NEJM January 1, 2025
In response to race-based disparities illuminated by the Covid-19 pandemic, U.S. medical and health care institutions began to increase support for health-equity initiatives. Many important efforts have been launched under the umbrella of diversity, equity, and inclusion (DEI), such as increasing investigation of health disparities, amending clinical algorithms in which race is a determinative variable, recruiting more clinicians from underrepresented groups, expanding community engagement in research and health outreach, and training clinicians to reduce the effects of their own implicit bias.1 Although these efforts are critical, there is a risk of limiting DEI to an organizational philosophy without clear mechanisms for achieving its main goals. In contrast, justice-focused approaches utilize well-studied and broadly tested processes that address the underlying axes...
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