USPSTF Members Release Statement on Addressing Systemic Racism

In a remarkable editorial, Addressing Systemic Racism Through Clinical Preventive Service Recommendations From the US Preventive Services Task Force, published in JAMA, the members of the U.S. Prevention Services Task Force (USPSTF) observed that health services offering lifesaving benefits are “not equitably available to Black, Indigenous, and Hispanic/Latino people.”  The USPSTF is a volunteer body of prevention and medical experts responsible for making evidence-based recommendations regarding clinical preventive services such as screenings, counseling services and preventive medications. The committee assigns a letter grade (A-D) to these services. Under the Affordable Care Act services with a recommendation of A or B must be covered without cost sharing. For example, the USPSTF gave an A recommendation that people with high risk of HIV acquisition be offered Pre-Exposure Prophylaxis (PrEP).

In the editorial, the USPSTF committed to “identify when systemic racism contributes to health inequities and to include evidence-based strategies that will reverse the negative effects of systemic racism on preventable disease.” They further committed to taking the specific actions:

• Consider race primarily as a social and not a biological construct and use consistent terminology throughout recommendation statements to reflect this view.
• Promote racial and ethnic diversity in addition to gender, geographic and disciplinary diversity in membership and leadership of the USPSTF and foster a culture of diversity and inclusivity as an enduring value of the USPSTF. This will be assessed annually prior to soliciting nominations for new members and internally assigning leadership roles.
• Commission a review of the evidence, including an environmental scan and interviews with clinicians, researchers, community leaders, policy experts, other guideline developers and patients from groups that are disproportionately affected to summarize the evidence on how systemic racism undermines the benefits of evidence-based clinical preventive services and causes preventable deaths. This will be completed by June 2021.
• Iteratively, update USPSTF methods to integrate the best evidence and consistently address evidence gaps for Black, Indigenous, and Hispanic/Latino populations. This includes measures to identify and track strategies to demonstrate progress in addressing health inequities regarding clinical preventive services.
• Use a consistent and transparent approach to communicate gaps in the evidence related to systemic racism in preventive care in Recommendation Statements and the USPSTF’s annual report to Congress. This includes an ongoing assessment of how the effects of systemic racism on the quality of the evidence and receipt of clinical preventive services perpetuate health inequities.
• Collaborate with other guideline-making bodies, professional societies, policy makers, and patient advocacy organizations on efforts to reduce the influence of systemic racism on health.

The Academy is deeply concerned about the evident disparities within the HIV field based on race and ethnicity, as well as gender and sexual orientation in HIV prevention and treatment settings. (Click here to read our DEI statement). We believe that this is an important effort by the USPSTF and urge them to combat and diminish health disparities in every way.