Utah and Minnesota have abandoned their controversial guidelines that made race a factor in deciding who receives Covid treatment, but it’s worth asking how such policies could have been passed in the first place. Part of the answer lies in the standards that inform public-health education and practice. Today, for anyone working in public health, embracing “health equity” has become a professional requirement.

In 2016, the Council on Education for Public Health—the agency that accredits schools of public health—updated its requirements to emphasize the importance of “health equity.” According to these standards, anyone who receives a masters of public health must be able to “discuss the means by which structural bias, social inequities and racism undermine health and create challenges to achieving health equity at organizational, community and societal levels.” Likewise, schools of public health must make “systematic, coherent and long-term efforts to incorporate elements of diversity.”

How do these requirements manifest? The University of North Carolina’s Gillings School of Public Health recently released an updated Inclusive Excellence Action Plan—a laundry list of diversity, equity, and inclusion measures. The plan cites the Council on Education for Public Health requirements, and mandates that “racism, social justice and health equity are integrated throughout and across curricula,” and that diversity, equity, and inclusion efforts be a condition for faculty promotion and tenure.

Across the country, public-health schools have adopted virtually indistinguishable plans. Last year, the Johns Hopkins Bloomberg School of Public Health—which ranks first in the country—released its Inclusion, Diversity, Anti-Racism, and Equity (IDARE) Action Plan. Measures include required land acknowledgments at school events (statements noting that the events are located on former Native American land), a new core competency “addressing the importance of IDARE in public health” required for all curricula, and new course evaluation questions on “diversity, inclusivity, anti-racism, and equity in the classroom climate and curriculum.”

The Harvard T. H. Chan School of Public Health, another top-ranked program, implemented many of the same policies in a plan called Foundation for Sustainable Progress and Transformation, including a social justice curricular review and employee performance reviews that assess DEI contributions. It also requires each department within the school to develop a diversity action plan, ensuring multiple layers of DEI programming.

The University of Minnesota School of Public Health adopted an especially ambitious Strategic Plan for Antiracism. Again, the plan mandates a new curriculum that prioritizes “antiracism and health equity,” along with faculty performance reviews that evaluate DEI contributions. Faculty who disagree with the progressive conception of social justice will face pressure to keep quiet. The plan also takes aim at admissions standards, calling on the school to remove its GRE requirement in favor of a holistic review, in which candidates receive consideration “regardless of whether or not they can demonstrate the prerequisites.”

In each plan, the message is clear: public-health professionals must commit themselves to advancing “health equity.” And as it turns out, this imperative aligns with new professional standards.

In October 2021, the Council on Linkages Between Academia and Public Health Practice revised its Core Competencies for Public Health Professionals, “a consensus set of knowledge and skills for the broad practice of public health.” The Council on Linkages is a collaboration between 24 public health organizations, including the American Public Health Association, the Council on Education for Public Health, and the Public Health Accreditation Board, which accredits state and local public-health agencies. Approximately 80 percent of state health departments and 90 percent of academic public-health programs use its competencies.

The update created a new category of “health equity skills.” Now, a competent public-health professional “applies principles of ethics, diversity, equity, inclusion, and justice,” “collaborates with the community to reduce systemic and structural barriers that perpetuate health inequities,” and “engages in advocacy for health equity and social and environmental justice,” to name just a few. Given the political connotations of terms like “inclusion,” “social justice,” and “health equity,” it’s no wonder that public-health officials embrace race-conscious policies by default.

The purveyors of “diversity” and “equity” share much in common with our public-health establishment—most of all, the notion that a better society can be forged through managerial dictates. The two have now joined forces. Even with increased public skepticism, expect more unpopular policies in the name of “health equity.”

Photo by Ira L. Black/Corbis via Getty Images


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