Racial and ethnic disparities in hematologic malignancies

Kedar Kirtane and Stephanie J. Lee

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  • Disparities need more work indeed. Let's do something about it!
    • Stephen C Nelson, Pediatric Hematologist Children's Hospitals and Clinics of Minnesota

    To the Editor: I read with interest the article by Kitrane and Lee, along with the associated
    commentary by Landgren in the October 12th issue of Blood describing inferior outcomes for adult Americans of color diagnosed with hematologic malignancies. Similar results were recently reported in children with ALL [1]. I was thrilled to see this work being highlighted and agree that “racial disparities need more work.” I particularly liked the conceptual framework for disparities in Figure 2. However, there was a huge missed opportunity here. I was disappointed to see no mention of how racism and whiteness affect care in either the authors’ framework or the commentary by Landgren. We need to stop admiring the problem and take action to address racial disparities.
    I invite us to investigate the structural barriers of institutional racism and whiteness and how
    these affect unconscious provider biases, the social determinants of health as well as the
    physiology of our patients of color. Racial health care disparities exist and provider bias,
    stereotyping, and prejudice contribute to these disparities [2-4]. I strongly and respectfully
    encourage ASH to pursue programs to increase awareness of race, racism, and whiteness and to
    improve our skills in caring for patients of color. Our group has shown that this can be done [5].
    Also, I encourage us to stop publishing manuscripts that use the common practice of describing

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    Conflict of Interest:
    None declared.