• US Preventive Services Task Force, Karina W Davidson, Carol M Mangione, Michael J Barry, Michael D Cabana, Aaron B Caughey, Esa M Davis, Katrina E Donahue, Chyke A Doubeni, Alex H Krist, Martha Kubik, Li Li, Gbenga Ogedegbe, Lori Pbert, Michael Silverstein, Melissa Simon, James Stevermer, Chien-Wen Tseng, and John B Wong.
• Feinstein Institutes for Medical Research at Northwell Health, New York, New York.
• JAMA. 2021 Dec 21; 326 (23): 2405-2411.

ImportanceUS life expectancy and health outcomes for preventable causes of disease have continued to lag in many populations that experience racism.ObjectiveTo propose iterative changes to US Preventive Services Task Force (USPSTF) processes, methods, and recommendations and enact a commitment to eliminate health inequities for people affected by systemic racism.Design And EvidenceIn February 2021, the USPSTF began operational steps in its work to create preventive care recommendations to address the harmful effects of racism. A commissioned methods report was conducted to inform this process. Key findings of the report informed proposed updates to the USPSTF methods to address populations adversely affected by systemic racism and proposed pilots on implementation of the proposed changes.FindingsThe USPSTF proposes to consider the opportunity to reduce health inequities when selecting new preventive care topics and prioritizing current topics; seek evidence about the effects of systemic racism and health inequities in all research plans and public comments requested, and integrate available evidence into evidence reviews; and summarize the likely effects of systemic racism and health inequities on clinical preventive services in USPSTF recommendations. The USPSTF will elicit feedback from its partners and experts and proposed changes will be piloted on selected USPSTF topics.Conclusions And RelevanceThe USPSTF has developed strategies intended to mitigate the influence of systemic racism in its recommendations. The USPSTF seeks to reduce health inequities and other effects of systemic racism through iterative changes in methods of developing evidence-based recommendations, with partner and public input in the activities to implement the advancements.

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