Renate B. Schnabel and Emelia J. Benjamin
The disparities amplified by the COVID-19 pandemic present disturbing evidence that we are far from cardiovascular health-care equity. Individuals, leaders and institutions must prioritize research, policies and structures to advance diversity, equity, inclusion and belonging — Diversity 4.0, a justice imperative, essential to advancing workforce excellence and cardiovascular health.
Introduction
A decade ago, Marc Nivet wrote for the Association of American Medical Colleges about the three phases of diversity1. Diversity 1.0 had an isolated focus on recruitment, laws and compliance, sometimes proffered (inaccurately) as potentially being at the ‘expense of excellence’. Diversity 2.0 emerged in the 1980s and emphasized the promotion of racial and ethnic student, faculty and staff ‘minority’ equity but remained siloed from the core academic mission in ‘minority’ affairs offices. In the past two decades, Diversity 3.0 recognized that diversity and a culture of inclusion were strategic imperatives to achieve excellence and health equity. However, with the inequities laid bare by the coronavirus disease 2019 (COVID-19) pandemic, and the Black Lives Matter and #MeToo movements, individuals and institutions in academic health sciences must come to the reckoning; incremental efforts will not achieve the transformation that is imperative for our times. We call upon academic health sciences to engage in Diversity 4.0 (Fig. 1). Individuals and institutions must actively engage in transformative personal and structural anti-racist, anti-sexist and anti-classist work to promote diversity, equity, inclusion and belonging (DEIB). A DEIB commitment will harness the innovation of all voices in academia to collectively address profound and persistent global structural health-care and workforce inequities.