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Introduction1
Over the past four decades, various task forces and committees, including those of the National Academies of Sciences, Engineering, and Medicine (National Academies), have released reports noting that the nation’s health care system is not available to all citizens and residents of the United States and that systemic barriers make it difficult for everyone to enjoy equal access to culturally appropriate health services. Over this period, research2 has shown that where someone lives, works, and plays and the associated social determinants of health have more to do with an individual’s health outcomes than genetics. The COVID-19 pandemic highlighted long-standing problems of the U.S. health care system including unequal access to care, pervasive inequities, and systemic racism, demonstrating that the health care system is complicit in perpetuating health inequities.
As a step toward addressing health inequities and unequal access to care, health systems have created formal positions to oversee their efforts to improve diversity, equity, and inclusion (DEI) both within the walls of
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1 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
2 https://health.gov/healthypeople/priority-areas/social-determinants-health (accessed December 20, 2023).
the health systems and in the communities they serve. To examine the successes and challenges of DEI and health equity executive-level offices (C-suites), the National Academies’ Roundtable on the Promotion of Health Equity held a one-day workshop on October 5, 2023, that explored how health organizations define, operationalize, and support DEI and health equity commitments to achieve internal and external goals.
This Proceedings of a Workshop summarizes the presentations and discussions. The speakers, panelists, and workshop participants presented a broad range of views and ideas. Chapter 2 presents an overview of the history, evolution, and impact of DEI and health equity in health care systems, public health, and government. Chapter 3 discusses C-suite and institutional DEI and health equity commitments. Chapter 4, part I explores research initiatives focused on the role of health equity officers; part II examines experiences from the field on DEI and health equity implementation, and how success is measured at the C-suite and institutional level. Chapter 5 discusses efforts to enact meaningful change in communities. Appendix A contains the workshop agenda, Appendix B provides biographical sketches of the speakers and session moderators, and the statement of task is shown in Box 1-1. The workshop speakers’ presentations have been archived online.3
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3 The workshop speakers’ presentations (as PDFs and video files) are available at https://www.nationalacademies.org/event/40823_10-2023_exploring-diversity-equity-inclusion-and-health-equity-commitments-and-approaches-by-health-organization-c-suites-a-workshop.
