U.S. Supreme Court Ruling Potentially Dampens Diversity

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With rheumatology facing a workforce shortage and lagging diversity compared with some other medical specialties, some rheumatologists worry about the potential lasting effect of the recent U.S. Supreme Court ruling regarding affirmative action.

By a vote of 6 to 3, the June decision ruled that the University of North Carolina and Harvard College admission programs were in violation of the equal protection clause in the Constitution barring racial discrimination by government entities.¹

In the decision, Chief Justice John Roberts wrote for the majority and stated that college admissions programs could allow an applicant to explain how their race influenced who they are if it would have an effect on the school they would attend. However, a student “must be treated based on his or her experiences as an individual—not on the basis of race,” he wrote.

Affirmative action became part of certain government, education and other initiatives beginning in the 1960s to address racial inequalities, thereby increasing diversity. It has faced legal challenges throughout the decades, however.

Like other medical societies, including the American Medical Association, the ACR released a statement regarding the Supreme Court ruling this summer. In part, it reads:²

The American College of Rheumatology is deeply concerned about the U.S. Supreme Court’s affirmative action ruling because of the potentially negative impact on rheumatology patients. Adults and children with rheumatic diseases from historically marginalized and under-resourced communities have greater disease burden and worse disease outcomes. Among other factors, a diverse and culturally responsive workforce plays a critical role in fostering strong patient-provider relationships and a climate for optimal health. In addition, educational environments with diverse perspectives and lived experiences create powerful opportunities for learning and skill building that advance patient-centered care.

The decision by [the Supreme Court of the United States] to prevent undergraduate programs from considering race and ethnicity, among other factors, in their admission policies undermines the valuable progress in addressing health inequities and disparities.

The statement goes on to say that fewer than 15% of ACR/ARP members represent racial and ethnic minority groups that are under-represented in medicine. “This ruling will impede the expansion of a diverse physician and health professional workforce that represents the patients they care for,” according to the statement.

A 2015 workforce diversity report from the ACR found that only eight of 1,011 adult rheumatologists identified as Black, 85 identified as Hispanic, three as American Indian/Alaska Native, 153 as Asian and one as Native Hawaiian or Pacific Islander.³