Committee Updates

Diversity, Equity, and Inclusion Committee Update

By Travis Reece-Nguyen, MD, MPH
Vice-Chair of the DEI Committee
travisreecenguyen@stanford.edu

Dr. Reece-Nguyen
Dr. Reece-Nguyen

Support for Diversity, Equity, and Inclusion (DEI) efforts has never been more apropos than now given the current climate of our nation. The COVID-19 pandemic exposed existing disparities in our healthcare system and further emphasized the need to address these important gaps in our healthcare and social support networks. Countless publications continue to confirm that a diverse healthcare workforce improves the quality of care for all patients, especially patients from historically underrepresented populations. A recent September 2020 article underscored this fact when it revealed that Black newborns die at three times the rate of White newborns in the United States when newborn-physician racial discordance is present. Predictably, newborn–physician racial concordance is associated with a significant improvement in mortality for Black infants.1 

Per the US Census Bureau, as of 2018, non-Hispanic white children under the age of 15 became the minority in their age group; therefore, minority children, collectively, have become the majority under the age of 15. This trend is projected to continue and truly highlights the need for pediatric anesthesiologists and children hospitals alike to proactively expand their knowledge and support of a more racially-diverse future. In order to improve patient care overall, we must ensure a more diverse pediatric anesthesiology workforce.

But what is the current diversity climate within our subspecialty? Thanks to the work of one of our distinguished committee members, Dr. Olubukola Nafiu, who examined anesthesiology resident and pediatric anesthesiology fellow demographic data from 2000-2018, we know that our subspecialty training programs achieved gender parity in 2010 and continue to train more female pediatric anesthesiologists even though male anesthesiology residents remain the majority. Unfortunately, the data also substantiated a longstanding underrepresentation of Black and Hispanic providers within both anesthesiology residency and pediatric anesthesiology fellowship training programs.2 It is difficult, admittedly, to recruit a more diverse pediatric anesthesiology workforce when many residency programs themselves remain rather stagnant in their ability to recruit underrepresented minorities. Although our subspecialty successfully flipped the gender balance in 2010, we have yet to see this evidenced in leadership roles within our hospital systems and professional societies.3   

In order to investigate the diversity of our field and to better inform the SPA Board and its committees about DEI issues within our professional society, the DEI committee was asked to develop and implement a survey which was distributed in March-May 2020. We received 1239 responses which represent approximately 38% of the SPA membership. THANK YOU to everyone who participated in this important initiative as your responses are informing our work moving forward. The DEI committee is performing a detailed analysis, including qualitative analyses of respondent comments, and plan to present the results at the Winter 2021 meeting.

Since the creation of the Diversity, Equity, and Inclusion Committee in Spring 2018, we have grown from 12 to nearly 50 members that increasingly reflect the diversity amongst SPA’s membership. As our mission statement articulates, we strive to foster a culture that recognizes and values diversity and inclusion by encouraging and supporting the participation, growth, and advancement of all members of our Society to recognize the utmost importance of representation in combatting health disparities experienced by the diverse population of children and families for whom we care. We are currently working with numerous SPA committees, including the Committee on Public and Professional Affairs (COPPA), as well as the SPA Board to inform about issues relating to diversity, equity, and inclusion. We also collaborate with other professional societies on specific programs to promote diversity, equity, and inclusion in pediatric anesthesia education at the fellowship and membership levels, quality and improvement initiatives to support equitable patient care approaches, research in vulnerable populations, and support activities for career development in academic and private practice.

A few specific DEI Committee achievements and ongoing projects we’d like to highlight:

  1. Education Subcommittee is developing a Lecture Series (in collaboration with the Society for Education in Anesthesia) on “Cultural Awareness in the Peri-operative Period” including; transgender youth/gender diverse families, families and patients with limited English proficiency, internationally adopted and refugee children, children with atypical neurodevelopment, and demographic changes in pediatric surgical population. Committee members also hosted a virtual diversity lecture for the SPA Trainee Special Interest Group.
  2. Quality & Safety Subcommittee is currently developing a prospective, multicenter audit study to uncover the complexities that contribute to surgical cancellation rates due to NPO violations within underrepresented populations.
  3. Research Subcommittee assisted in standardizing gender demographic questions in all SPA-sponsored surveys.
  4. Communications Subcommittee has devised a plan to amplify our voice on social media via SPA DEI Twitter Social Media Ambassadors.
  5. We are also planning the first DEI workshop for the SPA Winter Meeting. It will focus on equitable career advancement in pediatric anesthesiology.

With your support, we will continue working toward our common goal: To ensure that diverse voices are included in SPA’s work to further promote equitable healthcare for our increasingly diverse patients and their families.

This is an open committee and we want to encourage you to join our group by simply emailing us! You may also send an email to share your ideas about our current or future diversity, equity, and inclusion efforts within the Society.

Your DEI Committee Leadership Team

References

  1. Greenwood, Brad N., Rachel R. Hardeman, Laura Huang, and Aaron Sojourner. “Physician–Patient Racial Concordance and Disparities in Birthing Mortality for Newborns.” Proceedings of the National Academy of Sciences 117, no. 35 (September 1, 2020): 21194. https://doi.org/10.1073/pnas.1913405117.
  2. Nafiu OO, Leis AM, Wang W, Wixson M, Zisblatt L. Racial, Ethnic, and Gender Diversity in Pediatric Anesthesiology Fellowship and Anesthesiology Residency Programs in the United States: Small Reservoir, Leaky Pipeline. Anesth Analg. 2020 Oct;131(4):1201-1209. doi: 10.1213/ANE.0000000000004765. PMID: 32925341.
  3. Toledo P, Duce L, Adams J, Ross VH, Thompson KM, Wong CA. Diversity in the American Society of Anesthesiologists Leadership. Anesth Analg. 2017;124:1611–1616.

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