Diversity climate and discrimination at German universities: a cross-sectional study among students in health-related degree programs

Abstract Background Diversity is essential in higher education, particularly in health-related programs (e.g., medicine, psychology, and other health professions). Inclusive and non-discriminatory learning environments are crucial for promoting equity and preparing future health care professionals to care for diverse populations. However, empirical evidence on students’ perceptions of diversity in German universities remains limited. This study aimed to 1) assess students’ perceptions of the diversity climate in their health-related degree programs and university contexts and 2) examine differences in psychosocial and academic variables between students with and without experiences of discrimination. Methods A national cross-sectional online survey was conducted between January and April 2024 among students in health-related degree programs at German universities. Measures included sociodemographic and educational characteristics, students’ perceptions of diversity climate (across three dimensions: age, ethnicity, gender), experiences of discrimination, diversity- and equity-oriented beliefs, sense of belonging to the university, study engagement, general and academic self-efficacy, and general and study-related stress. Descriptive analyses were conducted as well as independent t-tests to examine differences between groups. Results A total of 987 students from 83 universities across all 16 federal states participated. Students’ perceptions of the diversity climate were moderately to highly positive across age (M = 3.91/5, SD = .59), ethnicity (M = 3.63/5, SD = .65), and gender (M = 3.83/5, SD = .59). While the majority reported no personal discrimination at their university, 28% experienced discrimination within the past two years, most commonly due to gender (42%), physical appearance (23%), mental health (20%), or racial reasons (13%). Additionally, 45% had witnessed discrimination. Students with personal experiences of discrimination reported significantly less positive perceptions of the diversity climate, lower academic self-efficacy, study engagement, and sense of belonging at the university, higher stress, and stronger diversity- and equity-oriented beliefs. Across the full sample, 61% indicated that teaching materials do not adequately represent diverse groups, and 50% perceived lecturers as insufficiently responsive to discrimination. Conclusion Despite generally positive attitudes toward diversity, the students' high rates of experiences of discrimination and their associations with psychosocial and academic variables highlight the need for systematic efforts to promote inclusive learning environments. Targeted interventions, such as diversity training for staff and students, improved representation in teaching materials and curricula, and stronger institutional policies, are essential to promote equity and well-being in health-related education. By using a nationwide scope, focusing on health-related degree programs, and conducting a multidimensional assessment of students’ perceptions of diversity climate, this study offers important evidence to inform such efforts and addresses a notable gap in the literature.