Despite the changing demographics of the nation and a growing appreciation for diversity and inclusion as drivers of excellence in science, engineering, and medicine, Black Americans are severely underrepresented in these fields. For example, Black Americans constitute 13 percent of the U.S. population, but make up less than 7 percent of medical students and less than 3 percent of practicing physicians (NASEM, 2018). In the science and engineering disciplines, Black Americans represent 4.8 percent of employed professionals (National Science Foundation, 2015). As documented in several key reports, including Altering the Course: Black Males in Medicine (Association of American Medical Colleges, 2015) and An American Crisis: The Growing Absence of Black Men in Medicine and Science (NASEM, 2018), racism and bias are significant reasons for this disparity, with detrimental implications on individuals, health care organizations, and the nation as a whole.
In 2017, the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine (the National Academies) and the Cobb Institute organized a national workshop that resulted in publication of An American Crisis (NASEM, 2018), mentioned above. That workshop served as a springboard for further discussion, with a number of articles and news stories on the subject appearing in print, and with acknowledgment that Black women face severe challenges as well. Among the discussion topics, it identified challenges encountered in the transition points to becoming successful physicians and scientists, including the impact of racism.
To address this and related issues, the Roundtable on Black Men and Black Women in Science, Engineering, and Medicine was launched at the National Academies in 2019. The Roundtable, comprised of 30 national leaders, has been charged to identify key levers, drivers, and disruptors in government, industry, health care, and higher education where actions can have the most impact on increasing the participation of Black men and Black women in these fields. The goals of the Roundtable are to:
- Compile and discuss quantitative and qualitative data relevant to the representation and experiences of Black men and Black women in science, engineering, and medicine;
- Convene a broad array of stakeholders representing higher education, industry, health care, government, private foundations, and professional societies;
- Highlight promising practices for increasing the representation, retention, and inclusiveness of Black men and Black women in science, engineering, and medicine; and
- Advance discussions that can lead to increasing systemic change.
The Roundtable focused its first public workshop on the role of racism and bias in the participation of Black men and Black women in science, engineering, and medicine (see Box 1-1 for the workshop Statement of Task). The workshop, entitled “The Impacts of Racism and Bias on Black People Pursuing Careers in Science, Engineering, and Medicine,” took place on April 16, 2020.1
The workshop and this proceedings are intended to be an initial exploration of the context for the Roundtable’s work; to surface key issues and questions that the Roundtable should address in its initial phase; and to reach key stakeholders and constituents. The workshop was not meant to be a comprehensive survey of the history and scholarship relevant to the complex topics of racism, bias, and impacts on Black men and Black women in science, engineering, and medicine.
This proceedings provides a record of the workshop discussions. The discussions covered racism (understood as conscious prejudice and antagonism), bias (which can operate unconsciously), and related barriers faced by Black men and Black women pursuing scientific, engineering, and medical
1 Throughout this proceedings, the terms used for racial and ethnic groups are those used by each presenter.
careers. Several of the speakers addressing historical and statistical topics primarily focused on trends and developments in medicine and medical careers. This is partly a reflection of the fact that many of the Roundtable’s inaugural membership cohort are medical doctors. These talks are summarized in Chapters 2 and 5. Chapter 5 also includes a discussion of trends and developments in graduate science and engineering fields. As the Roundtable continues to explore these topics in the future, it will focus on identifying and bringing forward experts and data sources that shed additional light on the Black men and Black women in science and engineering, as well as medicine.
Welcome and Background from the Roundtable Chair
Roundtable chair Cato T. Laurencin, M.D., Ph.D., University Professor and CEO of the Connecticut Convergence Institute for Translation in Regenerative Engineering at The University of Connecticut,2 opened the workshop and emphasized that the “urgency of now” called for holding it vir-
tually, rather than postponing for a point after resolution of the COVID-19 pandemic would allow for travel. Dr. Laurencin explained that the Roundtable established six Action Groups to foster information-sharing and development of an evidence-based approach; engage with key stakeholders and broader communities of scientists, clinicians, engineers, and administrators; and design and conduct workshops, write papers and publications, and conduct activities for meaningful change. Each action group plans to hold a workshop and lead a data-gathering effort to coincide with the Roundtable’s twice-yearly meetings. The current workshop, organized by the Racism and Bias Action Group, represents the first such effort, with future workshops organized by the five other groups: Public Advocacy; Mentorship and Advising; Psychological Factors; PreK to Graduate Education; and Financing.
