Key points are not available for this paper at this time.
Although there is a moral and ethical obligation for organizations to foster diversity, equity, and inclusion (DEI), there are also federal and state laws in the United States and in other countries to ensure that organizations do not wittingly or unwittingly adopt practices that are discriminatory.1,2 To mitigate discriminatory practices, organizations typically develop DEI policies, which cover the representation and participation of people of different gender, race, ethnicity, religion, age, sexual orientation, and disability status.3 A clear and robust DEI policy should be viewed as protection for the organization—and in turn its assets or profits—from prosecution or lawsuits for breaching employment laws. In this way, it is not dissimilar to having a fire safety policy or a data security policy. For example, adopting a strong DEI policy might have prevented the US Internal Revenue Service from breaching the law, and consequentially protected the entire US government and federal system from a successful lawsuit by a plaintiff, Mr. Moritz, famously represented by Ruth Bader Ginsburg.4 Apart from adhering to existing laws and regulations, there are economic benefits to improving DEI.5 Companies can reach a more extensive talent pool, incorporating different perspectives, and so enhancing the firm’s agility and innovation.6–8 DEI has been shown to foster a sense of belonging for all employees, and thus reduce turnover, including addressing burnout.9 All this strengthens the firm’s competitive advantage over other stagnant or ossified competitors, and corporate responsibility like DEI strategies has been effective at improving the well-being of employees.10,11 WHY ANESTHESIA and in turn, over time, this will help reverse the currently unequal representation of women, people of color, and other heretofore underrepresented groups in academic medicine. For example, a recent analysis in the United Kingdom (UK) revealed that, despite women and people of color comprising 32% and 39% of consultant staff (ie, attending physicians), respectively, only 19% and 16% of UK professors are from these 2 groups, respectively.15 RECOGNIZING THE PUSHBACK TO DEI: TOWARD “PEOPLE AND HEALTH ADVOCACY” Although there is a need for A the unique challenges facing disadvantaged minorities in the workplace; and legal or institutional frameworks that might create implicit biases. To that end, we have taken the decision, not lightly, to rename this section “People EICs, Editors-in-Chief; LMICs, lower- and middle-income countries. This prioritization can be bolstered by commissioning articles in response to global events or policies that have either positive or adverse proven or potential impacts on topics related to diverse representation, equity, inclusion, and engagement. Global examples include the possible adoption of new assisted dying legislation in the UK, and how these might affect vulnerable groups;22 or the impacts of restricting access to abortion services in some states in the United States and other countries, and how these might impact the health of women.23 These are sensitive and controversial issues. Therefore, when delving into these, it is important the Journal does not take any political stance, but remains an open forum for constructive, evidence-based discussion from all perspectives, focused on improving healthcare outcomes. An important role of the Section Editor for People & Health Advocacy will be collecting and analyzing demographic data, to shape and inform future strategic initiatives. If as a journal, we are committed to publishing these issues, then we need to know how well we are doing—but especially what we are not doing well and what to do about it. It is important to know who is determining what gets published: the demographic characteristics of editors and peer reviewers, as well as who is seeking to publish: the demographic characteristics of authors.24 In turn, these analyses synergize with parallel work on studies pertaining to academic promotions and departmental representation of traditionally underrepresented groups (ie, women, racial and ethnic minority populations).25 This dimension of the strategy may not be easy. Whereas geographic location, institution, qualifications and academic rank are generally self-evident, details of factors like gender, age, race, ethnicity, sexual identity, disability status are not straightforward to collect and require acknowledgement of privacy and data protection issues. After gathering and analyzing data on the demographics of our editors, reviewers, and authors, we can implement strategies to address systemic challenges faced by underrepresented groups in publishing. Efforts to counter systemic racism and discrimination will include mentorship and education on conducting research in this field, reviewing the relevant studies, and statistical approaches for research in collaboration with other journals and medical societies, thereby creating a pathway for underrepresented investigators to gain the skills and expertise to conduct and publish research. We will also review all policies to ensure our policies are equitable and do not prevent groups of individuals or certain topics from being published. In this way, the refreshed title emphasizes the “people” and also their expectation—and indeed fundamental right—to justice in the field of healthcare. One exciting opportunity to advance this theme is the new Journal Editorial Fellowship program: see: https://journals.lww.com/anesthesia-analgesia/Pages/Announcement.aspx. This initiative was originally designed over a decade ago when the current A&A Editor-in-Chief (J.J.P) was editor of Anaesthesia. It was adopted and expanded later by the British Journal of Anaesthesia. The Editor-in-Chief has taken advantage of the size and reach of A&A in introducing the Fellowship to our Journal. Successful applicants will spend a year shadowing 2 Section Editors, learning the mechanics of journal and article management and processing, including experience in how to peer review. Dedicated mentorship and training will not only assist the individual Fellow’s own career development but also serve as a pathway and create a pool of talent from which future peer reviewers and editors can be drawn.15 We already have applicants who have come from each continent and across wide demographic groups. We are confident that this Editorial Fellowship will add diversity to our editorial board. The Section Editor for People & Health Advocacy will not work in a vacuum. The Journal is justly proud of its 2 closely connected Healthcare Disparities by and Global Health by as there is and (eg, where a or and (eg, in a of in these themes are in ways that to be are connected as (a) if DEI policies (the focus of of People & Health are then healthcare disparities should be and (b) if this positive is then global health should However, there are some factors specific to each of these themes and the new also the the at the of the US issues pertaining to staff as well as clear the theme is not just about but open to discussion about legal and fundamental The of people and health health and global The that there is people and health healthcare and global there are issues that can be specific to each of The that policies related to people and health can health disparities or the reverse is the Healthcare disparities and global health are through common The in examples of issues that can be specific to each not health is still a for a people and health is to have in people and health political or events may not healthcare disparities if all are are for the populations and countries are not for DEI that remains the United cultures are in at the for DEI strategies (eg, In countries where DEI is well it might be argued by some that there is no a diversity and one can on to other to the response This the reality that a robust DEI strategy helps the organization from like an insurance and this risk is In a more way, some countries with DEI policies and as the currently are in about these the DEI policies have all the the Journal authors a unique and opportunity to the which will impact on the well-being of our to the People & Health Advocacy section will to the same scientific that are to all other submissions. any research that does not standards be a threat to the Journal and to advancing the of DEI in and perioperative medicine. it is to ensure our People & Health Advocacy policy is transparent and is This will include at scientific (eg, and publishing data the journal’s initiatives with as increased diversity among or in health equity content. The our Journal strategy, and nothing in it should be there are potentially One countries where for or political policies against women or people on sexual This into our commitment to be globally with our commitment to People & Health Even if the Journal does not take any political stance, discussion in our of the adverse health of some policies may in some of the and this may include the United response is to all to be are evidence-based and areas include issues like in the or to medical or participation in assisted In all these about the or are the of the Journal. is instead of is their impacts on and that of individual should when healthcare. All these have in A&A as a among journals in for professional justice and health equity. A&A will (a) to its peer reviewers with the relevant expertise, (b) to our editorial team on the of DEI, (ie, a culture of and and review our policies and to ensure we are all these themes in all of our work. We look to partnership with authors, peer reviewers, the editors, and all our in the United States and where DEI remains at the of the of in perioperative and management of is the DEI Section Editor for Anesthesia & is the Editor-in-Chief of Anesthesia & Analgesia and was not in the of this This was
Milam et al. (Fri,) studied this question.