After learning about the incredible local disparities reported in the Race to Equity report by the Wisconsin Council on Children and Families in October 2013, and after admitting a residency class lacking any people of color, the DFMCH began intentionally focusing on efforts to address issues of diversity, inclusion, and health equity.
From October 2014 through March 2015, the DFMCH sponsored the 2020 Initiative, an effort to engage our statewide department on issues of diversity, equity, and inclusion. Our objectives were to:
- Increase awareness of diversity issues in our geographical community, patient populations, and department (related video: The 2020 Initiative at DFMCH State of the Department);
- Identify and prioritize potential interventions that can increase department responsiveness to diversity issues (related video: The 2020 Initiative Roadmap Summary of Best Practice; and
- Develop a strategy that assures a departmental commitment to health equity, diversity and inclusion (related documents: individual brainstorm and group priorities).
In March 2015, the DFMCH formally launched its Diversity, Equity, and Inclusion (DEI) Committee.
- Diversity, Equity, and Inclusion Committee Charter
- Diversity, Equity, and Inclusion Committee Strategic Framework
- Goal Prioritization Worksheet
- DFMCH Mentorship Toolkit. To appreciate and attract greater diversity in our department, we must first embrace and support our own people. We developed a toolkit to support mentorship relationships across our department, including faculty mentorships (tenure, clinical health science (CHS) and clinician teacher (CT) tracks); faculty and clinical learner mentorships; and staff mentorships (clinical, educational, research and administrative). As this was broadly conceived, we welcome its application to other audiences.
- Diversity Dashboard. We are developing a model to track issues around diversity, inclusion and health equity in leadership; residency recruitment; faculty recruitment; curricular innovations for faculty development and residency teaching; and departmental training opportunities.
- Statewide lecture series on diversity, equity, and inclusion. From July 2016 through May 2017, our department hosted a lunch series, “It Starts With Me: Conversations About Identity, Privilege and Intersectionality.”
- Implicit bias training. We asked the UW-Madison Women in Science and Engineering Leadership Institute (WISELI) to expand its training opportunities to include more about bias related to race/ethnicity in addition to gender. On November 20, 2015, the DFMCH was the pilot site for an inaugural training by WISELI“Breaking the Bias Habit: A Workshop to Promote Racial Equity in Hiring and in Clinical and Work Settings,” which involved training more than 60 members of the department about their own personal biases as well as potential structural and organizational biases. This work has been further expanded upon and continues to be taught locally and nationally.
- Strategies to increase completion of exit interviews.
- Racial affinity caucusing sessions. We held several caucuses in which department members had the opportunity to work within their own racial/ethnic groups as a way to focus on critical understanding and experiences of racism.
For white people, a caucus provides time and space to work explicitly and intentionally on understanding white culture and white privilege and to increase one’s critical analysis around these concepts. It also puts the onus on white people to teach each other about these ideas, rather than constantly relying on people of color to teach them. For people of color, a caucus is a place to work with their peers on their experiences of internalized racism, for healing and to work on liberation. (related information on caucus affinity groups and an article on using them to build anti-racist collectives)
Medical Student Education
- Our faculty, along with their colleagues in the UW School of Medicine and Public Health (SMPH), teach the elective course “Health Care in Diverse Communities.”
- The Enhancing Representation to Improve our Community’s Health (EnRICH) program is a mentorship program for medical students who are underrepresented in medicine (URM) and who are interested in family medicine and primary care.
- Our faculty and staff teach a longitudinal health equity seminar series for residents in the DFMCH’s Madison and Baraboo programs. The series focuses not merely on health disparities, but also issues of structural competency: racism, privilege, intersectionality and resilience. Sample courses include:
- Toward Health Equity: Moving Beyond Disparities and Race
- Implicit Bias, Identity, and Privilege
- Theater of the Oppressed
- Patient Voices, Hope and Resilience
- Cross Cultural Issues
- Transgender care
- Rural health
- DFMCH residents engage in community health learning experiences that provide them with opportunities to apply an equity and empowerment lens to their work. They receive support from the Office of Community Health and faculty mentors who hold leadership positions in a variety of community-based organizations.
- Residents are also given opportunities to participate in racial affinity caucusing, as described in the “Departmental Development” section above.
- Our faculty’s current research includes programs aimed at improving the health of Hmong populations.
Institutional Development and Partnerships
- DEI Committee Chair Jennifer Edgoose, MD, MPH, directs the UW SMPH Diversity and Inclusion Advocates Program. This innovative program is part of the UW SMPH’s strategic plan around IDEA: inclusion, diversity, equity, and access. This program has trained a cohort of trusted faculty and administrators across SMPH to serve as a resource to broaden the faculty applicant pool and ensure equitable evaluation and selection criteria during the search process. They also will promote an inclusive learning and professional climate at SMPH.
- DFMCH faculty founded two programs that are now led at the UW SMPH level: Training in Urban Medicine and Public Health (TRIUMPH), which recruits and supports medical students committed to providing health care for urban populations and reducing health disparities; and the Native American Center for Health Professions, which aims to improve the health and wellness of American Indian people.
- The DFMCH has a close affiliation with the SMPH’s Center for Collaborative Health Equity, which connects academic and community partners to advance teaching, research, and service initiatives that improve health equity in Wisconsin’s underserved communities.