Responses to 10 common criticisms of anti-racism action in STEMM

Building Trust and Partnership with Black Pediatric Patients and their Caregivers

Systemic racism embedded within the US health care system results in disproportionately worse health outcomes for Black pediatric patients and their caregivers. One meaningful mechanism through which these health disparities persist is through discriminatory treatment and anti-Black bias from clinicians. Strengthening care provided to Black pediatric patients and their caregivers requires that clinicians adopt culturally tailored communication strategies that promote health equity and counter racism. We conducted a scoping review of evidence-based communication practices in the medical literature that improve care for Black pediatric patients. We mapped the specific practices to the Presence 5 for Racial Justice framework and identified cross-cutting themes to describe practices across the five domains. There are three cross-cutting themes that underlie the recommended practices: 1) promote unbiased implementation of clinician communication strategies (eg, providing equitable recommendations for preventive care), 2) tailor care to Black pediatric patients (eg, explore the importance of the family unit), and 3) address racism experienced by Black pediatric patients and their caregivers (eg, acknowledge any previous negative experiences with the health care system). This review highlights communication practices that clinicians can adopt to build trusting relationships, empower Black families, and promote racial justice in clinical care. Future opportunities include expanding to system level change and validating these practices with patients and clinicians.

COVID-19 as a chronic stressor and the importance of individual identity: A data-driven look at academic productivity during the pandemic

The COVID-19 pandemic impacted personal and professional life. For academics, research, teaching, and service tasks were upended and we all had to navigate the altered landscape. However, some individuals faced a disproportionate burden, particularly academics with minoritized identities or those who were early career, were caregivers, or had intersecting identities. As comparative endocrinologists, we determine how aspects of individual and species-level variation influence response to, recovery from, and resilience in the face of stressors. Here, we flip that framework and apply an integrative biological lens to the impact of the COVID-19 chronic stressor on our endocrine community. We address how the pandemic altered impact factors of academia (e.g., scholarly products) and relatedly, how factors of impact (e.g., sex, gender, race, career stage, caregiver status, etc.) altered the way in which individuals could respond. We predict the pandemic will have long-term impacts on the population dynamics, composition, and landscape of our academic ecosystem. Impact factors of research, namely journal submissions, were altered by COVID-19, and women authors saw a big dip. We discuss this broadly and then report General and Comparative Endocrinology (GCE) manuscript submission and acceptance status by gender and geographic region from 2019 to 2023. We also summarize how the pandemic impacted individuals with different axes of identity, how academic institutions have responded, compile proposed solutions, and conclude with a discussion on what we can all do to (re)build the academy in an equitable way. At GCE, the first author positions had gender parity, but men outnumbered women at the corresponding author position. Region of manuscript origin mattered for submission and acceptance rates, and women authors from Asia and the Middle East were the most heavily impacted by the pandemic. The number of manuscripts submitted dropped after year 1 of the pandemic and has not yet recovered. Thus, COVID-19 was a chronic stressor for the GCE community.

Junior scientists spotlight social bonds in seminars for diversity, equity, and inclusion in STEM

Disparities for women and minorities in science, technology, engineering, and math (STEM) careers have continued even amidst mounting evidence for the superior performance of diverse workforces. In response, we launched the Diversity and Science Lecture series, a cross-institutional platform where junior life scientists present their research and comment on diversity, equity, and inclusion in STEM. We characterize speaker representation from 79 profiles and investigate topic noteworthiness via quantitative content analysis of talk transcripts. Nearly every speaker discussed interpersonal support, and three-fifths of speakers commented on race or ethnicity. Other topics, such as sexual and gender minority identity, were less frequently addressed but highly salient to the speakers who mentioned them. We found that significantly co-occurring topics reflected not only conceptual similarity, such as terms for racial identities, but also intersectional significance, such as identifying as a Latina/Hispanic woman or Asian immigrant, and interactions between concerns and identities, including the heightened value of friendship to the LGBTQ community, which we reproduce using transcripts from an independent seminar series. Our approach to scholar profiles and talk transcripts serves as an example for transmuting hundreds of hours of scholarly discourse into rich datasets that can power computational audits of speaker diversity and illuminate speakers' personal and professional priorities.

Developing strategies to improve the sense of belonging and mitigate tokenism

Despite the increase in DEI initiatives and the rising social awareness, diversity, equity, and inclusiveness are still scarce in many work environments. In the process of implementing a diverse group in the workplace and training programs, retention efforts should always follow recruitment strategies; it is crucial to establish an environment that offers recruited women and minorities a sense of belonging and inclusiveness. Literature shows that diversity and belonging benefit not only the individual, but also the organization, society, and health care system. Many strategies to foster a sense of belonging in the workplace have been suggested, including, but not limited to, mentorship, sponsorship, affinity groups, dashboards, and surveys. Leaderships should acknowledge DEI initiatives, promoting efforts to enhance inclusiveness and mitigate tokenism. Amid DEI criticism and backlash, it is important to continue to promote education and positive discussions and aim for cultural changes targeting rooted systemic racism and discrimination, which continue to impose an obstacle to DEIB achievements.

