Editors of medical and scientific journals select and develop the research and opinion articles that are published, with important implications for research, patient care, and policy. Despite widespread stated commitments to promote diversity among editorial staff, there is little information about the composition of editorial teams. We developed and administered a survey to assess the diversity of editors at leading medical and scientific journals.
The survey, based on prior studies1 and input from content experts, had questions about demographics and professional characteristics (eAppendix in the Supplement).
Beginning in June of 2020, we used the Web of Science 2020 Journal Citation Reports2 and expert opinion to select 25 medical and scientific journals (17 based in the US and 8 in Europe) with impact factors greater than 10; namely, the American Journal of Psychiatry, Annals of Internal Medicine, British Medical Journal, Cell, Circulation, Circulation Research, European Heart Journal, Journal of the American College of Cardiology, Journal of the American Medical Association (JAMA), JAMA Internal Medicine, JAMA Neurology, JAMA Oncology, JAMA Pediatrics, JAMA Psychiatry, JAMA Surgery, Journal of Clinical Oncology, Lancet, Lancet Neurology, Lancet Oncology, Lancet Psychiatry, Nature, Nature Medicine, Nature Reviews Cancer, New England Journal of Medicine, and Science (eFigure in the Supplement).
We used mastheads and web pages (July 2020 to September 2020) to create a convenience sample of editors with job titles that suggested they regularly choose or develop content. We sent emails to the editors in chief introducing the study, asking that they notify their editors to expect the survey, and seeking input on which editor positions to include. Of the 25 editors in chief, 11 (44%) responded, and 9 (36%) confirmed which editor positions to include.
Between November 2020 and January 2021 we administered the survey via email, with 3 follow-up reminders. The University of California, San Francisco, institutional review board deemed the study exempt research on August 26, 2020, because data were derived from surveys. Data were analyzed with Stata (version 14.2, StataCorp).
Of the 681 editors, 654 had an identifiable working email address to receive the survey, and 368 of the 654 responded (56.3%). Editors were primarily employed as academic faculty or in editing, writing, or publishing (Table 1).
The mean age of the respondents was 51.1 years; 187 (50.8%) were men, and 177 (48.1%) were women (Table 2). Of the 20 editors in chief who responded, 7 (35%) were women, as were 8 of 26 (30.8%) of the statistical editors. Of the 368 editors, 284 (77.2%) identified as White, 55 (14.9%) as Asian, 14 (3.8%) as Hispanic, Latinx, or of Spanish origin, and 4 (1.1%) as Black. Regarding sexual orientation, 325 (88.3%) identified as heterosexual, 12 (3.3%) as bisexual, 11 (3.0%) as gay or lesbian, and 10 (2.7%) as either queer, asexual, questioning/unsure, pansexual, or other/not specified; 13 (3.5%) did not answer.
At 25 leading medical and scientific journals, our survey found nearly equal numbers of men and women editors, more than 75% White editors, about 15% Asian editors, very few Black, Hispanic, Latinx, or of Spanish origin editors, and no editors that identified as American Indian or Native American. For the US-based journals, the percentage of editors who identified as Black (1.1%) can be compared with 3.6% of US medical school faculty, 5.0% of practicing physicians in the US,3 and 13.0% of US adults4 who are Black; the editors who identified as Hispanic, Latinx, or of Spanish origin (3.8%) can be compared with 5.5% of medical school faculty, 5.8% of practicing physicians,3 and 16.4% of adults4 with these ethnicities. Data about sexual orientation and gender minority individuals (ie, nonbinary, transgender) in comparable populations are limited. About 11% to 12% of US medical school students identify as lesbian, gay, bisexual, transgender, or queer5; this can be compared with approximately 9% of editors, although none identified as transgender.
Our findings, although limited to a sample of 25 journals, provide novel data on multiple aspects of editor diversity via self-report, not assumptions about an editor’s identity based on a name or photograph. We could not, however, determine if the 368 editors who responded have similar characteristics to the 286 (43.7%) who did not. Moreover, although we asked each editor in chief to confirm the editors to survey, only 9 (36%) did so. Our race and ethnicity response options were based on widely used categories, but did not include important subcategories (eg, specific Asian ethnicities). Nonetheless, these 25 leading medical and scientific journals have substantial collective influence. As such, these data inform the ongoing discussion about the current state of editor diversity at top medical and scientific journals. Specifically, they identify racial and ethnic diversity of editorial leadership as an area in urgent need of improvement.
Accepted for Publication: April 13, 2021.
Published Online: June 11, 2021. doi:10.1001/jamainternmed.2021.2363
Corresponding Author: James W. Salazar, MD, MAS, Department of Medicine, University of California San Francisco, 505 Parnassus Ave, Room M-1480, San Francisco, CA 94143 (james.salazar@ucsf.edu).
Author Contributions: Dr Salazar had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Acquisition, analysis, or interpretation of data: Salazar, Claytor, Guduguntla.
Drafting of the manuscript: Salazar, Claytor, Habib, Guduguntla.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Salazar, Guduguntla.
Administrative, technical, or material support: Habib.
Supervision: Redberg.
Conflict of Interest Disclosures: Dr Salazar reported support from the National Heart, Lung, and Blood Institute under Award Number R38HL143581. Dr Redberg reported receiving research funding from the Arnold Ventures Foundation, the Greenwall Foundation, the Flight Attendant Medical Research Institute, and the National Institutes of Health. No other disclosures were reported.
Disclaimer: Drs Salazar, Claytor, Habib, and Guduguntla are Editorial Fellows, Dr Vittinghoff is a Statistical Editor, and Dr Redberg is Editor of JAMA Internal Medicine. They were not involved in the editorial review of the manuscript or the decision to accept it for publication.
Additional Contributions: We thank Leslie Suen, MD, and Eric Vittinghoff, PhD, both at the University of California San Francisco, for advice on the survey and study design. We thank current and past JAMA Internal Medicine Teachable Moment Fellows for participation in a pilot survey. Finally, we thank the surveyed editors for their consideration and participation. None of these individuals were compensated.
1.Suen
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