HOST:
One of the most prestigious journals in medicine is about to get a new editor-in-chief. Dr. Kirsten Bibbins-Domingo studies cardiovascular disease and health equity at the University of California, San Francisco. When she officially starts her new job this summer, she will be the first person of color to lead JAMA, the Journal of the American Medical Association. Her predecessor was asked to resign after a controversy involving questions about structural racism in medicine. Dr. Bibbins-Domingo, welcome to ALL THINGS CONSIDERED.
KIRSTEN BIBBINS-DOMINGO: Thanks for having me.
SHAPIRO: I want to briefly review the events that led to your predecessor's departure. Basically, in a podcast, two white doctors and editors for JAMA questioned whether structural racism exists in medicine. As a doctor, as a person of color, as someone who studies health equity, how did you feel watching that play out?
BIBBINS-DOMINGO: Well, the issues regarding bias, racism in science and medicine are no different than the way they play out in the rest of society. And one of the challenges is that science and medicine we oftentimes think of as being separate from these larger forces. And one of the most important things that I think we're faced with right now is for science and medicine to really understand that those of us who practice medicine, those of us who conduct science, are shaped by the same sets of forces that shape the larger society, the issues of bias, of racism, of sexism. And it's really important, then, if we're going to address these issues that do have an impact on our patients, that do have an impact on how scientific knowledge is generated and communicated, that we name these forces and that we work in every way possible to overcome them.
SHAPIRO: And of course, this is all playing out during a pandemic that has had huge inequities in death and hospitalization across racial lines.
BIBBINS-DOMINGO: Exactly right. Those of us who study the way in which health is sometimes distributed across lines that really highlight the inequities in society were not surprised to see these things play out. But the pandemic really exposed them in a way that I think highlighted them for many. And I think we're at this extraordinary time where we see these incredible scientific advances in the vaccines and the treatments. But we also know that the access to these scientific technologies, the access to the types of treatments and the ways in which many of our policies play out also reflect the types of inequities that we see in society. And there's never been a better time, I think, to highlight them, to think how we can, in science and medicine, work to improve the health of all of our communities and to do it in a trusted way? Because the other theme in this pandemic is the amount of mistrust people have about science and medicine. And I think it's important for a really outstanding voice like JAMA and the JAMA network to play a role in helping to improve in this area.
SHAPIRO: Can you identify one or two steps that you're really eager to take once you start the job that you think will move JAMA in the right direction?
BIBBINS-DOMINGO: Yeah, I think one of the things that I'm most excited by is to think about the voices that we oftentimes don't hear in scientific publications. I'm really excited to make sure that the entire process that leads to publication that we really expand the number of voices at the table. I think this is about publishing the best science, but also putting the best science in context for the larger challenges that we face in actually making sure that a scientific discovery actually leads to improvements in health for all communities in the U.S.
SHAPIRO: As you've said, this is a problem across science, across medicine. And so how does the work you're describing at one scientific journal fit into the larger ecosystem that you're talking about here?
BIBBINS-DOMINGO: Right. I think that this is just one journal, but it is a journal with a very - both a prominent voice and a broad reach. And you see that the larger scientific enterprise, which includes the funders of science, the people who conduct science, the communities who are involved and participate in science, the ways in which science is translated into medicine - all of those have their own parts that they need to play in this process. But I think movement in any one of those also moves the larger enterprise in the direction we'd like to see it going.
SHAPIRO: And do you feel like the goals you're describing are reflected across the field, or is everyone kind of working in silos right now and some are doing it better and faster than others, and some are just not doing it at all?
BIBBINS-DOMINGO: To be frank, I would say that it is unfortunate - and I say this as a physician myself - that we go into medicine because we want to serve our patients, and it's sometimes harder for us to acknowledge that the same biases that we have and that we are shaped by also influences how we care for our patients. So I would say medicine and science probably has been slower to address some of these issues. I think acknowledging that these forces exist should not come as a surprise to anyone, but rather as the first step to trying to make sure that science and medicine is something that really is working for the betterment of improving health for all.
SHAPIRO: Dr. Kirsten Bibbins-Domingo is the incoming editor-in-chief of JAMA. Thank you for speaking with us.
BIBBINS-DOMINGO: Thank you. Transcript provided by NPR, Copyright NPR.
