Elsevier glitch prompts temporary removal of critique of review on race and heart disease

A timing glitch prompted the temporary removal of a letter to the editor calling out a previously published study for “perpetuating historical harms” through its framing of race and ethnicity. 

The letter, “Race is not a risk factor: Reframing discourse on racial health inequities in CVD prevention,” appeared online in April in the American Journal of Preventive Cardiology, an Elseiver property. It came in response to a review article, published the month before, titled “Ten things to know about ten cardiovascular disease risk factors.”

As the abstract of the review stated: 

This “ASPC Top Ten CVD Risk Factors 2021 Update” summary document reflects the perspective of the section authors regarding ten things to know about ten sentinel CVD risk factors. It also includes quick access to sentinel references (applicable guidelines and select reviews) for each CVD risk factor section. The ten CVD risk factors include unhealthful nutrition, physical inactivity, dyslipidemia, hyperglycemia, high blood pressure, obesity, considerations of select populations (older age, race/ethnicity, and sex differences), thrombosis/smoking, kidney dysfunction and genetics/familial hypercholesterolemia. For the individual patient, other CVD risk factors may be relevant, beyond the CVD risk factors discussed here. However, it is the intent of the “ASPC Top Ten CVD Risk Factors 2021 Update” to provide a succinct overview of things to know about ten common CVD risk factors applicable to preventive cardiology.

That framing was unfortunate, wrote the authors of the letter: Luke G.Silverman-Lloyd, a medical student at the University of California, San Francisco; Naomi Bishop, of the University of Phoenix; and Jessica Cerdeña, of Yale University. According to the trio: 

the authors misleadingly frame race, rather than racism, as a risk factor for CVD. In November 2020, the American Heart Association released a scientific statement emphasizing the need to “move beyond statements that report on the well-known disparities in burden of risk factors, disease, and outcomes among specific subgroups of the population to intentionally address racism and structural inequities” [2]. We affirm this statement and highlight ways the present article perpetuates historical harms. 

Among the problems with the paper, the letter maintains, are its failure to adequately define race and ethnicity and its silence on the issues of “historical trauma” and structural racism as aggravating factors for cardiovascular disease. 

The letter also points to:

“several instances of problematic and dehumanizing language For instance, the authors refer to Black Americans as “Blacks” rather than “Black people” or “Black patients.” They also describe White people as “Caucasians,” a disfavored term that reflects antiquated and racist categories [11,12]. In addition, the authors persistently refer to the Akimel O’odham people as “Pima Indians,” using the settler colonialist term for the tribe, and also call them a “subset of Native Americans,” vastly underrecognizing the complexity and diversity of the Indigenous peoples of the Americas. Importantly, such terminology falls short of the Journal’s commitment to “use of inclusive language” as outlined in the Guide for Authors [13]

Erin Michos, one of the editors-in-chief of the journal, told us that the letter accidentally appeared online before she and her colleagues had a chance to formulate a response to the objections: 

This is not a RETRACTION, and we have repeatedly asked the journal to fix this and remove the word “WITHDRAWN” which is an error.

What happened is that this article was accidentally published early without our reply.  It was supposed to be published side by side with the Editor’s reply.  

So we asked the publisher to hold [the] piece back until the reply to the authors could be published alongside of it as a companion piece. It was supposed to be published side by side – the letter to the editor and our reply.  But the letter got published without our reply.  So I asked the journal to take it down until our reply could be published, but they wrote withdrawn instead.  Anyway our reply is now up, so we have asked the publisher to please remove the word “WITHDRAWN”.   That is a simple mistake that it was published too early but not withdrawn.

The retraction notice reads

The Publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated.

Cerdeña told us that she was mystified by the retraction:

We did not withdraw the article and it is not clear to us why it was withdrawn. I contacted Elsevier and received this response:

“The Editors and the members of our journal’s diversity team have crafted a response to the letter, and we are waiting on that to be finalized.   One of our diversity task members was away on vacation so there was a slight delay in the response letter, but this should be finalized by end of week.

Then your letter and our response will be published at same time.

But yes, we plan to publish your letter verbatim with no additional edits required on your part.  As soon as I have a publication date, I will let you know.   It should be on-line soon I anticipate.”

The journal’s response to the letter is now online. It thanks the authors and states, in part: 

Clearly, the Journal must be committed, as the authors point out, to the use of inclusive language, as well as promoting diversity, including the appropriate representation of the diverse populations discussed in many of our published papers. To this end, the Journal will continue to increase the diversity of our editorial board. Moreover, further instructions are being included to authors to ensure the use of inclusive language while avoiding the use of potential derogatory language. Finally, the Journal has assembled a Diversity Task Force, including several key editorial board members, who will help to promote a culture of inclusivity that will ensure the Journal’s priorities in publishing research, reviews, and practice statements that aim to reduce disparities in cardiovascular disease prevention among diverse and disadvantaged populations.

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5 thoughts on “Elsevier glitch prompts temporary removal of critique of review on race and heart disease”

  1. Science and the scientific endeavor are truly dead now that journals have “diversity teams” and “diversity task forces” to review papers for the proper racial and ethnic ideology.

    1. Yes and no.

      I think diversity teams are just a woke-washing and risk management function. The real problem is the scientists who spend their time trying to cancel anyone who uses a “settler colonial” term. The cancer comes from within.

      This doesn’t mean that scientific endeavor is dead. You can still do science and you’ll mostly be fine, just don’t ever do any science that’s relevant to people of a different race or sex than you.

  2. I’m honestly not sure how either of you jump to your conclusions, William or Anonymous.

    A “glitch prompted the temporary removal of a letter to the editor” that was challenging the initial review paper. In other words, if anything got ‘cancelled’ (and, to be clear, nothing seems to have been), it was the so-called ‘woke’ paper.

    That aside, science is rife with debates about the meaning of specific terms and the values those terms convey. In my fields, we debate the definition of terms like ‘social cohesion’ or ‘social entrepreneurship’, and on this very website it has been discussed how the term ‘retraction’ is perhaps too broad to capture the range and reasons why articles are taken down. Why should similar discussions about how we discuss a whole group of people not be warranted?

    Finally, it seems to me that the authors of the letter have made a very valid point that we may mix-up ‘race/ethnicity’ and many of the socio-economic realities generally associated with certain groups. You may not agree with that contention – which is fine! – but let’s not lump legitimate scientific debate with culture war terms like ‘woke’ and ‘cancel’

    1. It seems to me that the commentators were justly addressing the content of those letters, and not the “glitch” itself.

      It is clear from the amount, deafness and irrelevance of such “concerns”, that they are motivated by scientific impotence and woke activism of the concerned parties, rather than by any genuine issues with the terminology.

  3. It could be the case that racial history and circumstances are a confounding variable of race. But such a claim requires evidence, not conjecture, and will not clearly be facilitated by arguing about whether black people should be called black people, blacks, or black patients.

    The most important feature of terminology in science is whether that terminology is colloquially understood without ambiguity, and not whether it is offensive or inclusive.

    I personally fail to see why it anything but benign to a racial group “blacks” instead of “black people.” The term “blacks” does not seem like a very offensive slur. it does seem like the objectors have a lot of time to waste.

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