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Panelists at the Annual Research Meeting Discuss Progress on Racial Equity in the Field

Several breakout and plenary sessions at the 2021 Annual Research Meeting considered the role of health services research (HSR) in addressing health equity and structural racism, both in the field and in our health care system, particularly as we emerge from the COVID-19 pandemic.

group sitting in a circle in discussion, touching hands

Throughout the COVID-19 pandemic, conversations around health disparities and addressing structural racism have been center-stage for the field of health services research (HSR). These conversations continued at last month’s Annual Research Meeting (ARM), with plenary sessions highlighting ways COVID-19 exposed health inequities and work that still needs to be done to address structural racism in the field of HSR and within the health system itself.

One of the first plenary sessions at ARM attempts to answer the question “are we making progress on equity?” Many agree that yes, we are making some progress but, as panelist Joy Lewis noted, we’re not making progress to the degree or at the speed needed. Although many feel a sense of urgency to address these issues given COVID-19, the energy around Black Lives Matter movements, and renewed calls for social justice after the death of George Floyd last summer, there is still work to be done. For example, Lewis highlighted the proportion of physicians that are black has not increased since 1940 and has only increased 4 percent since the beginning of the 20th century.

Furthermore, panelist Dr. Nathan Chomilo observed that people are more comfortable with talking about racism and the fact that disparities exist, than with actually addressing and taking action for racial equity. A continued theme throughout this plenary and other breakout session at ARM: the field needs to act. As Dr. Lisa Cooper noted, the field has done research on how to improve health but hasn’t translated these needs into action and policy. “Inequities don’t just harm communities that are directly impacted but harm us all. Addressing health inequities helps us all,” Cooper said.

Not only do we have to address structural racism embedded within our field and workforce practices, but within our research methods. Another plenary showcased late-breaking research on equity issues related to the COVID-19 pandemic. Panelist Rachel Banawa highlighted her work examining racism experienced by Asian Americans and Pacific Islanders (AAPI) college students throughout the pandemic, noting that 25 percent of AAPI students experienced discrimination and/or hostility, and 50 percent witnessed racism—and many experienced a rise in anxiety and depression. Despite these numbers, AAPI individuals are the most underrepresented group studied in peer reviewed literature. Banawa noted that this is due to the “model minority” myth which contributes to the view that AAPI individuals are seen as white, not people of color.

In a breakout session on Structural Racism and Health, doctoral candidate Rebekah Israel Cross discussed that racism seems to be at the forefront, but she fears it will become a ‘hot topic’ researchers will use to chase publications instead of focusing on addressing poor health outcomes caused by structural racism in the health system. This concern of a focus on racism as a passing trend was echoed across the conference. For example, plenary panelist Nathan Chomilo also called structural racism the ‘issue of the moment,’ noting that the field has to leverage this focus on racism and make sure it doesn’t get forgotten in the next year or two.

Speakers across the conference agreed that funding and resources are key to sustained focus on advancing diversity, equity and inclusion (DEI). Another breakout session described findings from a recent survey examining the HSR workplace culture. Results showed that organizations often discuss DEI issues following news events (after incidents of police brutality, for example), but these conversations need to be long lasting and come with policy changes. The survey participants also indicated that many efforts to address diversity, inclusion, and structural racism were symbolic and tokenistic and do not lead to significant change. For example, organizations often put staff of color in DEI roles whether it’s appropriate to their professional expertise or not.  Further exploration of the survey data found that white respondents were less likely to agree that efforts were tokenistic. The survey also asked participants to describe incidents of professional discrimination. One quote from an open-ended response said “student representatives discussed[ed] how they didn’t like two Asian candidates because ‘they had an accent.’… The department ended up hiring white men for those positions.” Others noted that conversations about DEI in the field focused on disparities and race but avoided the real issue of structural racism. Another response read: “This is my sign that it’s failing. That you can go back 10 years and find the same conversations in the field as we’re having today.”

Like the field itself, AcademyHealth still has work to do on DEI issues. In early 2021, AcademyHealth announced the formation of an advisory group to provide guidance and strategic insights on the ways AcademyHealth could apply a racial equity lens to the organization’s programs and activities. The advisory group presented their recommendations at ARM. The recommendations included: elevating equity research and related careers, forming a coordinated funding strategy among multiple stakeholder organizations, developing a community of practice among organizations working on DEI in HSR, creating a glossary to standardize DEI-related terms, and more.

These recommendations are just the beginning of the work that AcademyHealth (and the field) has to do.  In July, we will be releasing the full report of the advisory group on DEI in HSR and sponsoring an anti-racism methods workshop that will be free to all who are interested, with support from PCORI and The Robert Wood Johnson Foundation.  Learn more about AcademyHealth’s DEI strategy here.

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Christina Tudor

Digital Communications Associate - AcademyHealth

Christina Tudor is the Digital Communications Associate at AcademyHealth. Read Bio

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