The Under-representation and Stagnation of Female, Black, and Hispanic Authorship in the Journal of the American Medical Association and the New England Journal of Medicine

Abstract

Publication in leading medical journals is critical to knowledge dissemination and academic advancement alike. Leveraging a novel dataset comprised of nearly all articles published in JAMA and NEJM from 1990 to 2020, along with established reference works for name identification, we explore changing authorship demographics in two of the world's leading medical journals. Our main outcomes are the annual proportion of male and female authors and the proportion of racial/ethnic identities in junior and senior authorship positions for articles published in JAMA and NEJM since 1990. We found that women remain under-represented in research authorship in both JAMA (at its peak, 38.1% of articles had a female first author in 2011) and NEJM (peaking at 28.2% in 2002). The rate of increase is so slow that it will take more than a century for both journals to reach gender parity. Black and Hispanic researchers have likewise remained under-represented as first and last authors in both journals, even using the best-case scenario. Their appearance as authors has remained stagnant for three decades, despite attention to structural inequalities in medical academia. Thus, analysis of authorship demographics in JAMA and NEJM over the past three decades reveals the existence of inequalities in high-impact medical journal authorship. Gender and racial/ethnic disparities in authorship may both reflect and further contribute to disparities in academic advancement.

Keywords: Authorship; Ethnic disparities; Gender disparities; Medical journals; Racial disparities.

Fig. 1

Stacked bar charts as a function of year, with color denoting gender membership, for the fraction of research articles with a first author belonging to a particular gender group in a JAMA and b NEJM; and the fraction of research articles with a last (senior) author belonging to a particular gender group in c JAMA and d NEJM. Notes: Androgynous names could not be confidently classified as a “male” or “female”. Consortia and study groups were excluded from this analysis

Fig. 2

Stacked bar charts as a function of year, with color denoting gender membership as predicted using the USSA database, for: the fraction of articles with a first author belonging to a particular gender group in a JAMA and b NEJM; and the fraction of articles with a last (senior) author belonging to a particular gender group in c JAMA and d NEJM. Notes: Consortia and study groups were excluded from this analysis for reasons described in the text

Fig. 3

Percent stacked bar chart depicting the probability that a first (junior) author of a research article belongs to any particular racial group, as estimated using the 2000 US census, as a function of year for JAMA using the a averaging-of-proportions approach and b binary approach, with line plots summarizing fraction of articles with a c Black first author and d Hispanic first author; and for NEJM “original articles” using the e averaging-of-proportions approach and f binary approach, with line plots summarizing fraction of articles with a g Black first author and h Hispanic first author. The dashed lines indicates the proportion of Black (13.4%) and Hispanic (18.5%) individuals in the USA in 2019, as well as the proportion of Black (7.9%) and Hispanic (6.8%) individuals with an MD since 2005. Abbreviations: API, non-Hispanic Asian and Native Hawaiian and Other Pacific Islander alone; AIAN, non-Hispanic American Indian and Alaska Native alone; 2PRACE, non-Hispanic two or more races. Notes: These categories and abbreviations are defined by the US Census

Fig. 4

Percent stacked bar chart depicting the probability that a last (senior) author of a research belongs to any particular racial group, as estimated using the 2000 US census, as a function of year for JAMA using the a averaging-of-proportions approach and b binary approach, with line plots summarizing fraction of articles with a c Black last author and d Hispanic last author; and for NEJM “original articles” using the e averaging-of-proportions approach and f binary approach, with line plots summarizing fraction of articles with a g Black last author and h Hispanic last author. The dashed lines indicates the proportion of Black (13.4%) and Hispanic (18.5%) individuals in the USA in 2019, as well as the proportion of Black (7.9%) and Hispanic (6.8%) individuals with an MD since 2005. Abbreviations: API, non-Hispanic Asian and Native Hawaiian and other Pacific Islander alone; AIAN, non-Hispanic American Indian and Alaska Native alone; 2PRACE, non-Hispanic two or more races. Notes: These categories and abbreviations are defined by the US Census

Fig. 5

Percent stacked bar chart depicting the probability that a first (junior) author of a research article belongs to any particular racial group, as estimated using the 2010 US census, as a function of year for JAMA using the a averaging-of-proportions approach and b binary approach, with line plots summarizing fraction of articles with a c Black first author and d Hispanic first author; and for NEJM “original articles” using the e averaging-of-proportions approach and f binary approach, with line plots summarizing fraction of articles with a g Black first author and hHispanic first author. The dashed lines indicate the proportion of Black (13.4%) and Hispanic (18.5%) individuals in the USA in 2019, as well as the proportion of Black (7.9%) and Hispanic (6.8%) individuals with an MD since 2005. Abbreviations: API, non-Hispanic Asian and Native Hawaiian and other Pacific Islander alone; AIAN, non-Hispanic American Indian and Alaska Native alone; 2PRACE, non-Hispanic two or more races. Notes: These categories and abbreviations are defined by the US Census

Fig. 6

Percent stacked bar chart depicting the probability that a last (senior) author of a research article belongs to any particular racial group, as estimated using the 2010 US census, as a function of year for JAMA using the a averaging-of-proportions approach and b binary approach, with line plots summarizing fraction of articles with a c Black last author and d Hispanic last author; and for NEJM using the e averaging-of-proportions approach and f binary approach, with line plots summarizing fraction of articles with a g Black last author and h Hispanic last author. The dashed lines indicates the proportion of Black (13.4%) and Hispanic (18.5%) individuals in the USA in 2019, as well as the proportion of Black (7.9%) and Hispanic (6.8%) individuals with an MD since 2005. Abbreviations: API, non-Hispanic Asian and Native Hawaiian and other Pacific Islander alone; AIAN, non-Hispanic American Indian and Alaska Native alone; 2PRACE, non-Hispanic two or more races. Notes: These categories and abbreviations are defined by the US Census