Recommendations to the Society for Epidemiologic Research for Further Promoting Diversity and Inclusion at the Annual Meeting and Beyond

Abstract

Increasing diverse engagement in the Society for Epidemiologic Research (SER) will positively impact the field of epidemiology. As the largest and longest-running epidemiologic society in North America, SER has long been a pioneer in promoting diversity and inclusion. A recent survey of SER members, however, showed there is still room for improving diversity, inclusion, representation, and participation in the Society. In this commentary, as members of both the SER and the Johns Hopkins Bloomberg School of Public Health Department of Epidemiology’s Inclusion, Diversity, Equity, Anti-Racism, and Science (Epi IDEAS) Working Group, we recommend 4 goals for the SER Annual Meeting and beyond: 1) convene epidemiologic researchers with diverse backgrounds and ideas; 2) promote an inclusive environment at the SER Annual Meeting; 3) develop, compile, and disseminate best practices to honor diversity in epidemiologic research; and 4) increase prioritization of health disparities research and methods. We also suggest strategies for achieving these goals so that SER can better include, support, and elevate members from historically disadvantaged groups. While our recommendations are tailored specifically to SER, the greater epidemiologic and academic communities could benefit from adopting these goals and strategies within their professional societies and conferences.

Abbreviations

Epi IDEAS Working Group

Department of Epidemiology's Inclusion, Diversity, Equity, Anti-Racism, and Science Working Group

HIV

human immunodeficiency virus

NIH

National Institutes of Health

SER

Society for Epidemiologic Research

Editor’s note: The opinions expressed in this article are those of the authors and do not necessarily reflect the views of the American Journal of Epidemiology.

In an article appearing in this issue of the American Journal of Epidemiology, DeVilbiss et al. (1) analyzed results from a survey of Society for Epidemiologic Research (SER) members and found that women and sexual minorities felt less welcomed by SER and were less frequently selected by SER to serve as chairs or committee members than their comparison groups. Persons from most racial/ethnic minority groups felt less welcomed and had lower self-initiated participation than those who were White (1).

Diversity in scientific teams leads to increased scientific productivity and innovation and more trustworthy research (2–5). As members of SER and the Johns Hopkins Bloomberg School of Public Health Department of Epidemiology’s Inclusion, Diversity, Equity, Anti-Racism, and Science (Epi IDEAS) Working Group—a student, faculty, and staff coalition promoting diversity and inclusion within the field of epidemiology—we appreciate SER’s tremendous and long-lasting efforts to improve diversity and inclusion within the Society. We write this commentary to offer recommendations, gleaned from our own experiences, to address the findings of DeVilbiss et al. We suggest 4 diversity- and inclusion-related goals for the SER Annual Meeting and beyond, offering strategies for achieving these goals so SER can better include, support, and elevate its members. While our recommendations are tailored for SER, the greater epidemiologic and academic communities could benefit from adopting these goals and strategies.

GOAL 1: CONVENE EPIDEMIOLOGIC RESEARCHERS WITH DIVERSE BACKGROUNDS AND IDEAS

The goal of the SER Annual Meeting is to “bring together epidemiologists from all stages of their career trajectory to discuss emerging epidemiologic research” (6). As the flagship SER event, it is a key opportunity to convene researchers of diverse backgrounds and ideas. Toward this goal, SER recently launched SERvisits, which sends SER researchers to give scientific presentations at institutions that are underrepresented at the Annual Meeting and provides financial support to epidemiologists-in-training with “underrepresented backgrounds” from those institutions to attend the Annual Meeting (7).

We suggest that SER expand its impact by offering scholarships to all epidemiologists-in-training from historically disadvantaged backgrounds, beyond those participating in SERvisits. This will require more resources; currently, SERvisits is wholly sponsored by 1 institution (7). Some options for fundraising include 1) offering Annual Meeting sponsors the opportunity to support diversity and inclusion efforts (e.g., scholarships or identity-specific meetups), 2) soliciting annual diversity and inclusion commitments from private or public institutions, and 3) adding an option for registrants to donate to the scholarship fund. SER could avoid a selection process based on meritocracy, which perpetuates the sense that one applicant is more deserving than others, and instead consider randomly selecting from a group of eligible applicants, as exemplified by organizations like the Travis Foundation (8). To alleviate the financial burden on trainees, these and existing scholarships could be offered in advance of the Annual Meeting rather than as reimbursements.

