Diversity is Essential for Excellence

Amanda Decimo, RN, MSN, MPH

Diversity improves academic workforce in clinical work, research and overall team dynamics. Yvonne (Bonnie) Maldonado, MD, Senior Associate Dean, Faculty Development and Diversity at Stanford University, provided evidence-based examples of why diversity improves academic medicine during the Host Program Panel II: Stanford University: Diversity in Academic Medicine on Thursday, May 13 at the AUA 2021 Annual Meeting. She also serves as the Taube Professor of Global Health and Infectious Diseases and Professor of Pediatrics (Infectious Diseases) and of Epidemiology and Population Health at Stanford University. In both the general labor force and in academic medicine, moving up the professional ladder, women and minorities are underrepresented despite having a diverse workforce and population in the US.

There is particularly poor representation of minorities at the level of full professor. Why are diverse faculty important? Diversity of thought leads to innovation, Dr. Maldonado explains. Diversity in medical education integrates cultural considerations, reflects the diverse communities these institutions serve, and provides role models for future leaders. A 2002 study on diversity in education, titled “Faculty of Color Reconsidered” in the Journal of Higher Education showed that faculty of color used a broader range of educational techniques and interacted more with students. These faculty view their work as being applied to change in society. 

In a study titled “Diversity Makes You Brighter,” and published in The New York Times, Sheen S. Levine and David Stark examined outcomes from diverse teams that demonstrated that heterogenous groups took longer to gain consensus. Diversity disrupts conformity of thought. The result was 58% more accuracy in outcomes and increased critical thinking in diverse groups compared to the homogeneous comparisons.

Diversity enhances research and clinical outcomes. Dr. Maldonado describes how most studies use male animals, which don’t take into consideration hormonal and genetic differences in pharmacodynamics before moving into human trials. Federally funded clinical trials and studies often underrepresent women and minorities. In 2011, 96% of genetic disease studies used only European populations. The failure to include diversity in research cohorts leads to inequity in treatment, since study results cannot be applied accurately to different groups.

Inclusive research is needed to optimize patient care. For example, Puerto Ricans have four times higher mortality rates due to asthma compared to European Americans. This led to the Genetics of Asthma in Latino Americans (GALA) study that found ethnicity can be the greatest predictor of drug response.

Dr. Maldonado concluded her session with a reminder that racial ethnic groups are disproportionately affected by social determinants such as frontline jobs, crowded living conditions, public transportation, food deserts, and inadequate insurance. These determinants increase overall social vulnerability to COVID-19 and other acute and chronic diseases.