# Building an Equity-Centered Ecosystem: University of Utah Health as a Microcosm

## TL;DR

This paper discusses the lack of diversity in academic medicine and proposes a comprehensive ecosystem to improve equity and inclusion.

## Contribution

The paper introduces a holistic ecosystem approach to address diversity and inclusion in academic medicine beyond traditional pathway programs.

## Key findings

- Family Medicine has the most diverse leadership among medical specialties.
- Diversity efforts need to go beyond pathway programs to achieve lasting change.
- Underrepresentation of marginalized groups in health sciences persists despite some progress.

## Abstract

Academic medicine, and medicine in general, are less diverse than the general patient population. Family Medicine, while still lagging behind the general population, has the most diversity in leadership and in the specialty in general, and continues to lead in this effort, with 16.7% of chairs identifying as underrepresented in medicine. Historical and current systematic marginalization of Black or African American, Latina/e/o/x, Hispanic or of Spanish Origin (LHS), American Indian/Alaska Native, Native Hawaiian/Pacific Islander, and Southeast Asian individuals has created severe underrepresentation within health sciences professions. Over the last 30 years, the percentage of faculty from these groups has increased from 7 to 9% in allopathic academic medicine, with similar increases in Osteopathic Medicine, Dentistry, and Pharmacy, but all lag behind age-adjusted population means. Traditionally, diversity efforts have focused on increasing pathway programs to address this widening disparity. While pathway programs are a good start, they are only a portion of what is needed to create lasting change in the diversity of the medical profession as well as the career trajectory and success of underrepresented in medicine (URiM) health professionals toward self-actualization and positions of leadership. This article elucidates all parts of an ecosystem necessary to ensure that equity, diversity, and inclusion outcomes can improve.