Diversity, Equity and Inclusion (DEI)

The Department of Emergency Medicine is committed to fostering a safe and inclusive environment for that embraces the uniqueness of all people.

  • We will provide outstanding and respectful service in all situations.
  • We will own our interactions in a positive way.
  • We will strengthen our diversity through education excellence and advancement of knowledge.

We have also partnered with other groups across campus with a similar mission including the Office of Patient Experience and the Office of Health, Equity and Inclusion 

Through its vision the department has created the following:

  • Diversity, Equity and Inclusion (DEI) Action Committee - which is inclusive of all job families in the ED.  All are welcomed and encourage to participate in the committee.  If you are interested in joining, please contact the committee at emDEIgroup@med.umich.edu
  • Commitment to Recruitment and Retention of a Diverse Workforce
  • Health Care Disparities Didactics and Research
  • Emergency Medicine Women’s Mentoring Group (Women-focused issues and programs)
  • Quarterly DEI Town Hall Meetings

Healthcare Inequity

The IOM 2002 report -Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care concluded that minority patients generally receive lower quality health care than whites in the US, regardless of their insurance status or ability to pay for care resulting in more deaths amongst minorities a than whites. 

Health Equity:

Healthy People 2020 defines Health Equity as - “The attainment of the highest level of health for all people.  Achieving this requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequities, historical and contemporary injustice, and the elimination of health and healthcare disparities.”  Healthcare provider behaviors and attitudes – Implicit Bias is a major contributor to healthcare disparities. To attain healthcare equity, we must become aware of our implicit bias and develop ways to decrease this.

Health Disparities

Differences in the presence of disease, health outcomes, or access to health care between population groups. 

Health inequities, on the other hand, are differences in health that are not only unnecessary and avoidable but, in addition, are considered unfair and unjust. Health inequities are rooted in social injustices that make some population groups more vulnerable to poor health than other groups.

Healthcare Disparities is defined as a unique component of health disparities that reflects differences in the care delivered.

Also relate to:

  • provider/patient relationships
  • provider bias and discrimination
  • patient variables such as mistrust of the health care system and refusal of treatment.

We need to bring awareness to health care disparities affecting marginalized groups such as LGBTQ patients, patients with mental illness, patients with poor health literacy, patients with disabilities, underrepresented minority patients and patients whose primary language is not English

These findings are part of the impetus to examine how structures, processes and behaviors in our healthcare system may be contributing to disparities.

What is Implicit Bias?

* The unconscious attribution of qualities to a member of a certain social group. 

* Shaped by experiences and based on learned associations between particular qualities and social categories, including race and/or gender

* Affects anyone who may be disadvantaged or have different exposures and backgrounds to that of the physician taking care of them. 

* Leads to barriers in receiving health care that is equitable for all and can lead to poor patient outcomes or outcomes different than the physician intended

 

We all have attitudes and stereotypes that affect our behaviors and decisions unconsciously. Some may have been engrained in us by our parents, some may not be good.

Project Implicit is an online tool which we encourage you to take to assess yourself and see where yours may lie. 

Why is this Important?

Ultimately, we want the best care and the best outcomes for our patients (Health Equity).  The Institute of Medicine, ACGME which provides accreditation and oversight for residency programs, and the LCME which is the accrediting body for educational programs at schools of medicine in the U.S. and Canada have all recognized that diversity, health equity, and inclusion is very important for our practice, our learners, and our patients. Research has shown that minority patients receive less pain medication and have healthcare disparities independent of insurance status or ability to pay for care when compared to their white counterparts (IOM report 202).  These differences likely occur from social counterparts (IOM report 202).  These differences likely occur from social determinants of health and may relate to implicit bias. 

What are social determinants of health?

Conditions in which people are born, grow, live, work, and age and are Influenced by distribution of money, power and resources at global, national, and local levels. (World Health Organization)

The CDC adds to the definition: where and how people learn, play, worship, and affects wide range of health, functioning, and quality-of-life outcomes and risks