136 - Anatomy's Missing Faces: An In-depth Analysis of Representation Gaps in Textbook Imagery

Poster Board Number: 136
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Co-authors:

David Zepeda - Rush University Medical Center; Marissa Pharel - Rush University Medical Center; Tyler Soy - UNC School of Medicine; Adam Wilson - Rush University Medical Center; Christopher Ferrigno - Rush University Medical Center

Abstract Body : Previous research suggests that underrepresentation in medical curricula perpetuates inequities in healthcare. This study aimed to quantify the prevalence of human phenotypic diversity (e.g., skin tone, sex, body size, and age) across eleven commonly used anatomy atlases and textbooks in pre-clerkship medical education published from 2015 to 2020. A systematic visual content analysis was conducted on 5,001 images in which at least one phenotypic attribute was quantifiable. Anatomy images most prevalently portrayed light skin tones, males, persons with intermediate body sizes, and young to middle-aged adults. Of the 3,883 images in which there was a codable skin tone, 81.2% (n=3,154) depicted light, 14.3% (n=554) depicted intermediate, and 4.5% (n=175) depicted dark skin tones. Of the 2,384 images that could be categorized into a sex binary, 38.4% (n=915) depicted females and 61.6% (n=2,384) depicted males. A male bias persisted across all whole-body and regional body images, regardless of the presence of internal or external genitalia. Within sex-specific contexts, darker skin was underrepresented, but male depictions display greater overall skin tone variation. Although most images could not be assigned into a body size or age category, when codable, these images overwhelming depicted adults (85.0%; 482 of 567) with smaller (34.7%; 93 of 268) or intermediate (64.6%; 173 of 268) body sizes. Ultimately, these outcomes provide reference metrics for monitoring future changes and efforts to address representation inequalities portrayed in anatomical imagery.