Intended for healthcare professionals


JAMA deputy editor resigns after critics hit out at podcast on structural racism

BMJ 2021; 372 doi: (Published 18 March 2021) Cite this as: BMJ 2021;372:n768
  1. Janice Hopkins Tanne
  1. New York

The deputy editor of the journal JAMA has resigned after a podcast on structural racism in medicine was widely criticised and a petition calling for an investigation into the broadcast attracted more than 2000 signatures.1

The podcast was published on 23 February and has since been withdrawn. But a tweet to promote the episode, which has been deleted, said, “No physician is racist, so how can there be structural racism in health care? An explanation of the idea by doctors for doctors in this user-friendly podcast.”

Both JAMA’s editor, Howard Bauchner, and James Madara, head of the American Medical Association, which publishes the journal, have apologised for the broadcast, saying, “Comments made in the podcast were inaccurate, offensive, hurtful, and inconsistent with the standards of JAMA.”2

The BMJ did not receive a response to a request for a copy of the podcast, which was based on a discussion between Ed Livingston, deputy editor of JAMA, and Mitchell Katz, a deputy editor of JAMA Internal Medicine and president and chief executive of New York City Health and Hospitals. However, the Medscape website reported that Livingston had said in the podcast that he thought racism was made illegal in the 1960s (when the US enacted civil rights legislation) and that the discussion should move from “structural racism” to focus on socioeconomic status.

He is reported to have said, “What you’re talking about isn’t so much racism . . . it isn’t their race, it isn’t their colour, it’s their socioeconomic status. Is that a fair statement?”

Katz disagreed, saying, “Structural racism refers to a system in which policies or practices or how we look at people perpetuates racial inequality.” In a press release Katz repeated the statement he had made on the now deleted podcast that racism existed, must be acknowledged, and should be eliminated.3

New podcast

In a press statement after the podcast was withdrawn Madara wrote, “Structural racism exists in the US and in medicine, genuinely affecting the health of all people, especially people of color and others historically marginalized in society . . .

“As physicians, and as leaders in medicine we have a responsibility to not only acknowledge and understand the impact of structural racism on our patients, but to speak out against racial injustices wherever they exist in health care and society.”4

On 16 March Bauchner led a new podcast on structural racism in medicine and healthcare with three prominent African-American physicians: Lisa Cooper, professor of medicine at Johns Hopkins School of Medicine, David Williams, professor of medicine at Harvard’s Chen School of Public Health, and Clyde Yancy, a cardiologist and professor of medicine and dean at Northwestern University’s Feinberg School of Medicine. They agreed that structural racism existed in society, in medical practice, and in journal publications and should be eliminated.5

Williams said that racial bias was “pervasive” in healthcare and in US society. Where people lived determined their access to good healthcare, good schools, and opportunities for a good future. He called for a “Marshall Plan” for disadvantaged communities.

Cooper said that resources allocated to minority communities were often of a lower level and provided by people “who don’t look like the people they serve.” Because such resources were in poor communities they attracted lower levels of staffing and support, she said.

Yancy pointed out the US lacked physicians of colour because of longstanding policies dating back to the 1910 Flexner report that led to the closure of many Black medical schools. African-American households are economically disadvantaged, earning 59 cents for every dollar earned by white households—the same ratio as in 1978.

Cooper suggested that the issue of structural racism should be considered in journal policies: who is on the editorial board, what articles they are reviewing, and what articles they are accepting.

Williams said, “Journals create the science.”