Q&A: IDSA task force ‘laying the foundation’ for diversity and inclusion in medicine
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Since its founding in 2018, the Infectious Diseases Society of America’s Inclusion, Diversity, Access and Equity Task Force (IDA&E) has worked to address racial and ethnic disparities in health care.
These gaps have become even more apparent during the COVID-19 pandemic, said Jasmine R. Marcelin, MD, FACP, an assistant professor of infectious diseases at the University of Nebraska Medical Center, who helps run the center’s internal medicine residency and antimicrobial stewardship programs.
Infectious Disease News spoke with Marcelin, an IDA&E task force member, about the program’s first 2 years and the impact that COVID-19 has had on its efforts.
Q: What are the goals of the task force?
A: The IDSA’s IDA&E Task Force was developed in 2018 to foster an environment that honors and ensures inclusion, diversity access and equity. The task force consists of 12 members supported by phenomenal IDSA staff. The IDA&E Task Force was charged with developing a framework and recommendations to ensure the implementation and full integration of IDA&E principles throughout IDSA.
Q: What impact has the task force had in the past 2 years?
A: The IDA&E Task Force has been very busy over the past 2 years. From our inception in 2018, we developed the following case statement for the society: "To promote unrivaled health care delivery, education, research and advocacy within our organization, IDSA embraces inclusion, diversity, access and equity as key drivers of excellence and innovation." We then developed guiding principles for IDSA to ensure that "the IDSA board and committees reflect the depth of diversity within our membership, including race, ethnicity, gender, sexual orientation, age, geographic location, clinical vs. nonclinical, among other factors.” We followed this with a roadmap and IDA&E strategies approved by the board of directors, identifying fundamental elements to further strengthen and support the IDSA commitment to embracing the principles of IDA&E — data, education, communication, action and accountability, reflection and assessment. In line with the task force’s activities, The Journal of Infectious Diseases published a supplement dedicated to IDA&E, featuring articles written by IDA&E Task Force members. Another similar supplement is being finalized for publication in September/October 2020.
Q: Has the COVID-19 pandemic elucidated additional health care-related issues for vulnerable patients?
A: This COVID-19 pandemic has uncovered existing racial and ethnic inequities, and
illuminated the fundamental premise that structural racism lies at the foundation of all of these inequities. We are seeing that Black, Hispanic, and Indigenous people in this country are at disproportionate risk for being diagnosed with, hospitalized for and dying from COVID-19. More poignantly, the pandemic has highlighted the structural differences in access to care, financial insecurity and sociodemographic factors that place minority populations at greater risk. Essential questions need to be asked about who has access to health care, testing and treatment, and who has the ability to fully engage in mitigation strategies being recommended to prevent COVID-19 (like working from home, physical distancing, frequent hand-washing, food delivery, etc.). There are also data showing that minority frontline health care workers are at higher risk for developing COVID-19. The data have not shown any evidence of a biological cause for the racial and ethnic inequities seen in COVID-19; therefore, efforts must be placed in elucidating the structural causes of these inequities and implementing structural change to combat them.
Q: How has the pandemic affected the task force’s activities?
A: We cannot afford to sideline IDA&E during a pandemic. Rather, we have seen that there is an even greater need to advocate for these principles. When the task force was started in 2018, we spent the time laying the foundation for equity and inclusion in IDSA. With the COVID-19 pandemic, we quickly pivoted to evaluate and address the health inequities and disparate impact the pandemic has had on minority populations. We published articles discussing the racial disparity of COVID-19 in African-American communities, the disparate health impact on the Hispanic/Latinx population, as well as other perspectives, policy briefs and blog articles related to these important conversations. IDA&E Task Force members have been guests and hosts on IDSA podcasts discussing the impact of these inequities on minority populations.
