A viral image of a black fetus underscores the need for diversity in medical illustration

Created by Nigerian medical student and illustrator Chidiebere Ibe, the image has resonated with countless people on social media, many of them said that they had never seen a black fetus or a black pregnant woman before. It also raised awareness of a bigger problem: Lack of variety in medical illustrations.

(While most fetuses are red – newborns come out dark pink or red and only gradually develop the skin tone they will have for life – the medical illustration is meant to depict patients unaccustomed to seeing their skin tone in such pictures.)

I said in an interview with HuffPost Germany that he hadn’t expected such an overwhelming response – his fetus illustration was one of many such pictures He originated as a medical illustrator, most of whom depict black skin tones. But it underscores the importance of a mission to which he has long been committed.

“The whole purpose was to keep talking about what I’m passionate about – health justice – and also to show the beauty of black people,” he told the publication. “We don’t just need more agencies like this – we need more people who are willing to create such agencies.”

CNN reached out to Ibe for comment, but did not elaborate on the subject.

Ni-Ka Ford, Chair of the Association of Medical Illustrators’ Diversity Committee, said the organization was grateful for Ibe’s illustration.

“In addition to the importance of black and brown body depiction in medical illustration, his illustration also serves to combat another major flaw in the medical system, namely the appallingly disproportionate maternal death rate of black women in this country,” she wrote in an email to CNN.

What is medical illustration?

Medical illustrations have been used for thousands of years to record and communicate procedures, pathologies, and other facets of medical knowledge, of the ancient Egyptians to Leonardo da Vinci. Science and art are combined to translate complex information into images that can convey concepts to students, practitioners, and the public. These images are used not only in textbooks and academic journals, but also in films, presentations, and other media.
There are fewer than 2,000 trained medical illustrators worldwide Association of Medical Illustrators. With only a handful of accredited medical illustration programs in North America, which are typically expensive and accept few students, the field has historically been dominated by white and male individuals – which in turn means that the bodies depicted are usually so too.

“Historical [medical illustrations] have always shown, and still do, white, stout male figures, “said Ford.” The bias toward one body type in medical illustration marginalizes all others. “

Studies have confirmed this lack of diversity. Researchers at the University of Wollogong in Australia found in a Study 2014 that of more than 6,000 images with an identifiable gender in 17 anatomy textbooks published between 2008 and 2013, only 36% of the bodies depicted were female. The vast majority were white. About 3% of the analyzed images showed disabled bodies while only 2% showed elderly people.

Why diversity is important in the industry

Diversity (or lack of) in medical illustrations is important as these images can have an impact on medical students, practitioners, and patients.

“Without fair representation and the constant commitment of only white, healthy patients portrayed in medical textbooks, health professionals are limited in their ability to accurately diagnose and treat people who do not fit this mold,” said Ford. “Healthcare professionals then tend to rely on racial stereotypes and generalizations because of this gap in knowledge about how symptoms vary in darker skin tones, resulting in poorer care.”

A study by the same researchers at the University of Wollogong published in 2018 found that gender-specific images from anatomy textbooks improved medical students’ scores on implicit bias tests. Another study that was published in the Journal of Plastic and Reconstructive Surgery – Global Open found in 2019 that white patients were over-represented in the images of plastic surgery journals, which the authors believe could potentially affect the care of non-white patients.
Black adults are more likely to report healthcare bias than whites and Latinos, a study found

“For decades, peer-reviewed scientific publications have used photographs and images that inadequately depict the demographic diversity of patients affected by certain diseases,” the researchers write. “This is particularly noticeable in the lack of diversity in medical illustration. These inequalities in medical reporting can have profound effects on the accessibility and delivery of health care. “

Ford said those who are not often depicted in medical illustrations can “feel left out and unrecognized in the healthcare system, leading to distrust and isolation in care.” She also said health professionals may feel less empathy for groups that are unrepresented – people who are black, tan, women, transgender, or non-binary – which can affect the quality of care they receive.

Health inequalities were well documented, with studies showing that black patients are more likely to experience bias and be misdiagnosed for certain conditions. Research has also shown that a significant proportion of white medical students and residents have misconceptions about biological differences between blacks and whites, which can lead to racial prejudice in the way their pain is perceived and treated.

Despite the continuing need for medical illustrations to depict the full extent of human diversity, the field of change is beginning to change, medical illustrator Hillary Wilson told CNN.

Wilson, whose Illustrations Depicting black people in infographics about eczema, sun damage, alopecia, and other conditions, said both patients and doctors could benefit from portraying diversity in medical illustrations. And through her work, she seeks to humanize People of Color and other marginalized groups by doing just that.

“The reality is that there are so many different types of people,” she said. “To me, a resource is not complete if I don’t at least take it into account and try my best to accommodate the fact that there are so many different types of people.”

While Ibe’s image of the black fetus seemed to mark a departure from the norm, Wilson hopes seeing black skin tones in medical illustrations will become a routine in the future.

“At some point, I hope it just becomes the thing that is expected,” she added.

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