Racial inequity has been interwoven within the fabric of the U.S. health care system from its beginnings. It has enabled and tainted medical research, using Black and Brown bodies for the pursuit of a “greater good” that did not include them. Racism—whether explicit, implicit or structural—continues to adversely impact the health care experiences and outcomes for Black, Indigenous, and People of Color (BIPOC). As a center dedicated to the advancement of the science of surgery through research that informs policy and program development for safe, high-quality and equitable, patient-centered care, we must acknowledge the existing racism within our health care system and within our own research institutions. We are committed to eliminating racism and its impact in health care globally, nationally and locally.

We are dedicated to directly investigating and exposing the role racism plays in how our health care system fails to serve all patients and how—and by whom—our research is conducted. We commit to designing and implementing interventions that promote and support health equity. We seek to eradicate racist policies and practices across the health care system, engaging directly with underserved populations, locally and nationally, to prioritize and direct our research. We are unwavering in our pursuit of a more just health care system for all patients.

In order to more fully address racial inequity within our existing goals, we will:

Expand and Share Knowledge: We are committed to transparency and sharing best practices, especially those focused on eliminating inequities. It is our intent to fundamentally alter how surgical health services research is conducted by:

• Recognizing racism—rather than race—as a contributing mechanism for inequities, acknowledging the fundamental intersectionality between race, community, education and income inequality;
• Expanding research collaborations with more diverse public health partnerships to better address the systemic inequities that impact surgical care;
• Partnering with communities of color to recruit more representative patient advisory councils, utilize community based participatory research to guide research questions and methodology, including mechanisms for collecting feedback on current and future research priorities, and communicate findings to relevant patient populations.

Transform Practice: We are committed to moving beyond the scope of our current system to seek innovative ways to deliver care with a particular focus on historically underserved populations and to eliminate bias and racism, including how we recruit and train. Our work and outcomes are measured by the improvement in access to and outcomes of those who are most vulnerable and have historically been denied access to health care. We will:

• Focus on developing and evaluating interventions targeted at eliminating surgical inequities;
• Evaluate and monitor surgical and research workforce to understand barriers to entry and advancement for BIPOC individuals;
• Interrogate the role of racism in inhibiting and degrading patient care.

Build a Culture of Excellence: Research directly reflects those who conduct it. It is essential that we recruit and maintain a diverse research team and that we cultivate and value a work culture that sustains them. We will:

• Promote and reward practices that are anti-racist;
• Diversify our recruitment strategies, expanding our networks to encourage a more diverse applicant pool;
• Require anti-racist and unconscious bias training for affiliated researchers, promoting an equitable and just work environment.

Train Future Leaders: We commit to providing future leaders in surgery a learning environment that fosters equity at all levels and prepares them to be advocates for health equity and racial justice. A surgical health services research training curriculum must include an understanding of the power imbalance between physicians, patients, and communities of color and the responsibility of clinicians and researchers to serve as advocates for public health. We will:

• Partner with historically Black colleges and universities to support the advancement and promotion of surgical health services researchers from a broader coalition of research centers;
• Participate in existing programs to improve access to careers in medicine for historically underserved communities;
• Interrogate existing networking systems for mentorship and sponsorship to promote BIPOC surgical health services researchers.

Engage the Policy Community: It is insufficient to identify inequities in health care without attempting to rectify them. As we continue to engage key stakeholders in government and health care to advance surgical care for all populations, we will:

• Partner with historically underserved communities, through activist organizations, neighborhood associations and health centers that serve BIPOC patients to guide the development of policies and interventions targeting their communities;
• Strengthen and diversify our policy network of local health advocates and government agencies;
• Support surgeons and researchers in becoming public health advocates.

In conclusion, we aim to transform the health system, addressing structural and implicit factors in order to improve access and outcomes for individuals who have been impacted by racism and work toward an equitable health system.