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Advocacy and Action: How Eve Higginbotham Is Dismantling Racist and Sexist Systems One Step at a Time

Eve Higginbotham

Between the pandemic’s disproportionate impact on communities of color, widespread economic hardship destabilizing society’s most vulnerable individuals, and nationwide demonstrations calling for the long-overdue dismantling of racist systems and institutions, the spotlight on some of the country’s most deeply entrenched issues has only become brighter.

Through all of these challenges, Eve J. Higginbotham, SM, MD, ML, vice dean for Inclusion and Diversity and professor of Ophthalmology at the Perelman School of Medicine (PSOM), has been busy sharing her voice and taking action.

She crafted an open letter sharing her horror and hope following the murders of George Floyd, Breonna Taylor, and so many other Black individuals at the hands of the police; moderated an emotional and enlightening virtual dialogue that delved into the meaning of this movement and the path to antiracism; and has served as a driving force behind Penn Medicine’s Action for Cultural Transformation (ACT) plan. Developed through a partnership between the Office of Inclusion and Diversity and Penn Medicine Academy, ACT serves as a framework for sustainable change across the health system and aims to eliminate racism, mitigate bias, better support the diverse communities we serve, and create a culture of diversity, inclusion, and equity.

Higginbotham has also long been invested in investigating the barriers that women — and particularly women of color — face in science, engineering, and medicine. A member of the National Academy of Medicine (NAM) since 2000, she serves on the NAM council and currently chairs a committee examining the impact of COVID-19 on the careers of women in these fields. She also recently served as a reviewer for a report published by the National Academies of Science, Engineering, and Medicine (NASEM) titled, Promising Practices for Addressing the Underrepresentation of Women in Science, Engineering, and Medicine: Opening Doors.

In the Q&A below, Higginbotham reflects on the findings of this groundbreaking report, the watershed moment that we all face, and how Penn Medicine is rising to the occasion and taking action.

Q: Tell me about NASEM’s recent report. What was your role, and what were some of the key findings and recommendations?

A: The report laid out recommendations for institutions to improve the representation of women in science, engineering, technology, mathematics, and medicine (STEMM). Even though more women are entering these disciplines, they’re still underrepresented. This report showed how bias, harassment, and discrimination often keep women from pursuing or advancing in STEMM careers. As a reviewer, it was my role to make sure this report effectively delivered its points, was evidence-based and authoritative, and met the rigorous standards of NASEM.

I have been interested in gender, ancestry, and building a diverse workforce and inclusive culture my entire career, so I’m really excited about the suggested interventions — like collecting demographic student, trainee, staff, and faculty data to keep institutions transparent and accountable, establishing mentorship and sponsorship programs to increase opportunities for professional development, and addressing funding disparities for women and underrepresented researchers.

Q: Conversations about representation and diversity in STEMM have been going on for a while, but more people are tuning in. Does this report take a novel or noteworthy approach?

A: Yes! I’ve never believed that you need to reinvent the wheel, and this report does an excellent job of building on the work of others and bringing that evidence for successful impact forward. But I really appreciate that it acknowledges that different disciplines and institutions have their own cultures, so there isn’t a one-size-fits-all strategy or solution.

Related to that, what’s most exciting to me is the report’s focus on intersectionality and how it deepens the understanding around bias and discrimination. [Coined by Kimberlé Crenshaw, “intersectionality” is a framework that examines how multiple types of discrimination compound due to a person’s converging identities, such as their race, gender, and class.] The report is focused generally on women’s professional development in STEMM, but it emphasizes that there are systemic issues and knowledge gaps that more significantly impact women of color, LGBTQIA+ women, women with disabilities, and other women with intersecting identities, and can prevent them from overcoming unfair barriers.

The intersectional focus broadens the report’s impact. We all have intersecting identities, and this report speaks to the importance of making the pie bigger for everybody. An inclusive environment is enriched by diverse perspectives, and people who are used to being in that environment are encouraged to think differently. By broadening opportunities for growth for all women, doors are opened for everyone, and there are new opportunities to innovate.

Q: Do you see any connections between the guidance offered by the report and the goals of ACT?

A: Given the pivotal moment that our institution and country are facing, the NASEM report is very timely. When it was published, I brought it to the attention of J. Larry Jameson, MD, PhD, [dean of PSOM and executive vice president of the University of Pennsylvania for the health system] because we share an interest in recruiting, retaining, and supporting diverse faculty, staff, and students, and cultivating an inclusive environment. The research emphasizes the importance of dedicated leadership, and I believe we are seeing that across Penn, as evidenced by our leaders’ commitment to cultural change. I also believe the suggested interventions will inform ACT’s long-term goals. We’re still getting feedback about what changes and conversations our faculty, staff, and students are prioritizing, but I think this report will help us translate possible solutions into practical, promising actions.

Q: The oft-used metaphor is that building more equitable, inclusive systems is a marathon, not a sprint. What has ACT accomplished so far? Why must Penn Medicine seize this moment and create sustainable change?

A: There are two main parts to ACT — long-term strategies that reflect ongoing needs at the system and entity levels, and “Just Do Its” that immediately make a difference. We’re maintaining an intersectional focus by welcoming ideas from town halls, facilitated discussions, and online feedback because we don’t want to miss any perspectives. However, though it will take time to develop plans with timelines and metrics, we can also check off quick, impactful priorities as we go. For example, a painting featuring an enslaved person was removed from HUP’s OB/GYN conference room, and by the end of the year, every member of the workforce will have completed unconscious bias training.

I think this is a really critical moment. This is a time in which we can come together as a community to accomplish a single goal: creating an antiracist and antisexist health system. It’s a complex goal, and many conversations still need to happen, but there’s nothing more powerful than a community being galvanized and pushing to become the best it can be. The most inclusive, the most innovative, the most equitable…. This is an opportunity for all of us to come together as one Penn Medicine and use the power of the people to make change that will benefit everyone we work with, care for, and teach.

Q: Fighting for justice, equality, and inclusion requires balance and resilience — no easy feat during a global pandemic. What keeps you motivated and hopeful?

A: My husband and my Peloton (no financial interest)! Exercise and spending time with my family provide a great starting point for any day. In addition, a sense of purpose keeps me grounded, and I truly am hopeful that the events of the last several months will bring change.

I’m also always inspired by my patients, especially now; they’re still coming in for highly technical tests during a pandemic, so it feels like there’s a meeting of the minds during their appointments. I’ve also had the privilege to serve as a counselor and mentor for many people during this period. I am so grateful for those opportunities because it is easy to slip into despair if you believe no one cares about your personal and professional well-being. And now that Penn Medicine has expressed a commitment to transform its culture, and we’ve made progress on our ACT initiative, I have that sense of purpose nudging me on — even when I only get a few hours of sleep!

Q: What would you like readers to do after finishing this Q&A?

A: Get involved. Embrace opportunities to learn from diverse perspectives. Examine your biases. Become a mentor. Tell us what we can do better as leaders. Share your priorities and areas of focus. Everyone has a role to play in the process and can make a difference.

To learn more about Penn Medicine’s Action for Cultural Transformation (ACT) initiative, visit the Office of Inclusion and Diversity’s website.

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