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Diversity, Equity and Community Engagement in the Department of Medicine: Our road ahead

UVA Latino Health Max Luna

Dr Max Luna

The country, the state, and our community in Central Virginia are living unprecedented challenges where a public health crisis like the COVID-19 pandemic and the exacerbation of racial-ethnic tensions are in the center of everybody’s lives.  Most importantly, this pandemic has vividly displayed how race, ethnicity, and the other social determinants of health

(SDoH) impact disease, access to care, and health outcomes with so much disparity. This is the moment to decide on what side of history we as individuals and as academic departments want to be on as we move forward in the analysis, mitigation, and solution of the many problems we are facing.

I am honored and humbled to serve in the new role of Vice-Chair of Diversity, Equity, and Community Engagement for the Department of Medicine at UVA. My hope is to encourage deep reflection and actions to further our missions of health care delivery, education, and research while embracing the importance of diversity in the Medicine team; faculty, trainees, students, and staff. We shall celebrate the richness of our diversity that enhances a plurality of ideas in our Department of Medicine agenda while developing a strategy of community engagement that directs our departmental efforts to better respond to people’s needs.

It is my belief that we cannot narrow the gap between health systems that have been estranged from communities of color if we do not promote a culture in which our providers embrace inclusiveness and cultural humility. The vigorous recruitment, retention, and promotion of diverse faculty of excellence will help bring about a culture that enhances the trust between our patients/communities and us.  At the same time, we should commit to more organized efforts of bringing in scholarly and non-scholarly efforts in community engagement. By community engagement we mean, “the application of institutional resources (e.g., knowledge and expertise of faculty and students, technical infrastructure, and physical space) to address and solve challenges facing communities through collaboration with these communities”, a definition that goes beyond community service or community outreach at a volunteer level.  The two goals of diversity and community engagement feed on each other in a symbiotic fashion, particularly if they happen with principles of equity and cut across all of our missions.

Quality and Safe Patient Care:  How are we providing and evaluating our clinical care in the domain of cultural competency and risk-stratified by SDoH? How do we partner with community organizations and government entities to assist us in keeping our community healthy?  How do we foster appropriate use of health services, minimize hospital re-admissions, and improve health care metrics in our underserved communities?

Education: How are we including components of health disparities, minority health, immigrant health, and other SDoH in the education and training of our medical students and trainees?  To what extent does our faculty think this is of value in medical education and training?  How do we improve this?

Research:  How does our research agenda address the most pressing needs of our communities locally, nationally, and internationally?  How does our translational research gain trust from our patients and communities so that they participate in a way that research participants represent the colors of our people? How do our research protocols practice principles of optimal cultural respect?

Faculty Development:  How can a department that aims “to provide compassionate patient care of the highest quality, and translate new knowledge into meaningful improvements in healthcare outcomes” achieve this by creating a culture of diversity, equity, and community engagement?  How can faculty efforts contribute to this culture, and at the same time, contribute to their professional development and promotion?

I’m very pleased that our departmental leadership is committed to the principles of Diversity, Equity, and Community Engagement as fundamental to achieve our goals. I’m deeply encouraged that our Department counts with leaders in the field that include among many others, our Associate Dean of Diversity and Inclusion of the UVA SOM, national leaders in anti-racism in Medicine, leaders in Health Policy and Health Disparities, leaders in the history of Eugenesis and integration of African Americans in Medicine, the founder of our 20-year-old Charlottesville Free Clinic and experts in Community Health.  I look forward to learning and working with these and many other members of our department interested in joining us on the road ahead.  The success of this challenging agenda will require an inclusive participatory effort from all of us.

Max A Luna, MD
maxluna@virginia.edu

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