Gastroenterology’s new DEI commentary, Racism is a Modifiable Risk Factor: Relationships Among Race, Ethnicity and Colorectal Cancer Outcomes, written by Drs. Carolyn Rutter, Fola May, Gloria Coronado, Toyya Pujol, Emma Thomas and Irineo Cabreros, highlights the importance of how we define race and consider characteristics related to race — including structural racism — when interpreting statistical models used to explore racial disparities in colorectal cancer (CRC).
When studying the role of race in health outcomes, in this case CRC outcomes, our experts suggest the following:
- Clearly describe how race was measured and categorized while adhering to inclusive reporting standards.
- Recognize that estimated effects of race and ethnicity are highly dependent on other variables that are also included in the model. The degree of adjustment required to draw causal inference may not be possible and, if possible, may not be realistic. Causal models focus on characteristics that can be modified.
- Racism — structural, interpersonal and internalized — is a modifiable risk factor.
- Identify factors that are amenable to policy intervention, such as access to care and quality of care, that are modifiable drivers of CRC outcome disparities that are rooted in structural racism.
- Recognize and acknowledge structural racism and social injustices as key drivers of poorer access to and receipt of high-quality care across all steps in the CRC continuum to enable new solutions to be imagined.
- Propose solutions, such as investments in the people, studies, policies, neighborhoods and processes, that can lead to more accessible and culturally competent care — care that can be delivered by health systems that foster community trust — and that achieve equal participation and timeliness of screening, treatment, clinical trials enrollment and survivorship care.
Read the full commentary, Racism is a Modifiable Risk Factor: Relationships Among Race, Ethnicity and Colorectal Cancer Outcomes, in Gastroenterology.