“Who am I to speak about diversity and inclusion? I am a middle-aged white woman from an upper-middle class family. I have been afforded numerous opportunities many of my students never have been, and possibly never will be, afforded. I am the picture of privilege.” This is what I told myself at times when the topics of diversity and inclusion came up. However, when you look at the racial/cultural makeup of most college campuses, if faculty “like me” do not broach the sensitive topics of diversity and inclusion, who will?
Therefore, when I was presented with the opportunity to creatively approach diversity and inclusion via a health disparities course, I saw this as an amazing, if not somewhat frightening, opportunity. The result has been both humbling and empowering for me personally. Health, inherently, is a very complex, dynamic, and enigmatic topic to begin with. When you then ask students to look at not only differences in health outcomes for various populations, but why those differences exist and are so pervasive, it becomes even more complicated. Why do some racial groups experience significantly poorer birth outcomes compared to other groups, particularly when there are no clear genetic/biological explanations? Why are rural residents at significantly higher risk of dying from a heart attack than urban residents? Why is the relationship between income and health so tight? These are just some questions we address in our health disparities course, and underlying these important questions is the need for a foundational appreciation and understanding of our individual strengths, challenges, and historical perspectives. Here are a few guiding principles I have learned along the way to help students, and myself, get somewhat closer to bridging some significant gaps related to diversity and inclusion.
Be a brave yet humble example. In my class I ask students to investigate, question, and reflect on their
own biases from a place of nonjudgment. Therefore, I must be willing to do the same and share the results of my personal inquiries. I must be brave enough to admit I may not fully understand and appreciate the challenges of many of the populations we discuss in this class. I must be brave enough to admit and investigate my own biases. I must be humble enough to recognize I will always have much to learn. I must set the example for approaching topics and situations that I am uncomfortable with from a place of compassion, a genuine desire to improve my own understanding, and an acceptance that I may not always get it right. What’s more, with the right intentions, I must not let the fear of getting it wrong keep me from trying.
Provide students the opportunity to investigate their own biases and/or cultural experiences from a place of nonjudgment. Several times a semester I provide in-class opportunities for students to sit quietly, reflect, and respond in a private journal to some leading questions about the population, topic, or disparity we will discuss. I encourage them to approach the exercise as a witness, not a judge. They should not feel the need to be punished for acknowledging their own biases. Instead I encourage students to investigate their biases and look at them as opportunities to learn more about themselves and ways they may interact with their environment and fellow humans. Once ground rules have been established, as well as an environment of mutual respect, we often move on to discussing and sharing our biases and typical stereotypes. This includes breaking down those stereotypes that appear on the surface as well-intentioned, such as Asians are good at math, Mexicans are hard workers, Native Americans are very spiritual, and African-Americans are good athletes. This often leads to great discussions regarding the danger of lumping people together even with seemingly positive attributes. It is also interesting that rarely, when I lead this discussion, can a class come up with any positive stereotypes for white people.
Emphasize that a collective response may not be appropriate for everyone identified with a particular “group.” When discussing diversity/inclusion issues, I have found it is critical to introduce the concept of intersectionality, and how different aspects of identity and discrimination can intersect or overlap. There is an activity from the Australian Attorney General’s Department that I have incorporated into my courses. It introduces, via an interactive activity, the concept of intersectionality (which originated during the women’s rights era, highlighting the fact that many of the voices of the women’s rights movement were white and were not representative of black women and their experiences with discrimination and disadvantage).
To begin the activity, students are first provided a new “identity.” Examples include: refugee woman, 35, recently arrived from the Congo through the women-at risk program; male, doctor, with two children; young boy, 14, who recently left home after confrontation with a physically abusive step-father. Once the students have assumed their new identities, they are asked to stand even in a line while statements are read aloud. Based on the statements read and their identities, students can decide if the statement applies to their identity in a negative (step back), positive (step forward), or neutral (stay in place) way. It is interesting for students to see how quickly some parts of an individual’s social identity can lead to advantage or disadvantage. In just several statements, students visibly see the gaps between themselves and their classmates’ new identities—very rarely do they ever meet again in the middle. I view our job as faculty, in part, as one to help students become responsible citizens who will somehow find ways to bridge these gaps.
Approach it from a competency perspective rather than a deficit perspective. Introduce students to opportunities and tools that will help them continuously build cultural competency. In my field there is an excellent, free online course on developing cultural competencies in the health professions. This online course, developed and delivered by the Department of Health and Human Services, provides the groundwork for us to discuss what cultural competency “looks like” in our field of health care. Students engage in the course online, which includes a pre- and post-test. There are scenarios, video vignettes, discussion questions, and reflections. I also point out to students that just because they earned a certificate indicating they completed a cultural competency course, it does not mean they have suddenly arrived at this magic place of being culturally competent. There is no such place; it is a journey, not a destination, and one we are on together.
Melissa Gomez is an associate professor in the Department of Health and Human Performance at Austin Peay State University.
Australian Attorney-General Department, (2010), AVERT family violence: Collaborative responses in the family law system. Intersectionality Exercise. Retrieved from: http://www.avertfamilyviolence.com.au/wpcontent/uploads/sites/4/2013/06/Intersectionality.pdf
Department of Health and Human Services, Office of Minority Health, (2016), Think cultural health: Culturally competent nursing care: A cornerstone of caring. Retrieved from: https://ccnm.thinkculturalhealth.hhs.gov/