How We Got Here: The Legacy of Anti-Black Discrimination in Radiology

Current disparities in the access to diagnostic imaging for Black patients and the underrepresentation of Black physicians in radiology, relative to their representation in the general U.S. population, reflect contemporary consequences of historical anti-Black discrimination. These disparities have existed within the field of radiology and professional medical organizations since their inception. Explicit and implicit racism against Black patients and physicians was institutional policy in the early 20th century when radiology was being developed as a clinical medical field. Early radiology organizations also embraced this structural discrimination, creating strong barriers to professional Black radiologist involvement. Nevertheless, there were numerous pioneering Black radiologists who advanced scholarship, patient care, and diversity within medicine and radiology during the early 20th century. This work remains important in the present day, as race-based health care disparities persist and continue to decrease the quality of radiology-delivered patient care. There are also structural barriers within radiology affecting workforce diversity that negatively impact marginalized groups. Multiple opportunities exist today for antiracism work to improve quality of care and to apply standards of social justice and health equity to the field of radiology. An initial step is to expand education on the disparities in access to imaging and health care among Black patients. Institutional interventions include implementing community-based outreach and applying antibias methodology in artificial intelligence algorithms, while systemic interventions include identifying national race-based quality measures and ensuring imaging guidelines properly address the unique cancer risks in the Black patient population. These approaches reflect some of the strategies that may mutually serve to address health care disparities in radiology. ^© RSNA, 2023 See the invited commentary by Scott in this issue. Quiz questions for this article are available in the supplemental material.

"Where do I even start?" Recommendations for faculty diversifying syllabi in ecology, evolution, and the life sciences

Diversifying curricula is of increasing interest in higher education, including in ecology and evolution and allied fields. Yet, many educators may not know where to start. Here we provide a framework for meeting standard curriculum goals while enacting anti-racist and anti-colonial syllabi that is grounded in the development of a sustainable network of educators. In addition to highlighting this professional learning process and sharing the list of resources our group has developed, we provide suggestions to help educators highlight contributions of minoritized groups, explore multiple ways of knowing, and perform critical assessments of foundational views of life and environmental science fields. We further discuss the key classroom dynamics that affect the success of such anti-racist and anti-colonial initiatives. The retention and success of minoritized students in ecology and evolution depends on whether we address injustices in our fields. Our hope is that our fellow educators will use this paper to catalyze their own efforts to diversify their courses.

A guide for writing anti-racist tenure and promotion letters

In a two-page tenure letter, senior faculty can make or break a career. This power has an outsized impact on Black academics and other scholars with marginalized identities, who are awarded tenure at lower rates than their white colleagues. We suggest that this difference in tenure rates is due to an implicit, overly narrow definition of academic excellence that does not recognize all the contributions that Black scholars make to their departments, institutions and academia in general. These unrecognized contributions include the (often invisible) burdens of mentoring and representation that these scholars bear disproportionately. Here we propose a set of practical steps for writing inclusive, anti-racist tenure letters, including what to do before writing the letter, what to include (and not include) in the letter itself, and what to do after writing the letter to further support the candidate seeking tenure. We are a group of mostly non-Black academics in science, technology, engineering and mathematics (STEM) based in the United States who are learning about and working toward Black liberation in academia; we hope these recommendations will help ongoing efforts to move toward an inclusive academia that appreciates and rewards diverse ways of doing, learning and knowing.

Inequity in Peer Review in Communication Sciences and Disorders

PURPOSE

The American Speech-Language-Hearing Association (ASHA) has committed to advancing diversity, equity, and inclusion (DEI) by retaining and advancing Black, Indigenous, and people of color (BIPOC) individuals in the discipline of communication sciences and disorders (CSD), amid critical shortages of faculty to train the next generation of practitioners and researchers. Publishing research is central to the recruitment, retention, and advancement of faculty. However, inequity in peer review may systematically target BIPOC scholars, adding yet another barrier to their success as faculty. This viewpoint article addresses the challenge of inequity in peer review and provides some practical strategies for developing equitable peer-review practices. First, we describe the demographics of ASHA constituents, including those holding research doctorates, who would typically be involved in peer review. Next, we explore the peer-review process, describing how inequity in peer review may adversely impact BIPOC authors or research with BIPOC communities. Finally, we offer real-world examples of and a framework for equitable peer review.

CONCLUSIONS

Inequity at the individual and systemic levels in peer review can harm BIPOC CSD authors. Such inequity has effects not limited to peer review itself and exerts long-term adverse effects on the recruitment, retention, and advancement of BIPOC faculty in CSD. To uphold ASHA's commitment to DEI and to move the discipline of CSD forward, it is imperative to build equity into the editorial structure for publishing, the composition of editorial boards, and journals content. While we focus on inequity in CSD, these issues are relevant to other disciplines.

Restitution Through Equity-Focused Mentoring: A Solution to Diversify the Physician Workforce

Minoritized and marginalized physicians who identify as Black, Latino/a/x and Native American (BLNA) remain unacceptably underrepresented in medicine. Multiple studies provide a compelling argument for prioritizing racial/ethnic diversification of the physician workforce to improve racial/ethnic physician-patient concordance and assist in achieving more equitable health outcomes. Despite a growing awareness for the tangible benefits of a diversified physician workforce, the number of physicians from minoritized and marginalized groups remains relatively stagnant or worsening in certain demographics. The 5:1 ratio of Black students and trainees to Black faculty exemplifies and exacerbates the increased risk for harmful isolation particularly experienced by many BLNA mentees. They too need and deserve the benefits produced by concordant racial/ethnic faculty mentoring and support. However, these demands on time, resources and bandwidth can lead to negative consequences for BLNA faculty engaged in these efforts by contributing to their emotional, mental and physical exhaustion. Given the perpetual paucity of BLNA physicians in academic medicine, immediate interventions to prevent attrition of BLNA faculty, trainees and students journeying along the physician career pathway are urgently needed. Requiring the implementation of mentoring programs explicitly focused on increasing the number of physicians from groups underrepresented in medicine must happen at every point of the education and training process.