Recent evidence shows an increased interest in and attention to DEI in medical and scientific writing, including the publication process.4 This evidence suggests DEI in scholarly publishing is critical to minimize biases related to factors such as sociodemographic characteristics, personal preferences, and institutional settings and to promote diverse disciplines, interdisciplinary scholarship, racial and ethnic diversity, and health equity.4 For example, a comprehensive approach to expansion of diversity in authorship, and along all aspects of the publication process, is required. Without this, we risk perpetuating the epistemological dominance and bias of the populations and perspectives that are included in the biomedical discourse.5 This can have multiple downstream effects: (1) systematic exclusion of ideas and solutions that are not aligned with the dominant narrative;5 (2) the perpetuation of health disparities;6 and (3) limitations on career advancement and retention for underrepresented investigators.7

While there have been limited investigations of approaches to enhance diversity in author lists and the quality of heath equity articles, we commend the editorial team at the Journal of Vascular Surgery for studying the impact of adding a DEI editor to the editorial board.8 With this addition to the editorial board, they found an increase in the number of DEI-related topics published, as well as the number of women authors and associate editors. However, this study was limited by their inability to report on metrics related to racial and ethnic underrepresented minority authors or editorial board members. Given the power and influence of EICs and editorial boards in dictating the global discourse of DEI and health equity,6 more research is needed on how to diversify these positions across identities and life experiences and throughout the publication process.

Prior recommendations to enhance DEI in scientific writing and publishing include (1) increasing diversity in representation of staff leaders and members, associate editors, review panels and committees, and editorial boards; (2) advancing equity by seeking feedback from partners on a journal’s vision, mission, and strategic goals to develop appropriate DEI guidelines and best practices; recognizing contributions from all partners; and implementing that feedback and those contributions into actionable plans; establishing accountability among journal editors and publishers; and (3) promoting inclusion by creating welcoming environments; training existing leaders to use more inclusive language and approaches; examining organizational policies; and fostering advocacy, civility, and expanded collegial networks.4,9 Others have suggested that the publication process include DEI statements; state the sex of animals being studied and/or the sex or gender of people participating in studies; offer DEI trainings and checklists; and adhere to DEI principles, specifications, and standards.4,6 One group recommends adapting strategies to achieve DEI in clinical and translational research for integration into the publication process. We agree with Raoun et al.’s6 assertion that “the ultimate goal of diversity initiatives [within the peer-reviewed journal publication process] should be to recalibrate the entire system so that access to opportunity for publishing is no longer contingent on assumed privilege, but rather based on merit, fairness, and inclusivity.” This involves moving beyond compositional changes (i.e., fixing the numbers) to intentionally addressing procedural factors and organizational climate.2,6