CHESTCHEST NewsAffirming Health Equity in Medicine in Support of Improving All Patient Outcomes

Affirming Health Equity in Medicine in Support of Improving All Patient Outcomes

August 9, 2024

In accordance with our mission to champion the prevention, diagnosis, and treatment of chest diseases and advance the best patient outcomes, CHEST is firmly committed to the necessity of diversity, equity, and inclusion (DEI) in health care research, education, and delivery.

Health care requires a solid patient-provider therapeutic alliance to achieve successful outcomes. Decades of scientific research have shown that a lack of clinician diversity worsens health disparities.1 For patients from historically underserved communities, having clinicians who share similar lived experiences almost always leads to significant improvements in patient outcomes. If identity concordance is not feasible, clinicians with considerable exposure to diverse patient populations, equitable approaches to care, and inclusive perspectives on health gained through continuing, comprehensive medical education and professional training can also positively impact outcomes.

Research also indicates that a diverse medical workforce improves cultural competence and can help clinicians better meet the needs of patients from diverse backgrounds and ethnicities and that the benefits of diverse learning environments enhance the educational experience of all participants.2 Education quality and access must be equitable for those of all backgrounds to ensure a diverse medical professional pathway.3 Learning pathways and programs emphasizing cultural humility and inclusion contribute to developing future clinicians, researchers, and health care professionals who are prepared to engage with diverse populations equitably.

It is crucial to acknowledge that significant health disparities in America are a persistent concern that must be addressed by every available means. Specifically, racial and ethnic health inequities illuminate the greatest gaps and worst patient outcomes, especially when compounded by disparities related to gender identity, ability, language, immigration status, sexual orientation, age, socioeconomics, and other social drivers of health.

Black Americans have significantly lower life expectancies.4 Asian Americans are the only racial group to experience cancer as a leading cause of death.5 Communities experiencing disproportionately high rates of COVID-19 infection, hospitalization, and mortality when compared with White Americans include Black, Latine, Asian, Native Hawaiian, and Native Americans.6 Nearly one-fifth of Latine Americans avoid medical care due to concern about experiencing discrimination.7

Guided by our core values of inclusion, community, innovation, advocacy, and integrity, CHEST is relentlessly committed to improving the professional's experience and patient outcomes equally. This commitment compels us to work toward eliminating disparities in the medical field. According to the most recent U.S. Census projections, by 2045, White Americans will no longer be considered a racial majority, with Black, Latine, and Asian Americans continuing to rise. It is incumbent upon us to ensure that our clinician workforce reflects the diversity of its local and national communities.

The underrepresentation of physicians from racially diverse backgrounds is factually clear. Black physicians comprise 5% of the current physician workforce despite Black Americans representing 13% of the population.8 Similarly, while Native Americans comprise 3% of the United States population, Native physicians account for less than 1% of the physician workforce, with less than 10% of medical schools reporting total enrollment of more than 4 Native students.9 Where gender is concerned, women make up about 36% of the physician workforce, a professional disparity that is further exacerbated given the intersections of race and gender, resulting in a significant impact on the current workforce.10 Allowing disinformation to influence the future of medical education and patient care directly contradicts our mission as clinicians dedicated to improving the health of all people.

If physician representation and patient outcomes are linked, as research shows, the lack of diverse medical school representation has dire consequences for matriculation, job recruitment, retention, and promotion. Without supportive policies, programs, and equity-focused curriculums in medical education, we will never close the gap on professional disparities, which means we will similarly never close the gap on health disparities.

Our commitment to our members, all health care professionals, and the field of medicine means that we will stand firm in our defense of DEI today and every day until we have achieved optimal, equitable health for all people in all places. CHEST is committed to an intersectional approach to equitable health care education and delivery. We strive to design solutions that center the most impacted and radiate support outward, ensuring our interventions benefit all others experiencing discrimination. To that effect, CHEST has taken the following actions:

References

  1. Goode, Christina A., and Thomas Landefeld. “The Lack of Diversity in Healthcare: Causes, Consequences, and Solutions.” Journal of Best Practices in Health Professions Diversity, vol. 11, no. 2, 2018, pp. 73–95. JSTOR, https://www.jstor.org/stable/26894210. Accessed 22 Apr. 2024. See also: "H.Res.1062 - 118th Congress (2023-2024): Declaring racism a public health crisis." gov, Library of Congress, 6 March 2024, https://www.congress.gov/bill/118th-congress/house-resolution/1062.
  2. Jackson, Chazeman S, and J Nadine Gracia. “Addressing health and health-care disparities: the role of a diverse workforce and the social determinants of health.” Public health reports (Washington, D.C.: 1974) 129 Suppl 2, Suppl 2 (2014): 57-61. doi:10.1177/00333549141291S211. See also: Whitla, Dean K et al. “Educational benefits of diversity in medical school: a survey of students.” Academic medicine: journal of the Association of American Medical Collegesvol. 78,5 (2003): 460-6. doi:10.1097/00001888-200305000-00007
  3. Montgomery Rice V. Diversity in Medical Schools: A Much-Needed New Beginning. 2021;325(1):23–24. doi:10.1001/jama.2020.21576
  4. Washington, Harriet. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. Vintage, 2008.
  5. The Asian American Foundation, “STAATUS Index 2024” TAAF Academic Advisory Committee. https://staatus-index.s3.amazonaws.com/2024/STAATUS_Index_2024.pdf
  6. Kaiser Family Foundation. COVID-19: Cases and Deaths by Race/Ethnicity, as of June 16, 2024. Available at: https://www.kff.org/coronavirus-covid-19/issue-brief/state-covid-19-data-and-policy-actions/#raceethnicity. See also: https://www.apmresearchlab.org/covid/deaths-by-race#data
  7. Togioka BM, Duvivier D, Young E. Diversity and Discrimination in Healthcare. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan
  8. https://www.aamc.org/data-reports/workforce/data/figure-18-percentage-all-active-physicians-race/ethnicity-2018#:~:text=Diversity%20in%20Medicine%3A%20Facts%20and%20Figures%202019,-Diversity%20in%20Medicine&text=Among%20active%20physicians%2C%2056.2%25%20identified,as%20Black%20or%20African%20American. AAMC 2018 report on workforce data
  9. https://www.ama-assn.org/education/medical-school-diversity/new-effort-help-native-american-pre-meds-pursue-physician-dreams
  10. https://www.aamc.org/data-reports/report/us-physician-workforce-data-dashboard

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