Assessing the Diversity of The Journal of Bone and Joint Surgery Editorial Boards

The first step in any effort to increase diversity is documenting the present state. In the fall of 2023, The Journal of Bone and Joint Surgery, Inc. (JBJS) embarked on an initiative to assess the diversity of the entire JBJS team, including the editorial boards across 6 journals, the Board of Trustees, and the staff. The initiative took the form of a survey, which was based on a questionnaire utilized by Salazar et al. in their assessment of editorial board diversity at 25 leading medical and scientific journals1. The JBJS survey was conducted anonymously. Among members of the JBJS editorial boards, responses were received from 111 (90%) of the 124 individuals surveyed. The results for these editorial board members are presented in Table I. Because the entire JBJS organization is committed to diversity, equity, and inclusion, the results for JBJS trustees and staff are also provided (see Appendix). TABLE I - Demographics of the JBJS Editorial Boards* Characteristic No. (%) Gender† (n = 111) Female 13 (11.7%) Male 98 (88.3%) Nonbinary 0 (0.0%) Transgender female 0 (0.0%) Transgender male 0 (0.0%) Prefer not to answer 0 (0.0%) Other 0 (0.0%) Race/ethnicity† (n = 111) Asian 21 (18.9%) Black or African American 4 (3.6%) Hispanic, Latinx, or of Spanish origin 2 (1.8%) American Indian or Native American 1 (0.9%) Pacific Islander 0 (0.0%) White 78 (70.3%) Prefer not to answer 5 (4.5%) Other 4 (3.6%) Age, in years (n = 111) <30 0 (0.0%) 30-39 8 (7.2%) 40-49 20 (18.0%) 50-59 28 (25.2%) 60-69 34 (30.6%) ≥70 20 (18.0%) Prefer not to answer 1 (0.9%) Sexual orientation† (n = 110) Asexual 2 (1.8%) Bisexual 2 (1.8%) Gay or lesbian 0 (0.0%) Straight/heterosexual 100 (90.9%) Queer 0 (0.0%) Questioning or unsure 0 (0.0%) Prefer not to answer 6 (5.5%) Other 0 (0.0%) Region (n = 111) U.S. Northeast 18 (16.2%) U.S. South 11 (9.9%) U.S. Midwest 15 (13.5%) U.S. West 24 (21.6%) Canada 5 (4.5%) Mexico/Central America 0 (0.0%) Europe 20 (18.0%) Asia 14 (12.6%) South America 1 (0.9%) Africa 0 (0.0%) Australia/Oceania 2 (1.8%) Prefer not to answer 0 (0.0%) Other 1 (0.9%) Specialty (n = 111) Basic science/pathology 1 (0.9%) Biomechanics 3 (2.7%) Elbow/shoulder 9 (8.1%) Foot/ankle 4 (3.6%) General 6 (5.4%) Hand/wrist 5 (4.5%) Hip/knee 18 (16.2%) Methodology/statistics 5 (4.5%) Oncology 7 (6.3%) Pain management 1 (0.9%) Pediatrics 16 (14.4%) Rehabilitation 0 (0.0%) Spine 10 (9.0%) Sports medicine 13 (11.7%) Trauma 13 (11.7%) Not applicable 0 (0.0%) Prefer not to answer 0 (0.0%) Career position (n = 111) Faculty position in academia 86 (77.5%) Physician (non-academic position) 8 (7.2%) Government or nonprofit organization 2 (1.8%) Physician assistant 10 (9.0%) Not applicable 1 (0.9%) Other 4 (3.6%) Academic rank (n = 109) Trainee 0 (0.0%) Lecturer 2 (1.8%) Instructor 0 (0.0%) Assistant professor 4 (3.7%) Associate professor 22 (20.2%) Professor 65 (59.6%) Professor emeritus 4 (3.7%) Not applicable 10 (9.2%) Prefer not to answer 0 (0.0%) Other 2 (1.8%) Editorial position (n = 111) Editor-in-chief 1 (0.9%) Deputy editor 36 (32.4%) Associate editor 52 (46.8%) Editor-at-large 2 (1.8%) Statistical editor 3 (2.7%) Editor emeritus 3 (2.7%) Not applicable 4 (3.6%) Prefer not to answer 2 (1.8%) Other 8 (7.2%) *Includes editorial board members across JBJS journals. Some respondents did not answer every question. Percentages are based on the number of respondents who answered that question, which is noted for each category.†Multiple selections per respondent were permitted. Some of the demographic variables examined in the editorial board survey, such as gender, race, and ethnicity, have been commonly assessed among orthopaedic surgeons in prior studies. For these variables, representation among JBJS editorial board members was generally found to be similar to that observed among orthopaedic surgeons as a whole, albeit with some exceptions. For example, individuals of Asian descent were found to comprise 18.9% of JBJS editorial board members compared with 6.7% of practicing surgeons, as documented in the most recent orthopaedic census2. Nevertheless, the representation of women (11.7%) and Black (3.6%) and Hispanic (1.8%) individuals on the JBJS editorial boards remains quite low relative to the population of patients treated by U.S. orthopaedic surgeons, which has been reported as comprising 50.4% women, 13.6% Black individuals, and 19.1% Hispanic individuals3. Other variables recorded in the survey, such as sexual orientation, have been less commonly assessed among orthopaedic surgeons previously. Although the representation of individuals identifying as heterosexual among JBJS editorial board members (90.9%) was similar to that among editors at top medical and scientific journals (88%)1 and the general population (87%)4, there were some differences in the representation of individuals identifying as asexual, bisexual, gay or lesbian, queer, questioning, and/or other. At JBJS, we consider the results of this survey to represent a baseline from which to grow and evolve. Specifically, we plan to administer the survey on a regular basis (every 3 years or so) to assess for changes over time. When readministering the questionnaire in future years, we hope to continuously improve the survey instrument to better measure the demographics at JBJS. For example, the current version of the survey instrument followed the lead of prior work1 by inquiring about gender but listing options typically utilized to describe sex (i.e., female, male, transgender female, and transgender male) instead of terms more appropriately utilized to describe gender (e.g., cisgender man, cisgender woman, transgender man, and transgender woman, in addition to nonbinary and other). Diverse companies are the most successful companies5. At JBJS, we view diversity as central to our mission of publishing the best possible research to guide clinical decision-making. We thank all of the editorial board members, trustees, and staff who took the time to complete the survey, and we look forward to the day when these editorial boards—as well as orthopaedic surgeons in general—will more closely reflect the population of patients whom we serve. Appendix Supporting material provided by the authors is posted with the online version of this article as a data supplement at jbjs.org (https://links.lww.com/JBJS/H926).

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