Underrepresentation issues persist in ophthalmology
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Diversity and inclusion in the workplace, in a profession or in any setting for that matter, are complex and challenging subjects to discuss. With some hesitation, I will share a few personal thoughts.
First, I have traveled globally for 40 years, and to my observation, the United States remains the most diverse and inclusive society in the world. The United Kingdom and Canada represent quite diverse societies but still fall short of America. In the U.S., 60.1% of the population is white non-Hispanic, 18.5% Hispanic/Latino, 13.4% Black/African American, 5.9% Asian and another 1% each Native American, Alaskan American and Pacific Islander, among others. America is 51% female and 49% male. So, while the U.S. is quite diverse and inclusive in regard to race and gender, white Americans remain the majority, and in leadership positions: white American men. My personal opinion, as a part of this white male majority, is that it is a privilege that also carries with it the responsibility to support social justice and a fair and equal opportunity for others.
Of interest to me, in America, the demographics of each individual state (and city) also vary significantly. I was born and raised in Minnesota, where 83.3% of the population is white non-Hispanic and only 1.7% Hispanic/Latino. My second home today is in California, where the opposite is true, with 39% of the population Hispanic/Latino, only 37% white non-Hispanic and another robust 15% Asian. My winter retreat for 10 years was Hawaii, which is home to 37.6% who are Asian, 25% white and 10.1% Pacific Islander. So, the racial majority and distribution are very different in each of the three states where I have lived and owned homes.
The racial majority, in my opinion, has the responsibility to advocate for social justice and equal opportunity for minorities. But the racial majority is different in every state and city in America and, of course, in every country worldwide. I am a strong advocate of diversity and inclusion, and well-done studies confirm that diverse and inclusive companies and organizations, including professions and the societies that support them, are the highest performers. I am also an advocate for equal opportunity. The mandate created and enforced by the U.S. government’s Equal Employment Opportunity Commission is that no one should suffer reduced opportunity because of race, color, religion, gender, natural origin, political affiliation, sexual orientation, national origin, disability, genetics, age, participation in an employee organization, parental status, mental status or any other non-merit factors. I find it important that merit (or lack thereof), by this mandate, can legally play a role in opportunity.
Throughout my career as an educator, I have repeatedly reminded those I train and mentor that while I can provide them opportunity, I cannot guarantee them success. I am not an advocate for any quota system and have not been impressed that affirmative action works well when trying to create a sustainable top-performing company or organization. Diversity, inclusion, equal opportunity and reward of merit that are openly supported by leadership and part of the culture are hallmarks of the most successful companies, organizations and professions. Merit, the concept that through hard work, perseverance and innate talent an individual is worthy of something, especially the rare honor and responsibility of being a physician and surgeon, remains a foundational value of success. While diversity, inclusion and equal opportunity are critical for a profession such as ophthalmology, so is merit.
Social justice and the concepts of fairness and equitable treatment demand that leaders, especially those representing a majority, actively seek greater diversity and inclusion when the data suggest they are absent in their company, organization or profession. In my opinion, we have solved the problem of gender imbalance in our U.S.-based medical schools and ophthalmology residencies/fellowships. We are also not underrepresented in regard to our Asian citizen minority. However, we remain deficient and are clearly underrepresented in regard to Hispanic/Latino, Black/African American and Native American participation in the medical profession and ophthalmology in America. I see no quick fix or easy solution, but a first step toward solving any problem is to recognize the issue, and that is the purpose of this issue’s cover story.
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