Abstract
Increasing diversity among the health workforce is not enough to address healthcare disparities. Advisors and administrators need to understand the role of justice, equity, diversity, and inclusion in the development of anti-racist organizations. This chapter considers the history and impact that the systemic exclusion of Black, Indigenous, People of Color (BIPOC) has on the healthcare system, provides an overview of modern efforts to attempt to resolve this problem through pipeline programs, considers one institution's efforts to make anti-racist change, and discusses how administrators and advisors in pre-health programs and pipeline programs can apply an antiracist organizational change model to build their capacity to support historically excluded students.
TopBackground
Throughout this chapter, we frame our discussion around pathway programs and anti-racist organization change through the lens of justice, equity, diversity, and inclusion (JEDI) over diversity alone (Ward, 2021). We argue that diversity alone is insufficient to make meaningful and long-term change within a program or institution because the sole focus of diversity is increasing the number of people without providing attention to the structural issues that impact their success. We also discuss various programs designed to invest in historically excluded communities using the broad term “pathway program.” We use the term pathway, as opposed to pathway program, to suggest that effective programs provide more flexibility to students in terms of where they enter these programs and when they choose to exit (e.g., entering the workforce after high school, completing a two- or four-year degree program, or pursuing graduate training) or return (e.g., enter the workforce after high school, get direct experience in a health profession, and pursue additional education after the “traditional” age of college enrollment). In other words, the term pathway suggests a single entry and exit point for all students, which may not be appropriate given each student’s unique goals. Investing in pathway programs that address all elements of JEDI is one way by which our institutions can become anti-racist.
Key Terms in this Chapter
Inclusion: Fostering a space where everyone feels safe, validated, included, and welcomed.
Diversity: Ensuring representation of various perspectives and social identities within a space.
Bias: The negative evaluation of one group and its members relative to another (Blair, Steiner, & Havranek, 2011).
Anti-Racist: One who expresses the idea that racial groups are equals and none needs developing, and supports policy that reduces racial inequity (Kendi, 2019).
Equity: Providing a fair and constant redistribution of resources and power to ensure that no single social identity has priority or power over another.
Racism: A system of structuring opportunity and assigning value based on the social interpretation of how one looks that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources (Jones as cited by Kaiser Permanente Institute for Health Policy, 2016).
Justice: Dismantling systemic and historic barriers to equity (e.g., assessing internal policies that hinder the ability of historic communities to get ahead).
Privilege: Unearned advantages granted to members of a group by prejudicial and powerful social, institutional, and cultural systems that allocate resources and designate value (People’s Institute for Survival and Beyond, 1997).
Whiteness: Whiteness refer[s] to the way that white people, their customs, culture, and beliefs operate as the standard by which all other groups are compared (National Museum of African American History and Culture, n.d.).
Antiracism: Anti-racism is the active process of identifying and eliminating racism by changing systems, organizational structures, policies and practices and attitudes, so that power is redistributed and shared equitably” (National Antiracism Council International Perspectives: Women and Global Solidarity, n.d. as cited by Alberta Civil Liberties Research Centre, 2021)
Structural Racism: A system in which public policies, institutional practices, cultural representations, and other norms work in various, often reinforcing ways to perpetuate racial group inequity (Aspen Institute, 2016).