Incorporating the social and structural determinants of health into clinical practice: Creating a welcoming practice and building diversity among the health care team

Despite extensive research documenting the potential of diversity, health equity, and inclusion initiatives to improve outcomes for the most vulnerable patients, attacks on these efforts in both private and public sector health care institutions are proliferating. Given demographic trends in the United States, diverse health care teams are a strategic necessity to bolster the experiences and outcomes of marginalized patients, foster inclusive research and innovation, and lower health care expenditures. To create diverse health care teams, physicians and allies must deepen their understanding of the complexities of structural racism and address the socially imposed forces that persist and result in the loss of underrepresented minorities on the path to health careers. Practicing physicians and other health care professionals can individually and collectively contribute to the development, recruitment, and retention of a more diverse and inclusive workforce to serve all patients. Strategies that physicians can use to achieve this goal include making diversity core to the practice's mission, focusing on retention, connecting with local school districts and colleges, and striving for more equitable policies and procedures.