IDSA has always been a strong advocate for eliminating health care disparities because we see many of these manifest in HIV, STDs, hepatitis and the opioid epidemic, among others. However, the pandemic has underscored the role of IDSA in loud advocacy against structural racism, and as we have seen, COVID-19 and structural racism collide in a syndemic that has proved deadly for Black, Hispanic and Native American communities. The IDA&E Task Force supported IDSA’s statement in response to the killing of Mr. George Floyd, a commitment and call to action to implement structural change needed to make an impact. More recently, the IDA&E Task Force supported the development of a 21-day racial equity challenge to empower members to take actions that eliminate racial injustice and bring healing to those impacted. The capstone of this challenge was a racial equity habit-building challenge webinar on Aug. 21. We can’t and won’t stop until the principles of inclusion, diversity, access and equity are infused throughout IDSA membership, leadership and the society around us.
Q: How is the task force addressing diversity in the infectious disease field?
A: The IDA&E Task Force takes diversity and inclusion in our specialty very seriously. This challenge is twofold: addressing the pipeline pathway of recruiting individuals from diverse backgrounds and ensuring that opportunities to engage and progress in leadership tracks are equitable. Over the last 2 years, we have made notable progress, but there is still more work that needs to be done. The governance changes recently allowed the IDSA board of directors to amend the bylaws as needed to respond to the needs of the society, as well as adapt to infuse IDA&E into the organization. IDSA and the IDA&E Task Force are committed to ensuring that the definition of diversity in our specialty is broad and multifaceted and includes race, ethnicity, gender, age, geographic region, type of practice setting, professional degree and training status. The society volunteer process has been changed to ensure that members have equitable access to volunteer and leadership opportunities. The current volunteer appointments reflect this commitment. I am proud to be a part of an organization that not only recognizes and advocates for these principles of IDA&E, but one that follows these words with measurable actions and constantly reassesses how it can improve. The future of infectious diseases and the IDSA is bright, and I am excited to play a role in shaping it.
References:
- APM Research Lab. The color of coronavirus: COVID-19 deaths by race and ethnicity in the U.S. https://www.apmresearchlab.org/covid/deaths-by-race. Accessed August 20, 2020.
- Gil RM, et al. J Infect Dis. 2020;doi:10.1093/infdis/jiaa474.
- IDSA. COVID-19 podcast: The disparate effects in Latinx communities. https://www.idsociety.org/Podcasts/podcasts/coronavirus-the-disparate-effects-in-latinx-communities/. Accessed August 20, 2020.
- IDSA. COVID-19 and health disparities in the United States. https://www.idsociety.org/globalassets/idsa/public-health/covid-19/covid19-health-disparities.pdf. Accessed August 20, 2020.
- IDSA. COVID-19 in Navajo Nation: shedding light on health disparities among Native American populations. https://www.idsociety.org/Podcasts/podcasts/covid-19-in-navajo-nation-shedding-light-on-health-disparities-among-native-american-populations/. Accessed August 20, 2020.
- IDSA. IDA&E Task Force. https://www.idsociety.org/about-idsa/governance/inclusion-diversity-access-and-equity-idae-task-force/. Accessed August 20, 2020.
- IDSA. IDSA/HIVMA and PIDS participate in the 21-day racial equity challenge. https://www.idsociety.org/21-day-challenge/. Accessed August 20, 2020.
- IDSA. IDSA Members vote to modernize society governance. https://www.idsociety.org/idsa-newsletter/february-19-2020/IDSA-Members-Vote-to-Modernize-Society-Governance/. Accessed August 20, 2020.
- IDSA. Inclusion, diversity, access and equity roadmap and strategies. https://www.idsociety.org/globalassets/idsa/about-idsa/idae/idae-task-force-roadmap-and-strategies-board-approved.pdf. Accessed August 20, 2020.
- IDSA. Response to the death of George Floyd. https://www.idsociety.org/news--publications-new/articles/2020/idsahivma-response-to-the-death-of-george-floyd/. Accessed August 20, 2020.
- IDSA. Strengthening the response to COVID-19 in correctional facilities. https://www.idsociety.org/globalassets/idsa/public-health/covid-19/covid-19-in-correctional-facilities.pdf. Accessed August 20, 2020.
- Kullar R, et al. J Infect Dis. 2020;doi:10.1093/infdis/jiaa372.
- Nguyen LH, et al. Lancet Public Health. 2020;doi:10.1016/S2468-2667(20)30164-X.
- Sears CL, et al. J Infect Dis. 2020;doi:10.1093/infdis/jiz125.
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