We are seeing an organized and escalating attack on Diversity, Equity, and Inclusion (DEI). Academic squabbles have become political lightning rods, while critics cite clunky and controversial administrative moves as evidence that “DEI Inc.” has gone too far–and should be rolled back or defunded altogether.
These arguments may sound compelling at first, but the thinking behind them is misguided.
As a physician, I am trained to weigh the potential harms of over-treating against the risks of treating too little or failing to act. The critical risk in DEI is not that we will occasionally overreach or fumble our efforts. We should accept as a given that no organization will perfectly navigate the nuances of equity and inclusion. Rather, the more likely and more dangerous risk is that we will do too little in the face of staggering inequities–and dire health disparities.
All credible evidence shows that health disparities are persistent, pervasive, and deadly. This demands an organized response from healthcare organizations, as well as institutions like the Philadelphia College of Osteopathic Medicine and others in higher education. Especially in STEMM and health professions, we are upstream of these disparities and compelled to act.
A recent study from the National Bureau of Economic Research garnered attention when it showed that Black moms and babies continue to experience higher mortality and poorer health outcomes compared to white peers–even among the wealthiest Black patients.
One in five Black people report having personally experienced discrimination in healthcare settings and 70% believe that our healthcare system treats people differently based on race and ethnicity. A stream of evidence shows that Black patients often experience the worst inequities, but other groups face health disparities too.
Patients with disabilities struggle to access care. The same goes for disproportionately uninsured immigrants, as well as Asian Americans based on language barriers, racial bias, and cultural differences. The LGBTQ community continues to face high suicide rates. A new report by the Centers for Disease Control and Prevention found that almost half of LGBTQ youth have considered a suicide attempt. Even rural health comes into play when we discuss disparities and health equity. I could go on.
It is well established that cultural competence among providers of all backgrounds is associated with better outcomes and fewer disparities. We also know that patients receive better care and more preventive care when they see doctors who look like them and that Black doctors are more likely to practice in high-need areas. And yet Black providers and others from diverse backgrounds remain underrepresented, with populations in need suffering the consequences.
The point is: DEI is neither a bogeyman nor a bureaucracy. It would be a disservice to everyone–including patients and future health professionals of all races and ethnicities–if we failed to confront these inequities head-on. In medical education, this means we must create opportunities for underrepresented students, embed health equity in our curriculum, and equip graduates to address both symptoms and structural issues when they enter practice. Other institutions must consider their own response.
If we malign these efforts as “DEI Inc.” or identity politics run amok, then what is the alternative?
People are dying prematurely and experiencing poor health outcomes because of discrimination and disparities in their care. This necessitates an urgent and ongoing commitment to DEI across all institutions–in the classrooms where future health professionals are training, and more broadly across all companies and organizations.
We can’t back away from our values out of fear that we may stumble into a political tug-of-war.
Jay S. Feldstein, DO, is the president and CEO of Philadelphia College of Osteopathic Medicine(PCOM). He is board certified in emergency medicine and occupational medicine and is a fellow of the American College of Preventive Medicine.
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