Remarks from the President of the National Academy of Medicine
Victor Dzau, M.D., president of the National Academy of Medicine, welcomed participants and placed the workshop in the context of the COVID-19 crisis. He said the disproportionate impact of the disease on majority Black versus majority white counties is partly explained by differences in underlying health conditions and access to care. He noted:
Many fewer primary care physicians and health care providers are from underrepresented racial and ethnic backgrounds. A diverse workforce has been identified as an important component of a quality and competent health care system. As Dr. Louis Sullivan [president emeritus of Morehouse School of Medicine and former secretary of the U.S. Department of Health and Human Services] has stated, “Failure to reverse these trends places the health of at least one-third of the nation’s citizens at risk.” And I think that’s what we are seeing.
A shortage of Black men and Black women also persists in science and engineering, Dr. Dzau noted, which threatens the quality of the scientific enterprise and hampers progress for all. Lack of role models, lack of mentors, and socioeconomic factors are often mentioned to explain the causes of the shortage. But, he said:
We have to recognize that bias and racism are the fundamental causes for the lack of Black men and women pursuing careers in
science, engineering, and medicine and the increasing health disparities as being bias and racism.… Discrimination, prejudice, and unconscious and conscious bias create exclusionary environments that prevent Black men and women from entering the pipeline and pursuing careers in science, engineering, and medicine. It is critical that we recognize that persistent structural racism and stereotyping still facing African American males and females is a significant problem, and unless we recognize it and start addressing this, we will not be able to address the underrepresentation of Black men and women in our fields.
Vaughn Turekian, Ph.D., executive director of Policy and Global Affairs at the National Academies, thanked the Roundtable for leadership in pushing issues related to diversity and racism within the National Academies and, more broadly, in the nation and the world. “What we are seeing in this current crisis of COVID-19 is amplifying the very issues that we were raising before,” he said. He expressed hope that the group can “pull a community and society to a better place to demonstrate the real positive outcomes by bringing people together.”
The co-chairs of the Racism and Bias Action Group also spoke briefly at the start of the workshop to place the agenda in the current context. Camara Phyllis Jones, M.D., M.P.H., Ph.D., 2019-2020 fellow at the Radcliffe Institute for Advanced Study at Harvard University, stated:
The same things we are considering today in terms of racism and bias on Black people pursuing careers in science, engineering, and medicine are the same things that are causing more Black people to die from COVID-19. It’s important for us to be naming racism again and still … [P]ositioning the National Academies to come out on this topic, to saying the word ‘racism’ is very important.
Action Group co-chair Cedric Bright, M.D., FACP, associate dean at the Brody School of Medicine at East Carolina University, acknowledged the discussions during the workshop would at times be uncomfortable but would take place in a “safe zone.” He asked participants to be “introspective, circumspective, and engaged as part of the discussion.”
The remainder of this publication is organized to follow the agenda of the workshop. Chapter 2 highlights the keynote address by Dr. Camara Jones on some of the causes and manifestations of racism. A presentation by Harriet A. Washington summarizes relevant medical and public health history in Chapter 3. Chapter 4 highlights Richard Rothstein’s summary of federal legislation that segregated housing and education, rebutting the idea that residential segregation occurred in a de facto fashion. An overview of diversity, equity, and inclusion in higher education, with a focus on medical school application and enrollment data, was presented by David Acosta, M.D., and appears in Chapter 5. Howard Ross discussed racism in relation to Black men and Black women in science, engineering, and medicine, in Chapter 6. Chapter 7 presents concluding remarks. The workshop agenda and biographical sketches of the speakers can be found in the Appendixes.
Association of American Medical Colleges. 2015. Altering the Course: Black Males in Medicine. Washington, DC. https://store.aamc.org/altering-the-course-black-males-in-medicine.html.
National Academies of Sciences, Engineering, and Medicine (NASEM). 2018. An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop. 2018. Washington, DC: The National Academies Press. https://www.nap.edu/catalog/25130/an-american-crisis-the-growing-absence-of-black-men-in.
National Science Foundation. 2015. Employed Black Scientists and Engineers, as a Percentage of Selected Occupations: 2015. https://www.nsf.gov/statistics/2017/nsf17310/digest/occupation/blacks.cfm.