Equity, Diversity, and Inclusion Programs in Health Care Institutions: A Systematic Review and Meta-Analysis

TL;DR

A systematic review and meta-analysis finds that equity, diversity, and inclusion programs in healthcare increase workforce diversity and are generally perceived as beneficial.

Contribution

This study provides the first systematic review and meta-analysis of EDI interventions in healthcare, showing their effectiveness in increasing minority representation.

Findings

EDI interventions are associated with increased workforce diversity in healthcare institutions.

Meta-analysis shows increased minority representation in competitive medical residencies after EDI program implementation.

Most studies reported perceived benefits of EDI initiatives in promoting underrepresented minority populations.

Abstract

What outcomes are associated with equity, diversity, and inclusion (EDI) interventions in health care institutions?

In this systematic review and meta-analysis of 43 studies involving more than 15 000 individuals, predominantly from the US, a wide range of EDI interventions were successful and perceived as beneficial in increasing diversity in health care. Furthermore, the meta-analysis of 2 studies demonstrated increased minority representation in competitive medical residencies following program implementation.

A broad range of EDI initiatives were associated with increased workforce diversity in health care institutions.

This systematic review and meta-analysis assesses equity, diversity, and inclusion initiatives in health care institutions that aimed to promote a more inclusive and equitable health care culture for individuals who beloing to racial and ethnic minority groups.

Equity, diversity, and inclusion (EDI) initiatives are politically polarizing and increasingly adopted in the health care setting. Their broader impact across different health care career types, career stages, and various levels of education remains largely unknown.

To assess EDI programs and their associated outcomes within health care institutions.

A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020–compliant systematic review searching PubMed, Scopus, Web of Science, CINAHL, and PsychINFO databases from January 2010 to December 2023.

Two independent reviewers screened studies that assessed EDI programs or policies in health care institutions.

Programs were categorized based on reported outcomes, including participant satisfaction, increased awareness of EDI-related topics, increases in the proportion of underrepresented minority individuals within medical education or the health care workforce, and overall program impact. Odds ratios (ORs) were pooled using a random-effects model. Analyses followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Analysis was conducted June 2025.

Outcome measures included the proportion of diversity among the workforce, employee and patient satisfaction, and the proportion of employees recruited and retained after program implementation.

In total, 43 studies incorporating more than 15 000 individuals involved in EDI programs were included. Interventions were multifaceted, including 14 career advancement and training programs, 16 diversity representation programs, 11 academia and research support initiatives, and the growth of 2 pipeline programs. Furthermore, interventions demonstrated consistent improvement in EDI initiatives, with perceived benefit in promoting underrepresented minority populations. Findings from the meta-analysis of 2 studies showed that minority representation in competitive medical residencies increased after implementation of 2 EDI interventions (OR, 1.73; 95% CI, 1.21-2.47). Among the 43 studies included in the Joanna Briggs Institute assessment of methodological quality, 7 (16.3%) were rated as high quality, 20 (46.5%) as moderate quality, and 16 (37.2%) as low quality.

In this systematic review and meta-analysis of EDI initiatives in health care institutions, programs were associated with an increased workforce diversity. These findings support the continued use of EDI initiatives to promote a more inclusive and equitable health care culture.

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