An Upstream Reparative Justice Framework for Improving Diversity in Radiology

Peter Abraham; Tonuka Chatterjee; Efren J Flores; Johnson B Lightfoote; Karla A Sepulveda; Lucy B Spalluto; Marc H Willis

doi:10.1016/j.jacr.2023.03.016

An Upstream Reparative Justice Framework for Improving Diversity in Radiology

J Am Coll Radiol. 2023 Jul;20(7):652-666. doi: 10.1016/j.jacr.2023.03.016. Epub 2023 May 18.

Authors

Peter Abraham¹, Tonuka Chatterjee², Efren J Flores³, Johnson B Lightfoote⁴, Karla A Sepulveda⁵, Lucy B Spalluto⁶, Marc H Willis⁷

Affiliations

¹ Department of Radiology, University of California, San Diego, San Diego, California; RSNA Health Equity Committee Resident member, ACR Representative to the Radiology Health Equity Coalition. Electronic address: pabraham@health.ucsd.edu.
² Meharry Medical College, Nashville, Tennessee; RSNA Health Equity Committee Medical Student Trainee Member, ACR Medical Student Subcommittee Education Lead.
³ Associate Chair for Equity, Inclusion and Community Health, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
⁴ Commission for Women and Diversity, American College of Radiology, Reston, Virginia; Department of Diagnostic Radiology, Pomona Valley Hospital Medical Center, Pomona, California.
⁵ Commission for Women and Diversity, American College of Radiology, Reston, Virginia; Department of Radiology, Baylor College of Medicine, Houston, Texas.
⁶ Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Co-Chair RSNA Health Equity Committee, Past-President American Association for Women Radiologists.
⁷ Department of Radiology, Stanford University School of Medicine, Stanford University, Stanford, California; Alliance of Medical Student Educators in Radiology, President, AUR Board of Directors; Radiology-TEACHES Chief Editor.

PMID: 37209760
DOI: 10.1016/j.jacr.2023.03.016

Abstract

Health care workforce diversity is vital in combating health disparities. Despite much recent attention to downstream strategies to improve diversity in radiology, such as increased recruitment efforts and holistic application review, workforce diversity has not tangibly improved in recent decades. Yet, little discussion has been devoted to defining the obstacles that might delay, complicate, or altogether prevent persons from groups that have been traditionally marginalized and minoritized from a career in radiology. Refocusing attention to upstream barriers to medical education is vital to develop sustainable workforce diversity efforts in radiology. The purpose of this article is to highlight the varied obstacles students and trainees from historically underrepresented communities may face along the radiology career pathway and to provide concrete corollary programmatic solutions. Using a reparative justice framework, which encourages race- and gender-conscious repair of historical injustices, and the socioecological model, which recognizes an individual's choices are informed by historical and ongoing systems of power, this article advocates for tailored programs to improve justice, equity, diversity, and inclusion in radiology.

Keywords: Health equity; reparative justice; socio-ecological framework; upstream; workforce diversity.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Cultural Diversity
Health Personnel
Humans
Minority Groups*
Radiology*
Social Justice
Workforce

Grants and funding

K08 CA270430/CA/NCI NIH HHS/United States