SER has also been a pioneer in recruiting women to make up a significant proportion of its speakers, committee members, and chairs at the Annual Meetings. For example, SER has had a substantial number of women leaders since the 1960s, and more than 70% of the current Society leaders are women (9). Today, many conferences assess the sociodemographic composition of their speakers and award recipients (10–13); prominent public health leaders, including National Institutes of Health (NIH) Director Dr. Francis Collins, have set an example by vowing to only accept invitations to speak on panels that include women (14). However, to our knowledge, apart from a mention in the 2019 SER President’s Address (15), SER has not made these types of statistics public. Routinely tracking and publishing statistics on the sex/gender and race/ethnicity of conference speakers, committee members, etc., would improve transparency, increase accountability, and potentially inspire more epidemiologists from historically disadvantaged backgrounds to speak and lead at the Annual Meeting.

Based on our experience initiating Epi IDEAS, we learned that listening is critical to avoid a checklist approach to diversity and inclusion. We have firsthand experience that climate assessments and regular, in-person check-ins can effectively guide such efforts: A year after Epi IDEAS started to implement recommendations solicited from student feedback, we saw a 21% absolute increase in students’ endorsement of the department’s value for diversity and inclusion. Although these small-group forums required time and repeated contact, we found them invaluable for identifying issues and solutions in our epidemiology department. Therefore, in addition to SER’s planning an annual survey on diversity and inclusion, we recommend considering a listening tour and/or focus groups to, for instance, learn more about never and one-time attendees or which research perspectives are over- and underrepresented at the Annual Meeting.

GOAL 2: PROMOTE AN INCLUSIVE ENVIRONMENT AT THE SER ANNUAL MEETING

The SER Annual Meeting is already becoming a more welcoming environment for all attendees by offering food options for various dietary restrictions, providing information about child-care availability during the meeting (in the online registration form), and establishing the Diversity and Inclusion Committee (16). SER could bolster these organizational changes with additional efforts to acknowledge the needs and identities of its diverse membership. SER could ask registrants if they require support services (e.g., American Sign Language translation) and ensure that all conference and event venues meet the Americans with Disabilities Act Accessibility Guidelines (17). Other considerations include spaces for prayer, rooms for lactating mothers, and all-gender bathrooms adjacent to the conference proceedings so members can avoid time-consuming trips to their rooms. Since SER Annual Meetings are typically held in hotels, many of the above suggestions will depend on existing facilities. Nevertheless, SER should consider these factors in choosing the venue, because explicitly advertising their availability demonstrates a commitment to the needs of members from historically disadvantaged groups.

SER has also made consistent efforts to establish inclusive programs and conference policies. Examples include the SER mentoring program, in which participants can match with a mentor on their identity; the policy of limiting each speaker at the Annual Meeting to 2 podium presentations (15); and the SER Code of Conduct (18). Future work could extend the code to include recommendations from the Geek Feminism Wiki (19), with practices such as preconference education for volunteers to support antiharassment policies. Additional efforts could sustain momentum from the “Black Epi Meetup” held at the 2019 Annual Meeting that resulted in #BlackEpiMatters and the @Black_epi Twitter account (Twitter, Inc., San Francisco, California), which “supports and uplifts epidemiologists representing the Black Diaspora” (20). For example, SER could advertise, support, and include this meetup in its official programming at future Annual Meetings and initiate additional identity meetups (e.g., for lesbian, gay, bisexual, transgender, queer+ communities or people of Latinx heritage).

GOAL 3: DEVELOP, COMPILE, AND DISSEMINATE BEST PRACTICES TO HONOR DIVERSITY IN EPIDEMIOLOGIC RESEARCH

We, as researchers, can honor diversity in how we talk and think about people in our work. All epidemiologic disciplines are bound by a common interest in defining populations, and we believe SER is uniquely positioned to facilitate conversations and establish standards on using accurate, nonstigmatizing language and research methods. Epi IDEAS has begun promoting inclusive language by expanding the core epidemiologic curriculum at the Johns Hopkins Bloomberg School of Public Health to teach about race versus ethnicity and sex versus gender as part of understanding the perils of measurement misclassification. We recognize that SER and other institutions have substantial knowledge in this area that could benefit the epidemiologic community with discussions through SER-sponsored activities.

