Diversity, equity, and inclusion (DEI) efforts in academic radiology are under threat as anti-DEI legislation continues to be introduced to the U.S. Congress, according to a research letter published August 26 in the Journal of the American College of Radiology.
This type of legislation will have an effect on all kinds of radiology practices, but academic radiology programs are "particularly vulnerable, as university-associated practice members may be considered employees of the bills targeting institutions of higher education," wrote a team led by Florence Doo, MD, of the University of Maryland School of Medicine in Baltimore.
"[Anti]-DEI efforts negatively impact all radiology practices by shrinking the workforce pool of candidates at all levels, exacerbating the current shortage of radiologists and other healthcare workers," the group explained.
Radiology has worked diligently to support diversity, equity, and inclusion (DEI) initiatives, Doo and colleagues noted. But since 2022, legislation has been introduced to the U.S. Congress that would "negatively influence DEI efforts in institutions of higher education," they wrote.
"These legislative efforts include proposals to eliminate DEI offices, ban DEI training, limit DEI statements in hiring/promotion, and prevent DEI consideration in admissions or employment," they noted.
To assess the state of DEI legislation, Doo's team gathered three data sets: A list of proposed anti-DEI legislative bills and their status from December 2022 to May 2024 at both the state and U.S. congressional level, information regarding the geographical spread of both academic and nonacademic radiology practices, and demographic trends within full-time academic radiology faculty between 2012 and 2021 (the pre-DEI legislative period).
The authors found the following:
- A total of 85 bills were introduced during the study period of December 2022 to April 2024, with peaks in January 2023 and January 2024.
- Of these bills, 14 (16%) have been signed into law; 26% are in the "introduced" phase.
- The most frequently addressed issues in these DEI bills are "Diversity Statements" (42/85, 49%); "Mandatory DEI Training"(37/85, 44%); "Identity-based Preferences" (30/85, 35%); and "DEI Offices" (29/85, 34%).
- By state, Missouri has the highest number of anti-DEI bills introduced, at 13 out of 85 (15%), followed by Texas (7 out of 85, or 8%), then Arizona (5 out of 85, or 6%).
- Texas and Florida have the most anti-DEI bills signed into law, with two in each state; 10 other states have one bill signed into law: Alabama, Idaho, Indiana, Iowa, Kansas, North Carolina, North Dakota, Tennessee, Utah, and Wyoming.
This trend indicates increasing risk not only of "losing the advancements made in diversifying the radiology workforce and creating an inclusive educational/patient care environment" but also negatively impacting patient care -- especially if the anti-DEI legislation allows for employees to be fired for violation of anti-DEI regulations, Doo and colleagues noted.
"Threats of termination, lack of institutional support from a defined DEI office, and withheld state funding for DEI activities could disproportionately drive radiologists from underrepresented backgrounds away from states that enact anti-DEI legislation," they wrote.
What can radiologists do to respond to anti-DEI efforts? Doo's team suggests that they make "thoughtful adaptation of current DEI initiatives within new legal bounds, [engage] in DEI policy advocacy, and [develop] intra- and extra-departmental partnerships to strategically align institutions of higher education with broader community DEI goals."
The effort to establish DEI frameworks is an opportunity to shape radiology culture, Doo told AuntMinnie.com via email.
"As we face workforce challenges including recruitment, we have an opportunity to redefine our radiology workplace culture while navigating the local DEI politico-legal landscape [so that it includes] mentoring diverse talent, advocating for equitable hiring and promotion practices, and ensuring department support matches values (i.e. family leave, tele/part-time options, etc.)," she noted. "It's about making inclusion a daily intentional practice, not just a policy."
The complete study can be found here.
