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JAMA. 2021 Dec 21;326(23):2405-2411. doi: 10.1001/jama.2021.17594.

Actions to Transform US Preventive Services Task Force Methods to Mitigate Systemic Racism in Clinical Preventive Services.

JAMA

Karina W Davidson, Carol M Mangione, Michael J Barry, Michael D Cabana, Aaron B Caughey, Esa M Davis, Katrina E Donahue, Chyke A Doubeni, Alex H Krist, Martha Kubik, Li Li, Gbenga Ogedegbe, Lori Pbert, Michael Silverstein, Melissa Simon, James Stevermer, Chien-Wen Tseng, John B Wong

Affiliations

  1. Feinstein Institutes for Medical Research at Northwell Health, New York, New York.
  2. University of California, Los Angeles, Los Angeles.
  3. Harvard Medical School, Boston, Massachusetts.
  4. Albert Einstein College of Medicine, New York, New York.
  5. Oregon Health & Science University, Portland.
  6. University of Pittsburgh, Pittsburgh, Pennsylvania.
  7. University of North Carolina at Chapel Hill.
  8. Mayo Clinic, Rochester, Minnesota.
  9. Fairfax Family Practice Residency, Fairfax, Virginia.
  10. Virginia Commonwealth University, Richmond.
  11. George Mason University, Fairfax, Virginia.
  12. University of Virginia, Charlottesville.
  13. NYU Grossman School of Medicine, New York, New York.
  14. University of Massachusetts Medical School, Worcester.
  15. Boston University, Boston, Massachusetts.
  16. Northwestern University, Chicago, Illinois.
  17. University of Missouri, Columbia.
  18. University of Hawaii, Honolulu.
  19. Pacific Health Research and Education Institute, Honolulu, Hawaii.
  20. Tufts University School of Medicine, Boston, Massachusetts.

PMID: 34747970 DOI: 10.1001/jama.2021.17594

Abstract

IMPORTANCE: US life expectancy and health outcomes for preventable causes of disease have continued to lag in many populations that experience racism.

OBJECTIVE: To propose iterative changes to US Preventive Services Task Force (USPSTF) processes, methods, and recommendations and enact a commitment to eliminate health inequities for people affected by systemic racism.

DESIGN AND EVIDENCE: In February 2021, the USPSTF began operational steps in its work to create preventive care recommendations to address the harmful effects of racism. A commissioned methods report was conducted to inform this process. Key findings of the report informed proposed updates to the USPSTF methods to address populations adversely affected by systemic racism and proposed pilots on implementation of the proposed changes.

FINDINGS: The USPSTF proposes to consider the opportunity to reduce health inequities when selecting new preventive care topics and prioritizing current topics; seek evidence about the effects of systemic racism and health inequities in all research plans and public comments requested, and integrate available evidence into evidence reviews; and summarize the likely effects of systemic racism and health inequities on clinical preventive services in USPSTF recommendations. The USPSTF will elicit feedback from its partners and experts and proposed changes will be piloted on selected USPSTF topics.

CONCLUSIONS AND RELEVANCE: The USPSTF has developed strategies intended to mitigate the influence of systemic racism in its recommendations. The USPSTF seeks to reduce health inequities and other effects of systemic racism through iterative changes in methods of developing evidence-based recommendations, with partner and public input in the activities to implement the advancements.

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