Inequity Within: A Call for Inclusion of Latina/o/x Scholars in Faculty and Leadership Ranks in Schools and Programs of Public Health

Social justice and health equity have become the banner of contemporary public health. Although public health has its origins in American colonialism and patriarchy, many members of the public health community embrace and lead efforts toward health equity here and abroad. Yet, within academic public health, schools and programs continue to systematically exclude Latina/o/x from faculty and leadership roles.^1,2

The data break the silence. Of the 10 326 total public health faculty in the United States, only 416, or 4%, are Latina/o/x (Association of Schools and Programs of Public Health [ASPPH] Data Center, unpublished data, February 2021) despite representing 18.7% of the US population. ³ The data on public health faculty are from members of ASPPH (n = 135), of which 65 are schools and 70 are programs of public health. ⁴ However, in total, there are 227 institutions accredited by the Council on Education for Public Health (CEPH), of which 68 are schools of public health, 139 are programs of public health, and 20 are stand-alone baccalaureate programs. ⁵ By faculty rank, the racial and ethnic disparities are glaring: 68.6% of full professors are White and 3.1% are Latina/o/x; at the associate professor level, 61.6% are White and 4.9% are Latina/o/x; at the assistant professor level, 53.8% are White and 4.8% are Latina/o/x. Similarly in medicine, Latina/o/x people represent 3.2% of faculty and only 5.1% of faculty across all universities.^6,7 In this article, we refer to Latina/o/x as a diverse group of people representing more than 20 nations, primarily from Latin America; Mexican American and Puerto Rican people represent about 75% of this group. Latinx emphasizes gender inclusion and affirmation in the Latina/o/x community.

The problem is clear. We cannot reduce the burden of disease, or effectively address pandemics as they affect people of color, when we exclude those same people from the work of developing solutions. We need underrepresented minority faculty to attract, retain, and promote faculty of color.^8,9 Education is richer when classrooms, textbooks, and laboratories represent the diversity of our society, and health organizations and programs can be more effective than what they are now when their workforce is diverse and able to create and sustain community engagement.

Public health has a racial and ethnic equity problem. Decades of state and federal defunding, racism, and the toxic academic culture (eg, isolation, individualism, competitiveness) for scholars of color have diminished the already limited number of Latina/o/x public health faculty and weakened pipelines and pathways.^10,11 Public health academic institutions have yet to move from statements and offices of diversity and inclusion to meaningful and tangible change, which is a major obstacle to achieving health equity.

The problem is deep and will take generations to solve. This is not the first time (and will not be the last time) that racism within the health professions has been called out. The Sullivan Commission provided strong evidence and policy recommendations in 2004. ¹² Unfortunately, we believe the changes have not been substantial. For example, the Health Careers Opportunities Program, managed by the Health Resources and Services Administration, showed some success, yet its funding has been harshly reduced by the federal government. We will insist and continue, at the very least, raising our voices against racism and in support of policy change and restoration of funding.

We are a national collective of Latina/o/x public health faculty that remain deeply concerned with the lack of representation in faculty and leadership roles in our academic institutions (https://www.latinpublichealth.com/who-we-are). We come together to speak up and request action. We stand united in this call with our systematically excluded African American/Black and Native American colleagues and are inspired by the brave efforts of Centers for Disease Control and Prevention (CDC) employees, who recently demanded an end of the agency’s culture of racism.^13,14 We will support each other against strategies to divide us.

Public Health Implications

We invite our leaders and colleagues from academic institutions as well as the American Public Health Association, ASPPH, the National Institutes of Health, CDC, and CEPH to join us in this call to increase the representation and power of Latina/o/x faculty in our schools and programs of public health.

We urge schools and programs of public health, as well as their respective leaders—from deans to boards of trustees—to endorse and take the following 8 actions. These recommendations are based on our collective knowledge and promising practices across disciplines and institutions ¹⁵ :

1. Publicly acknowledge the racial inequity on faculty ranks and the need to recruit, retain, and promote Latina/o/x faculty. We ask institutions to make a public statement (eg, on a website or newsletter) and endorse this call.

2. Make publicly available the racial and ethnic composition of faculty and staff. Data should include gender composition, rank, and type of appointment (eg, full-time equivalency; tenure, nontenure, or temporary; and funding structure).

3. Develop a plan to achieve racial and ethnic diversity and inclusion in faculty, staff, and leadership. This plan should have measurable goals and a time frame and should be made publicly available.

4. Commit to hire new tenure-track Latina/o/x faculty until the organization’s diversity and inclusion goals are achieved. We recognize that the 2016 and 2021 CEPH criterion G1 requires an identification of “self-defined priority under-represented population” for faculty.^16,17

5. Include Latina/o/x faculty in the organization’s leadership team, beyond offices of diversity and inclusion, and provide resources for them to succeed.

6. Ask accrediting bodies and funders to set and apply rigorous and enforceable criteria for racial and ethnic inclusion and diversity for schools and programs of public health. CEPH requires accredited units to identify underrepresented priority populations, but this has not yet produced documented, meaningful changes.

7. Engage in institutional culture transformation to lessen racism within the organization. This change could include policies and programs, such as incentivizing departments to recruit and retain underrepresented faculty of color and institutionalizing mentoring of faculty. Such policies and/or programs should be made publicly available.

8. Include Latina/o/x faculty and staff in the leadership of our major public health bodies, such as ASPPH and CEPH.

Let’s face it: do we continue profiting from the “health equity” agenda while excluding Latina/o/x people from faculty and leadership ranks? Or do we acknowledge the racism within and act to transform it right now as an essential step toward health equity?

Our drive is to move beyond diversity and inclusion. Our aim is to dismantle and uproot the system that has taken us to this call. We, Latina/o/x faculty, demand our place at the table to change academic public health and fulfill the promise of health equity and social justice.