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New JAMA editor says she will focus on communication, diversity, and health equity

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o2295 (Published 22 September 2022) Cite this as: BMJ 2022;378:o2295
  1. Janice Hopkins Tanne
  1. New York

The new editor of the Journal of the American Medical Association, Kirsten Bibbins-Domingo, has said she will emphasise communication, diversity, and equity among authors, reviewers, and editors to improve public health.

Bibbins-Domingo became the journal’s 17th editor on 1 July and the second woman and first person of colour to lead the journal in its 139 year history.1 She took over after a controversy about a podcast on racism in medicine that led to the resignation of JAMA’s previous editor in chief, Howard Bauchner, last year.2 She is on leave from her position as professor of epidemiology, biostatistics, and medicine at the University of California, San Francisco, where she has spent her entire career. She will now oversee JAMA and its 13 specialty journals.

In an online interview with the health news website STAT Bibbins-Domingo described herself as a “science data nerd” who had excellent mentors, including the Nobel laureate Harold Varmus, in whose laboratory she earned her doctoral degree before she went on to receive an MD and master of applied science.3 She said it was in Varmus’s laboratory that she began to think about science’s effects on human health. She also chaired the US Preventive Services Task Force from 2010 to 2017, a time of often difficult discussions about race and equity.

“Science, medicine, and public health are at extraordinary crossroads, crystalized by the pandemic,” Bibbins-Domingo wrote in a JAMA editorial.4 She said the covid pandemic showed how important it was for people to communicate about science and its effects on health in different communities.

Role as editor

Bibbins-Domingo said that becoming editor of JAMA was an opportunity to take what was important to her at UCSF and to lead an organisation at the forefront of communicating about science and serving as a trusted voice for science in the clinical and public health communities.

Trust in JAMA and its peer review process was critical for authors who submit their science, she said. She added that trust was essential for translating science into information to improve the health of patients, communities, and populations.

In recognition of the journal’s worldwide readership and authorship, Bibbins-Domingo said that JAMA, its specialty journals, and JAMA Network Open would be seeking as broad a group of reviewers as possible and would encourage submissions from around the globe. Fees might be waived if they would be prohibitive.

She added that the journals were not just interested in things that affected US patients or scientists. “We [the US] don’t achieve the health outcomes that are achieved in many other countries,” she said, adding that there was a gap between scientific knowledge and its translation into health improvements.

She said that JAMA and its journals needed a model that applied to people in low income countries and to those at less well resourced institutions in the US or who were at early stages in their careers.

Through JAMA and its associated journals “we want to be able to communicate to the broadest possible audience,” she said, publishing state of the art science that will shape clinical care and public health. “Clinical trials are a bedrock, but we know that there are more data sources that can help us think through other questions important for clinical care.”

Equity and diversity

The questions of racism and health equity that arose in the podcast episode were not unique to medical and scientific publishing, she said. “It is a strain that we see throughout the biomedical enterprise. We need to have all the voices at the table to understand the forces that shape health.”

She said, “Communication is important, leaning in is important, [and] not being afraid of controversy,” but she added that conversations needed to happen in a way that helped people understand different points of view. “I’m worried when we retreat into our silos and don’t have the discussions.” she said.

Health equity should be part of all our work, Bibbins-Domingo said. She said JAMA and its journals had already moved to make equity front and centre, with each journal having a DEI (diversity, equity, inclusion) editor. “They are part of the teams, part of our discussions of every manuscript that we publish,” she said, adding that lack of equity was part of the reason many policies in the pandemic did not succedd.

The barriers between scientific discoveries and population health improvement often stemmed from the failure to realise that large segments of the population didn’t benefit from a particular discovery, because of access issues, other competing priorities, or policy issues, she said.

JAMA and its journals will look for input from authors and readers about their experience and how the network of journals is perceived, she said. They needed authors and teams of reviewers and editors who can evaluate a broad range of science—“more voices in the room.” She said the journals needed to think about science that will have an impact on the largest segments of the population that the journals communicate with.

She said she hoped to include trainees who could spend a rotation of months or even a year with the team at the JAMA network as a crucial way to experience scientific publishing. “We would benefit from making the process a bit more open and allowing those early in their careers to understand the process.”

References

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