Background: Editorial boards of academic journals serve as providers of scientific knowledge, that shape research priorities, methodological standards, and clinical trends. As positions of power, these roles must be equitable, inclusive and diverse to ensure an array of different perspectives and minimize viewpoint bias. Despite advances in gender equity within medicine, women remain underrepresented in editorial academic positions [1]. In rheumatology, this gap is evident where prior studies describe persistent disparities among men and women authors, speakers, and editorial board members [2, 3]. Thus, women are less likely to achieve high impact research metrics compared to their male peers. Given that diversity drives scientific progress, understading how gender affects research impact in rheumatology publishing is essential.

Objectives: To assess the distribution of male and female editors across country income levels and compare their research impact metrics in rheumatology journals worldwide.

Methods: From 84 peer-reviewed rheumatology journals indexed in five major databases (Web of Science, Journal Citation Reports, Scopus, SciELO, and Redalyc), editors holding chief, executive or senior editorial roles were extracted (e.g., Editor-in-Chief, Deputy Editor, Executive editor). Manan’s editorial role classification was used to determine their positions [4]. Duplicates, arising from editors holding multiple positions in different journals, were eliminated. Editor identity and primary institutional affiliations were verified using official journal websites and institutional profiles. Sex was inferred using GenderAPI retaining only predictions with >90% probability of being male or female. The country of the editor’s primary academic affiliation was classified according to the World Bank Group’s 2024 income categories: low-income (LIC), lower-middle-income (LMIC), upper-middle-income (UMIC), and high-income countries (HIC). Bibliometric data (publications, citations, and H-index) were extracted from Web of Science (Clarivate) author search. When profiles were incomplete, or unavailable, Google Scholar and Scopus were used as supplementary sources. Descriptive statistics summarized demographic and impact metrics. The distribution of editors’ sex and country income level was tested using Pearson’s chi-squared test. Comparisons of research impact metrics were performed by sex using the Mann-Whitney U test. Finally, Spearman’s rank correlation coefficient tested the relationship between country income level and each research metric.

Results: 1,219 editors were extracted, and after eliminating 155 duplicates, 1,064 editors were analyzed. 678 (63.7%) were men and 386 (36.3%) were women. A significant difference in distributions existed between editors’ sex and country income group (χ ² = 18.7, p = 0.004): women represented most editors in LMICs (52.8%), whereas men constituted over 60% of editors in UMICs and HICs (Table 1). Male editors exhibited significantly higher research impact: median publications (187 vs. 106, p < 0.001), median citations (4,865 vs. 2,139, p < 0.001), and median H-index (36 vs. 23, p < 0.001) (Table 2). Lastly, country income level showed a weak but statistically significant positive correlation with research output: publications (ρ = 0.181, p < 0.001), citations (ρ = 0.270, p < 0.001), and H-index (ρ = 0.270, p < 0.001).

Conclusions: Parity in rheumatology editorial leadership remains unmet, especially in high-resource settings. The strong presence of women in lower-middle-income countries demonstrates that equitable representation is feasible. The correlation between national income and research impact suggests a deeper structural imbalance: scientific influence in rheumatology is disproportionately skewed by authors from HICs, narrowing the agenda to priorities relevant to wealthier nations, while marginalizing low-resource contexts. Professional societies must adopt proactive policies targeting equity and diversity, including transparent editorial appointment processes, mentorship for underrepresented scholars, and geographic diversity targets to build a more inclusive and scientifically robust rheumatology community.

REFERENCES: [1] Mamtani, Mira et al. “Quantifying gender disparity in physician authorship among commentary articles in three high-impact medical journals: an observational study.” BMJ open vol. 10,2 e034056. 25 Feb. 2020, doi:10.1136/bmjopen-2019-034056

[2] Ross, Laura et al. “Pursuing Gender Equity in Rheumatology: Thinking Beyond Gender Representation to Assess Gender Equality.” The Journal of rheumatology vol. 52,2 112-115. 1 Feb. 2025, doi:10.3899/jrheum.2024-0840

[3] Barajas-Ochoa, Aldo et al. “Gender representation in rheumatology journals: an assessment of editors, editorial boards, and authors.” Rheumatology international vol. 43,10 (2023): 1811-1819. doi:10.1007/s00296-023-05390-7

[4] Manan, Muhammad Romail et al. “Diversity, Equity, and Inclusion on Editorial Boards of Global Health Journals.” Asian bioethics review vol. 15,3 209-239. 16 Mar. 2023, doi:10.1007/s41649-023-00243-8

Acknowledgments: NIL.

Disclosure of Interests: None declared.