Tackling the Minority Tax: A Roadmap to Redistributing Engagement in Diversity, Equity, and Inclusion Initiatives

Abstract

Academic medical centers striving to implement diversity, equity, and inclusion (DEI) and antiracism initiatives often ask faculty to volunteer substantial time to committee work, recruitment, mentoring, community, and administrative responsibilities. These requests are not in lieu of current workload and seldom count toward scholarship; the service may go unrecognized, unrewarded, and uncompensated. URiM faculty (underrepresented in medicine) providing such service thus pay a minority tax when precious time is syphoned away from career-advancing activities and personal growth. The resulting strain on available resources has social, psychological, and monetary ramifications that can undermine the long-term objectives of DEI initiatives. We examine the facets of the minority tax, consider the current state of diversity, and present a roadmap to redistribute, reform, and reduce URiM taxation through shared engagement in DEI initiatives. Key interventions include ascribing value to DEI efforts, implementing evidence-based policies to reduce bias, and promoting mentorship, sponsorship, and allyship.

A Peculiar Trend: Family Medicine Residents of Color Are Less Burned Out

“…It defies logic that residents who identify as Black, Indigenous, or a Person of Color (BIPOC) experience lower levels of burnout when they are differentially and systematically burdened by experiences of discrimination, microaggressions, and inequitable access to mentorship and structured opportunity and lack of belonging compared to their non-BIPOC colleagues. [2][3][4] In the discussion, the authors did not have room to explore why burnout trends show the opposite of what we would expect to see. We offer the following insights as to why these findings might be valid, and we would welcome discussion from the authors on this finding.…”

Undue burden: Black faculty, COVID-19, and the racial justice movement

“…[18][19][20] Participation in these efforts includes a combination of recruiting, mentoring, teaching, committee membership, and conducting trainings or workshops designed to, directly or indirectly meet the institution's stated DE&I goals. A distinctive consequence of these activities 21 is they often hinder the academic advancement of URGs, 20 effectually "taxing" groups for whom there are significant career achievement gaps (e.g., research grant funding, publications, and promotion) when compared to their White counterparts. 22 This tax is a welldescribed challenge 18,19 brought to the forefront of our collective consciousness, along with the other long-standing societal maladies of racial and ethnic health inequities and systemic racism, by the dual pandemics of COVID-19 and racial injustice.…”

“…When the pandemic is eventually over, and the attention and interest in antiracism likely wanes, health inequities and racial justice will still matter and their collective impact will still weigh heavily on Black faculty. Recommendations to address the tax on career advancement in this context include protection of time for early career faculty 21 re-evaluating the meaning of research excellence, 13 and institutions demonstrating the value they place on DE&I through investment in and compensation of those doing the DE&I work. 13,28 COMMITMENT vs.…”

“…13 Recommended approaches to mitigate these stressors include the creation of peer support and affinity groups, and "tax advising" where trusted senior colleagues can help Black and other URGs strategically navigate the demands of DE&I work. 21…”

“…In addition, there are concerns that truly speaking truth to power in demanding the fundamental changes needed to achieve the diversity, equity, and inclusion espoused by institutions, Black faculty run the risk of retaliation and/or social isolation, and potentially compromising their careers [14]. Recommended approaches to mitigate these stressors include the creation of peer support and affinity groups and "tax advising" where trusted senior colleagues can help Black and other URGs strategically navigate the demands of DEI work [22].…”