In recent years, "DEI" has become a political buzzword — and health systems' efforts aren't immune to the consequences, leaders in the field say.
Diversity, equity and inclusion efforts were rolled out en masse in 2020. Healthcare was among the many industries to adopt such programs, aiming to broaden the workforce, improve employee satisfaction and address disparities in patient populations. C-suite leaders were appointed to lead sweeping culture changes and revamp hiring practices; offices were installed to research and educate.
But these programs have come under mounting scrutiny, especially after the Supreme Court overturned affirmative action in June. Chief DEI officers have been leaving their roles as some organizations funnel their responsibilities under human resources departments and replace "DEI" with less-charged terms.
The DEI sector is unique in health systems, as it often guides data-backed, financially justifiable health equity efforts. However, some leaders in the space still struggle to continue as online backlash spreads like wildfire. The chief diversity officer of Baltimore-based Johns Hopkins Medicine resigned March 6 after a newsletter defining the term "privilege" went viral on social media, leading a politician to call for her firing. Progress, in some cases, has been one step forward and two steps back.
"After George Floyd's death, we saw this acceleration where everyone was embracing equity. I thought that was really our tipping point, where we could really move past and gain some substantial impact in this country," Yolanda Lawson, MD, president of the National Medical Association, told U.S. News & World Report. "But unfortunately, now we have seen this backlash."
This week, U.S. News interviewed three health equity experts to gauge momentum in the field. Their general consensus: The pushback is apparent, but not new, and not enough to halt DEI efforts.
Joneigh Khaldun, MD — former chief medical officer for the state of Michigan and current chief health equity officer at CVS Health — told the publication that interest in health equity and disparity has naturally ebbed and flowed throughout history, even before the term "DEI" caught on. The challenges aren't new, per se — they've just taken on a new name.
"While I do think the 'flashiness' of health equity and diversity, equity and inclusion has perhaps gone down a bit in the past couple of years since the pandemic has kind of waned, I still know that there are organizations that are really committed to it," Dr. Khaldun said. "And I'm also proud of the work we're doing at CVS."
The organization, like other healthcare companies, is looking to understand DEI as "just a way of doing their work," Dr. Khaldun said. It's looking to incorporate those efforts into a wide range of initiatives, from data analysis to hiring practices to health advancement in different communities.
Hugh Mighty, MD — senior vice president for health affairs at Howard University in Washington D.C., one of the few historically Black universities in the U.S. with a medical school — echoed the sentiment that DEI isn't new.
"People have been doing DEI forever, but we've been doing it quietly," he said. "But then we gave it a name and we elevated its presence, and then it became a threat."
Dr. Mighty continued: "So yes, there has been pushback on DEI and there continues to be pushback. Companies have pulled back and there has been movement — certainly within the last two years — to roll back the concept of DEI. But that doesn't happen if the largest companies in this country sit down at a table, form a consortium and say they are now all about DEI. Who's going to be able to stop that?"
The debate isn't necessarily earth-shattering, and companies don't need to stop talking about DEI to make progress, Dr. Mighty said: Efforts to build out a diverse work pipeline are going to continue.
But according to Dr. Lawson, the public's lack of acknowledgement of health inequities and disparities is dangerous and threatens real impact.
"For me, because of the lack of acknowledgement, I feel that it's going to stall progress," Dr. Lawson said.
"Not only does it stall progress, but we're starting to see a reversal of progress," she continued, nodding to the Alabama Supreme Court's recent ruling that embryos used in in vitro fertilization are children.
Empathetic leaders are needed to bridge the gap, Dr. Lawson said: those who can understand a broader range of perspectives, or at least are willing to listen.