For example, SER could highlight a different diversity-related theme each year to encourage members to cultivate awareness around and critically examine the language and methods used within that theme. Discussions could occur at the Annual Meeting (e.g., panels and plenary speakers) and outside of it (e.g., podcasts). At the end of the year, SER could summarize these discussions into abstract submission policies and stand-alone papers that would help researchers to respectfully talk and think about historically marginalized populations.

To begin, SER could explore the meaning of diversity. For instance, SERvisits focuses on epidemiologists from “underrepresented backgrounds” (7); however, this phrase may not fully represent SER’s underlying goals. Being “underrepresented” is highly contextual. Since women members dominate SER, does a man, based on his gender, count as “underrepresented”? Instead, more accurate phrasing might pull from the NIH definition, “underrepresented in health-related sciences on a national basis” (21). In addition, if SER aims to apply a justice-oriented framework to the creation of an equitable society by subverting oppression perpetuated by people and systems, phrases like “historically disadvantaged/underprivileged” or “socially oppressed” might be more appropriate (22). These terms recognize the socialization processes that create dominant identities with privilege and subordinate identities without it (23).

Another topic could be the positive changes that SER recently made to their membership and event registration forms to offer more inclusive gender and race/ethnicity options. We suggest that most epidemiologists would benefit from conversations with one another and education from experts on best practices for gathering these data. One opportunity could be a discussion on the Williams Institute’s recommendations to collect data on biological sex (e.g., male, female, intersex) separately from information on gender (e.g., select all that apply: man, woman, trans, nonbinary, agender, a gender not listed) (24). The discussion could touch on arguments for a “select all” option for gender and why one should exclude the term “other” as a gender and race/ethnicity option. We also suggest discussions on the use of compassionate, people-centered language (e.g., “people living with human immunodeficiency virus (HIV)” instead of “HIV-infected people” or “person lost from care” instead of “defaulter”) (25).

Many epidemiologists are also trained to talk about and use race as a confounder when economic, neighborhood, and other social determinants might be more accurate causal variables. “Race” is a social construct, distinct from genetic ancestry, and the term is rampantly misused in our practice, which perpetuates the myth of its biological basis (26). Race is also often used as a proxy for socioeconomic position or racism, without discussions of the limitations and implications of doing so. We recognize that several prominent epidemiologists in SER have written on this topic (27–29), and it would be beneficial to continue educating SER members and considering these concerns during abstract selection.

GOAL 4: INCREASE PRIORITIZATION OF HEALTH DISPARITIES RESEARCH AND METHODS

We recognize epidemiologic methods as a frequent focus and unique strength of the Annual Meeting. We also see opportunities to further emphasize health disparities research and methods. This work is particularly important to prioritize, since health disparities often arise from the same systems of injustice and exclusion we aim to dismantle through diversity and inclusion efforts. Yet, at the 2019 SER Annual Meeting, only 3 of more than 50 sessions were dedicated to health disparities research—1 on diversity and inclusion, 1 on novel methods in disparities research, and 1 on race as a social construct (30). These disparities-focused seminars are typically hosted in too-small rooms (that overcrowd due to high interest), which may make disparities-focused researchers feel less valued by SER.

The choice of valued focus topics and methods throughout SER’s programmatic offerings has implications for attracting people from historically disadvantaged racial/ethnic groups to SER. A recent analysis of NIH funding found that Black investigators more frequently choose research on health disparities, reflecting the persistent disparities experienced by their communities (31, 32). In a follow-up commentary, Carnethon et al. (33) highlighted that NIH reviewers typically do not prioritize health disparities, thereby disadvantaging Black investigators in the grant review process. Bringing a renewed focus on disparities research to SER would have implications for the diversity of conference attendees and our field by 1) helping scholars from historically disadvantaged racial/ethnic groups feel more welcomed by demonstrating that their research interests are valued and 2) influencing senior Society members in positions of scientific and editorial leadership whose opinions on important research topics may be determined—consciously or subconsciously—by national scientific meetings. In this way, SER can help emphasize diverse research and researchers, influence reviewer priorities, improve funding rates for these scholars, and ultimately improve the diversity of the field.

CONCLUSION

In summary, increasing diverse engagement in SER will positively impact the entire field of epidemiologic research. SER has long been a pioneer in promoting inclusion and diversity. We recommend that SER further its actions, as outlined above, to adopt inclusive conference practices, increase the visibility and voices of people from historically disadvantaged groups, promote best practices to honor diversity within our field, and prioritize health disparities research and methods.