Academic medical centers must change how they recruit, retain and engage talent to address structural racism, said faculty and staff from Ohio State University in commentary published Friday by Nature Reviews Gastroenterology & Hepatology.
Even though many would do well in leadership roles, people of color are often excluded from them because they don't match the profiles of leaders who came before them. Experts say academic medical centers need to evaluate and reform their recruiting and retention practices to create a more inclusive workplace and learning environment. Instituting term limits for leadership roles and developing mentorships for rising faculty and staff of color could improve representation and, ultimately, organizational performance.
"The time is now for academic medical centers to cultivate and sustain healthier environments for their patients, staff, faculty and learners by approaching all facets of these vital anchor institutions with an anti-racist lens," Dr. Darrell Gray II, lead author, associate professor in the College of Medicine and chair of the Health Equity Steering Committee at Ohio State Wexner Medical Center said in a statement.
Likewise, academic medical centers should adopt a "stop the line" policy for racist culture and encourage patients, students, trainees, staff and faculty to point out—without fear of retribution—racist behavior, policies and practices and help address them.
Leaders should also create "a local community council to review institutional health equity initiatives, advise senior leadership on anti-racism strategies and provide feedback," the authors said in a statement. Council members should include community residents and communities of color.
Such reforms would help create a more welcoming environment where people of all backgrounds could thrive and improve care quality, experts say.
But academic medical centers need to back up those actions with the financial resources to "support clinical, education and research goals around anti-racism action," said co-author Dr. J. Nwando Olayiwola, chair and professor of the Department of Family and Community Medicine at Wexner Medical Center. "Anti-racism initiatives can reduce costs and increase value-based care model incentives by improving care and addressing analytical bias."
Experts say lack of representation in leadership across institutions has made society less responsive to the issues facing communities of color and impaired the nation's ability to respond to the pandemic, potentially costing tens of thousands of lives.
Several issues have combined to worsen existing health inequities throughout the COVID-19 pandemic, including significant racial disparities in income, wealth and access to care, among other factors. According to the Centers for Disease Control and Prevention, people of color are about twice as likely to die from the virus as white people.
Communities of color are more vulnerable to infection than the general population because their jobs disproportionately require them to work in-person and they are less likely to have health coverage. People of color are also more likely to live in intergenerational households, making it easier for them to give the virus to higher-risk people and more difficult to quarantine when infected.
HHS' Office for Civil Rights Monday reminded providers and state and local agencies that it's illegal to discriminate based on race, color or nationality. The agency is concerned that communities of color have worse access to testing, suffer from excessive wait times when seeking treatment and are more likely to be denied access to care.