Chief diversity, equity and inclusion positions, which were the fastest-growing C-suite roles in 2022, are now dwindling in many industries. In healthcare, the role and its evolution are more complex.
Over the past year, there has been a noticeable change in the DEI role's development, according to Yolanda Wimberly, MD, senior vice president and chief health equity officer at Atlanta-based Grady Health System. Fewer professionals are applying to such positions, and many roles that were formerly in play are being transitioned out, moved under the human resources umbrella or cut entirely due to funding.
"In the wake of the new ruling with affirmative action, [organizations are] even changing some of the titling in some states," Dr. Wimberly told Becker's. "I have friends across the country who were doing this work, who now are no longer doing it or have had to reinvent themselves, had to retitle themselves, and in some instances, just had to shut to down shop because of everything else on the outside that pressured them to not be able to still do this valuable work."
That's not the case at Grady, Dr. Wimberly said. The system is actually expanding its health equity initiatives — gathering data on patient populations, identifying inequities and rolling out interventions to address them — with the aim of increasing life expectancy in the community. The outward-facing nature of the role is insulating, to some extent.
"At Grady, we are actually increasing the level of accountability and visibility of health equity, while some hospital systems are starting to either downsize it or eliminate it," Dr. Wimberly said. "Some of the other foundational approaches that people use, they might have been more inward, internal — increasing the diversity of their employees, increasing diversity of whatever internal indicator they have. That one becomes a little bit trickier when you're talking about what your ultimate goals are, how you get there, what those interventions look like, what type of programming has to be put into place."
"I would say those who built their [DEI programs] on the foundational principles of community-focused equity, we're probably still within the realm of being able to carry on what our mission is," Dr. Wimberly continued. "When you start to look at some of the other roles that talk about diversity, equity and inclusion, in my opinion, that's where we start to see — depending on the leadership of the institution, what their beliefs, values, goals are, in addition to the political climate of the community, as well as the state that they're in — that may have had some negative impact on what that look like."
It's a sentiment that Lois Greene, DHA, BSN, RN, echoed in conversation with Becker's. Dr. Greene is the senior vice president of wellness, diversity, equity and inclusion at Newark, N.J.-based University Hospital, but long before she was an executive, she was an emergency department nurse; in clinical practice, she began to see the value of an equity-focused approach, well before it was widely adopted by C-suites.
"I feel like the emergency department of any town is sort of where you see the microcosm of what goes on in the town. So that's where I really, really got to learn about urban communities," Dr. Greene said. "[A hospital] is not just a provider in the community, we are a community member, right? As a hospital, there's lots of things that we see. And if we don't share our information, then the community ills can continue to happen."
If the emergency department sees a lot of falls, for example, it has a responsibility to put out information on fall prevention. But if the hospital studies the data through an equity lens, and notes that the majority of falls are from Bangladeshi patients, it can also put out information on fall prevention in Bengali — thus taking a more effective approach, according to Dr. Greene. Data-based DEI initiatives help take the guesswork out of a hospital's response.
She believes that health systems do see the value in these initiatives, because diversity, equity, inclusion and belonging touch every aspect of an organization, from turnover rates to care quality. The role must be multifaceted, Dr. Greene said, acknowledging her long title — the ability to pivot preserves any job's viability.
"You cannot just focus on one thing, right? If I'm the pencil officer, and everybody's using typewriters or pens, then I'm not addressing the needs of the organization," Dr. Greene said. "In the past, a DEI role could be sort of set up as, you know, 'We are racist and we need to fix that.' It's not that. It's coming from a place of understanding that everyone is different. And when you put all these different people into one space, you're going to have conflict, you're going to have misunderstandings. How do we learn to communicate better as an organization?"
The DEI role is at a pivot point, both executives said — like healthcare itself. It is largely reliant on conversations among leadership: fleshing out how equity aligns with the strategic mission, can benefit the organization financially, and can be infused into other parts of the health system, from clinical work to HR.
"I think for us [DEI officers] and the health equity offices, it's important for us to really demonstrate why it's important for us to be in that role, and why it's important for the hospital system or the institution to have a whole office that only thinks about this all day long on a daily basis," Dr. Wimberly said. "Health equity is not an add-on. It's not something that you think about when you get in trouble. It's something that you should think about on a daily basis, and that you integrate into everything that you do."
And although the role is changing, it isn't disappearing, Dr. Greene said. Evolution takes time, trial and error.
"I don't want the data that the DEI position is on the decline to communicate that it's not important to organizations," Dr. Greene said. "It's a journey, right? It's not a destination. And this is an important conversation to keep having: how we can just continue to improve and transform as an organization to be a best place to work, to be a best place to provide care, because it's quality and safety that we all want to provide in healthcare."