Equality Is Not Fair: Imaging and Imagining the Road to Health Equity

Social Determinants of Health Framework to Identify and Reduce Barriers to Imaging in Marginalized Communities

Social determinants of health (SDOH) are conditions influencing individuals' health based on their environment of birth, living, working, and aging. Addressing SDOH is crucial for promoting health equity and reducing health outcome disparities. For conditions such as stroke and cancer screening where imaging is central to diagnosis and management, access to high-quality medical imaging is necessary. This article applies a previously described structural framework characterizing the impact of SDOH on patients who require imaging for their clinical indications. SDOH factors can be broadly categorized into five sectors: economic stability, education access and quality, neighborhood and built environment, social and community context, and health care access and quality. As patients navigate the health care system, they experience barriers at each step, which are significantly influenced by SDOH factors. Marginalized communities are prone to disparities due to the inability to complete the required diagnostic or screening imaging work-up. This article highlights SDOH that disproportionately affect marginalized communities, using stroke and cancer as examples of disease processes where imaging is needed for care. Potential strategies to mitigate these disparities include dedicating resources for clinical care coordinators, transportation, language assistance, and financial hardship subsidies. Last, various national and international health initiatives are tackling SDOH and fostering health equity.

Female Authorship Trends Among Articles About Artificial Intelligence in North American Radiology Journals

Purpose: To examine trends in female authorship of peer-reviewed North American radiology articles centred around artificial intelligence (AI). Method: A bibliographic search was conducted for all AI-related articles published in four North American radiology journals. Collected data included the genders of the first and last (senior) authors, year and country. We compared the trends of female authorship using Pearson chi-square, Fisher exact tests and logistic regression models. Results: 453 articles met the inclusion criteria. Among these, 107 (22.3%) had a female first author and 97 (27.3%) had a female senior author. Female first authors were over three times more likely to publish with a female senior author. Among the four journals, the CARJ had the highest proportion of female senior authors at 45.5%. The only significant temporal trend identified was an increase over the years in female senior authors in Radiology. Twenty-four countries contributed to the included articles, with the largest contributors being the United States (n = 290) and Canada (n = 30). Of the countries contributing more than 15 articles, there were none with above 50% female authorship. Conclusions: Female authors are underrepresented in AI-related radiology literature. However, there has been an encouraging recent increase in female authorship in AI-related radiology articles trending towards significance. There is a great opportunity to improve female representation in AI with intentional mentorship and recruitment. We urge more platforms for female voices in radiology as AI becomes increasingly integrated into the radiology community.