DIVERSITY, EQUITY AND INCLUSION COMMITTEE LITERATURE REVIEWS
The Diveristy, Equity and Inclusion Committee has identified the following literature reviews to help identify best-practice and appropriate standards for clinical management of pediatric surgical disease.
If you have questions, contact Erika A. Newman.
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Literature Reviews
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The Impact of Racism on Child and Adolescent Health.
Trent et al. Pediatrics. 2019;144(2):e20191765.
PMID: 31358665
What is known
Racism is a social determinant of health that has a profound impact on the health status of children, adolescents, emerging adults and their families. Evidence to support the continued negative impact of racism on health and well-being through implicit and explicit biases, institutional structures and interpersonal relationships is clear.
What this adds
This policy statement from the American Academy of Pediatrics provides an evidence-based focus on the role of racism in child and adolescent development and health outcomes. By acknowledging the role of racism in child and adolescent health, pediatric health professionals will be able to improve the health and well-being of children and adolescents by optimizing clinical care, workforce development, professional education, systems engagement and research.
Surgical Time Out: Our Counts are Still Short on Racial Diversity in Academic Surgery.
Abelson et al. Am J Surg. 2018;215(4):542-548.
PMID: 28693843
What is known
Health care disparities according to race and ethnicity remain a persistent problem in the United States despite several decades of initiatives to improve them. Increasing diversity of the physician workforce may be one method to improve the care of minority patients. Surgery and its subspecialties have historically amplified challenges in physician diversity.
What this adds
In 2014-15, Blacks represented 12.4% of the US population but only 5.7% of graduating medical students, 6.2% of general surgery trainees, 3.8% of assistant professors of surgery and 2.0% of full processors of surgery. Similar underrepresentation can be seen in the Hispanic population. A multi-level national focus is imperative to elucidate effective mechanisms to make academic surgery more reflective of the US population.
Working Toward Gender Diversity and Inclusion in Medicine: Myths and Solutions.
Kang et al. Lancet. 2019;393(10171):579-586.
PMID: 30739693
What is known
Women’s representation in science and medicine has slowly increased over the past few decades. This increase in gender diversity has not been matched by a rise in gender inclusion – despite increasing representation, women still encounter bias and discrimination when compared with men in these fields across a variety of outcomes.
What this adds
This review draws on several decades of research to identify five myths that continue to perpetuate gender bias and five strategies for improving not only the number of women in medicine, but also their lived experiences, capacity to aspire and opportunity to succeed. Argument is made for interventions that address structural and systemic changes rather than focusing on interventions aimed at targeting individual attitudes and behavior.
Social Inequality and Racial Discrimination: Risk Factors for Health Disparities in Children of Color.
Sanders-Phillips et al. Pediatrics. 2009;124 Suppl 3:S176-S186.
PMID: 19861468
What is known
Social experiences and environment influence a child’s sense of control over life and health outcomes. Experiences of racial discrimination can foster perceptions of powerlessness, inequality and injustice for racial minority children. These perceptions may influence child health outcomes and disparities by affecting biologic functioning, the quality of the parent-child relationship and psychological stress levels.
What this adds
This article reviews existing theoretical models and empirical studies of the impact of racial discrimination on the health and development of children of color in the United States. A conceptual model of exposure to racial discrimination as a chronic stressor and risk factor for poor health outcomes and child health disparities is presented.
Improving Diversity Through Strategic Planning: a 10-year (2002-2012) Experience at the Medical University of South Carolina.
Deas et al. Acad Med. 2012;87(11):1548-1555. P
MID: 23018331
What is known
African Americans, Latinos and Native Americans are severely underrepresented in the health professions. Increasing the diversity of the physician workforce is desirable for several reasons: to decrease health disparities; to improve the care of a diverse patient population; and to increase the trust of minority populations in research participation.
What this adds
This paper describes a systematic plan launched by the Medical University of South Carolina to infuse diversity among its students, resident physicians and faculty in 2002. Diversity became a central component of the College of Medicine’s strategic plan and efforts resulted in a doubling of the number of underrepresented-in-medicine (URM) students; a more than threefold increase in URM residents / fellows; expansion of mentoring and pipeline programs; the advancement of women and URM individuals into leadership positions; and enhanced learning for individuals from all backgrounds