Throughout my time as a summer intern at AcademyHealth, I’ve been able to witness and partake in some of the initiatives and projects that drive the mission of diversity, equity, inclusion, and accessibility in the health services research (HSR) community. For the past ten years, AcademyHealth’s Center on Diversity, Inclusion and Minority Engagement has focused on providing support and professional resources to underrepresented racial and ethnic minority (URM) researchers in the form of research support, professional development, and networking opportunities. The  AcademyHealth Diversity Scholars Program has made significant investment in the professional development of URM researchers, providing them with mentorship support in their respective fields of interest and the opportunity to attend the AcademyHealth Annual Research Meeting (ARM).

At ARM, many researchers, speakers, and panelists are from underrepresented communities, and present on DEIA issues in health care and how we can better utilize the research we have available to improve health outcomes for minority and underrepresented populations. At this convening HSR stakeholders gain access to information and networks that aid in understanding how the evidence before us could inform the decisions ahead of us. Other AcademyHealth initiatives have also incorporated a strong DEIA focus.

Annual Research Meeting 2023 Sessions Prioritize DEIA Topics and Methods

This year, I had the amazing opportunity to attend ARM 2023 in Seattle, WA. The experience was nothing short of enriching—I had the opportunity to connect with a vast network of inspirational and brilliant individuals in the field, all while taking in valuable information through poster presentations and panel sessions. One session that particularly stuck with me was "Using Demographic Data to Ensure Equity and Data Quality" where Dr. Aileen Duldulao  of the Oregon Health Authority noted how important it is to include smaller communities in studies, despite the presumption that there wouldn’t be enough people to represent them in demographic data. In fact, the opposite can be true. When we fail to include niche communities such as Filipino or Native American that often get labeled as not “significantly sized” enough to show up in the data, we do a disserve to health equity efforts and contribute to the rejection of specific care for communities who have unique experiences.

This theme of being holistically representative in data collection was also addressed in the “Racism and Disparities: Data, Measurement, Models session. In this panel, presenting author Lucy Rabinowitz Bailey, M.P.H. demonstrates the importance of collaborating with state Medicaid programs and managed care organizations (MCOs) to understand the barriers and solutions to data collection and accessing quality data. In the study, Data Collection in Medicaid to Advance Health Equity: Findings from Interviews with States and Managed Care Organizations, Bailey highlights the importance of engaging community members and other stakeholders in the health equity data collection process, so the bidirectional relationship between the researchers and their communities of impact can be well-established. This, along with other enhancements to data systems, such as using delivery system levers and public-facing data dashboards, improves state, MCO, and provider accountability for improving data collection that advances health equity.

Creating spaces like ARM where the dissemination of this type of information can reach so many different audiences is vital, and it’s amazing to see the organizational commitment to highlighting this research be demonstrated on such a large scale.

Student and Early-Career Engagement Is Crucial to Setting the Field’s Direction

As a fresh graduate, I have observed that AcademyHealth is in a unique position to change the trajectory of the careers of those just breaking into the field.

Now, don’t get me wrong, this stage of life has its unique advantages—but it comes with its drawbacks, too. Many of us don’t get unique exposure, visibility, or consideration in the field, especially when we are part of underrepresented and minority populations. At the 2023 ARM, I remember standing at the registration tables decorating my nametag with the colorful flags, some of which said: “First-Timer,” “Speaker,” “Tweeter,” “Student,” and many more. A few undergraduate students who were attending the conference came to the tables to customize their nametags. While sifting through what was available, one student picked up the “Student” tag but then hesitantly put it back down and said, “I shouldn’t put the Student one on— they’re not going to want to talk to me.”

This anecdotal experience is a prime representation of how many early career health care/HSR scholars feel when we are just starting out in the field. We tend to be full of robust, innovative, and challenging ideas because of our unique perspectives and we do our best to put ourselves in positions for those ideas to be considered. But so often, there are individuals who have been here much longer than us who don’t always see the value in our experiences and insight because we are fresh in the field. Programs like the Public Voices Fellowship,  organized by AcademyHealth in partnership with the OpEd Project, push back against this narrative. The Fellowship’s primary goal is to raise the visibility of new, diverse voices in order to share those thought-striking questions and ideas. Fellows write at least two op-eds, with the goal of using higher impact, more equitable research to address the systemic and structural barriers in health care and HSR.

Input from Members of the Field Informs How We Continue to Grow

AcademyHealth regularly seeks feedback from its members, partners, and broader HSR community about how to build on the work that’s already been done.  One example is  the 2021 HSR Culture Survey, which revealed how health services and policy researchers view DEI initiatives. While the conclusions of this study support that there is a commitment to diversity in HSR workforce, there is still work to be done, as 53.4 percent of the participants “did not believe that the current workforce reflects the diversity of communities impacted by health services and policy research.”

And honestly, it makes sense—the push for DEI is relatively new in many spaces. It can be challenging to view organizational initiatives as genuine and meaningful when they’re still in the early stages of “planning,” and not necessarily moving into “implementation.” That was a contributing factor as to why nearly 40 percent of the respondents categorized their organizations’ DEI initiatives as “tokenistic.”

These study results indicate a long road ahead to achieving a truly inclusive field and we must consider these real-world experiences if we are serious about creating environments for underrepresented individuals to get the access and visibility they deserve. How we receive this information and decide to move forward with it is what can set organizations on the right path to achieving the goal of an inclusive and diverse community of practice.

Advancing DEIA at Every Level Is Necessary to Progress

We need to address DEI in health care, at every level. It’s not enough to say there needs to be more accessible health care options in minoritized communities. We must go further to consider how we make these populations visible in our research, in our workplace and professional settings, and in our own personal interactions. Not only do we have to create and implement the processes to meaningfully engage these populations, but we must evaluate the impact of our efforts to date. Only then, when we incorporate DEI fully into our workforce and workflows, can we truly begin to understand what it means in a field so integral as health care.

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Khadeejat Lawal

Intern - AcademyHealth

Khadeejat Lawal is an Intern at AcademyHealth, where she conducts evaluations of AcademyHealth mentorship, fel... Read Bio

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