ASN Positions

ASN Disagrees with SCOTUS Decision in SFFA vs Harvard

Thursday, June 29, 2023

The American Society of Nephrology (ASN) disagrees with the US Supreme Court's decision to limit the consideration of an applicant's race in the admissions process for higher education. The court's decisions in "Students for Fair Administration (SFFA) vs President and Fellows of Harvard College" will hamper long-standing efforts to diversify the health care workforce, including physicians, in the United States.

Medical schools, health care systems, and medical specialties like nephrology that embrace racial diversity are more innovative, more empathetic, more inclusive, and perform at a higher level (1). Such organizations also experience less turnover, are considered more satisfying workplaces, are financially more profitable, and impact the business sector more positively (2). Growing evidence indicates that race concordance between patients and their physicians results in higher levels of communication, trust, and adherence to medical advice (3).

Unfortunately, longstanding inequities within the educational system in the United States disproportionately disadvantage minoritized groups, especially Black Americans. From 1970 to 2020, the proportion of US medical school graduates who were Black Americans did not change significantly (from 2.8% to 6.2%) (4). By comparison, the proportion who were women increased from 8.4% to 49.6% (5).

The Supreme Court's ruling in this case will make it even more difficult for applicants from minoritized and historically disadvantaged racial groups to enter undergraduate programs from which candidates are accepted into US medical schools. This decision will also have wide ranging effects across undergraduate and graduate medical education as well as science, medicine, and health care. The court's decision is a step backwards from advancing diversity in the practice of medicine.

Of the more than 37 million people with kidney diseases in the United States, a disproportionate number are Black people (6). As is well documented, the kidney health of these Americans is unacceptable (7). Increasing diversity in the health professions, including nephrologists, will make it more likely that communities with a greater burden of kidney diseases receive better care.

ASN is committed to strengthening the diversity of health professionals, including nephrologists. While disappointed with the outcome of this decision by the Supreme Court, ASN will continue to work to increase diversity, whether racial or otherwise, within our specialty of nephrology because it will lead to improved outcomes for Americans living with kidney diseases.

References

1. World Economic Forum. The business case for diversity in the workplace is now overwhelming. April 29, 2019. https://www.weforum.org/agenda/2019/04/business-case-for-diversity-in-the-workplace/.
2. McKinsey & Company. Diversity wins: How inclusion matters. May 19, 2020. https://www.mckinsey.com/featured-insights/diversity-and-inclusion/diversity-wins-how-inclusion-matters.
3. Takeshita, J, Wang, S, Loren, AW et al. Association of racial/ethnic and gender concordance between patients and physicians with patient experience ratings. JAMA Netw Open. 2020;3(11):e2024583. doi:10.1001/jamanetworkopen.2020.24583.
4. Association of American Medical Colleges. Data & Reports. https://www.aamc.org/data-reports.
5. Campbell KM, et al. Projected estimates of African American medical graduates of closed historically Black medical schools. JAMA Netw Open 2020; 3:e2015220. doi: 10.1001/jamanetworkopen.2020.15220.
6. National Institute of Diabetes and Digestive and Kidney Diseases. Kidney disease statistics for the United States. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease.
7. Gadegbeku CA, et al. Identifying, confronting, and addressing systemic racism in US nephrology. Kidney News June 2021, 12–13. https://www.kidneynews.org/view/journals/kidney-news/13/6/article-p12_5.xml.