A February petition on Change.org successfully fought back against a recent claim that the American Academy of Dermatology's (AAD) Diversity, Equity and Inclusion (DEI) Initiatives is politically motivated and supports racial division. The petition was started by three female dermatologists, Wendy Roberts M.D., Jeanine Downie M.D. and Heidi Waldorf M.D., to combat the criticism and promote excellence and inclusion in dermatologic care.
The AAD advisory board voted to reject the resolution to remove the DEI initiatives and expand the academy’s mission to prioritize diversity and address inclusion issues within the field, per NBC News.
Related: Embrace Diversity with Inclusive Skin Care
AAD's DEI Initiative
AAD launched a DEI initiative in 2022 and operates a website dedicated to its objectives that lists many different diversity initiatives on local and national levels. One of the initiatives is its Diversity Mentorship Program, in which medical students from underrepresented groups team up with a dermatologist of their choice for a month of one-on-one mentorship.
The AAD DEI statement of intent states, “The Academy believes in creating a diverse and inclusive environment where all its members have opportunities that enable them to succeed and thrive and is committed to ensuring quality medical care for all our patients regardless of race, ethnicity, religion, gender or sexual orientation.”
The Proposed Resolution
The “Sunsetting all diversity, equity, and inclusion (DEI) programs" resolution, which is no longer available online, was introduced by Brian Raphael, M.D., a dermatologist in East Syracuse, New York. According to Raphael, the resolution links the “DEI movement” to antisemitism and claims DEI efforts have evolved into an unfair political movement that stifles “diversity of thought” and creates a “racist” or “nonracist” binary. The resolution was co-authored by dozens of AAD members looking to cease the DEI initiatives and programs implemented by the institution, per NBC News.
Doctors opposing the resolution requested specific examples of members experiencing antisemitism to be presented to the DEI committee and AAD board so that the issues could be addressed directly and corrected immediately. Skin disease in people of color is under-diagnosed, often goes untreated and is more deadly, due to a lack of experience and proper training in the differences presented in variable skin types.
“We celebrate diversity in all forms including, but not limited to, religious, ethnic, cultural, gender, and racial identities and aim to improve disparities in health care,” AAD president Terrence Cronin Jr. told NBC News. “We aren't opponents of any form of antisemitism, Islamophobia, anti-Asian hate and racism of any kind.”
Dr. Raphael said in a statement to Allure that the resolution wasn’t received in the way he intended.
Lack of Dermatological Literature on Skin of Color
A 2023 study found the 5-year survival rate for skin disease is 66% for non-Hispanic/Black patients, compared with 90% for non-Hispanic Whites and the risk of surgical delay for melanoma was found to be increased in non-White patients.
According to data presented at the Maui Derm Hawaii 2024 conference in Wailea, Hawaii, there is a significant gap in the representation of sunscreen use in patients of color within medical literature. However, DEI initiatives have helped to reverse those trends.
Per the report, from 1988 to 2022, approximately 4.35% of the total 5760 papers referencing sunscreen focused on patients with skin of color. Researchers noted that the majority of these papers emerged post-2007, with a substantial increase noted since 2014. As of June 2022, 21% of total sunscreen papers were dedicated to patients with skin of color, indicating a potential record-high for the year.
According to the dermatologists who started the petition, a lack of representation can impact public health. Patients are less fearful of doctors they can relate to and are more likely to see them for potential issues. In particular, the petition points to a lack of Black physicians as promoting medical mistrust, late diagnosis and poorer health outcomes in a group that is traditionally distrustful of the medical establishment.
In an interview with Dermatology Times, Miranda Uzoma Ewelukwa, M.D., FAAD, emphasized the significance of DEI in dermatology training. She said that dermatologists should become involved in recruiting students from DEI organizations and incorporate more educational materials that show a variety of skin types and phototypes with certain conditions to improve training on diverse populations.
