The woke roll back continues

I don’t think it’s rolling back on all the progress- it’s recognizing that DEI in its current form (T-centred, doctrinaire and spiteful) is undesirable to customers, the majority of employees, and employment tribunals.

@GustyFinknottle

The only clear cut case of racial discrimination I have seen in a hiring process was when a black male who the interviewers acknowledged was the best person for the job was actively passed over in favour of a white transgender woman who was also very vocal on DEI initiatives and who the interviewers feared (probably correctly) would make a big discrimination issue if not hired.

The black male meanwhile just wanted to get on with the job and when not hired, his view was f' them and very quickly got a job with a competitor on double the money.

Oh, come on — let's not pretend that the T-takeover of DEI hasn't been catastrophic for disabled people in particular, but also for lesbians and gay people for whom gender ideology is actively homophobic. With all the emphasis on the T (which is heavily skewed towards white, middle class and largely male individuals) I'm hearing from black friends that they feel racism is creeping back into their organisations.

And lastly- we are doing the necessary research, setting up institutes to do so and working to fix the problem - which includes systemic racism!

There is now alot of money and effort dedicated to research into why the outcomes are poorer. There are significant research gaps that have been identified and need to be addressed. There have been calls for decades into more research funding to understand why Black women are 3X more likely to die in childbirth than others. And maternity care in general needs to improve and women are not listened to - but there is evidence that this particular women are even more ignored than women in general AND particularly by midwives of other races.

I have never seen any leader (and I am a national leader in healthcare) say anything about listening to the negligence of research. I cannot comment on what individuals say or bystanders. I am speaking from the perspective of healthcare leaders, policymakers and lead researchers.

Lastly the risk gene in South Asians for COVId acts in the context of other factors - which includes age, comorbidities, over-crowded housing etc. Which were all factors initially identified to have contributed to the higher rate of death in those communities in the first wave. And the identification of the gene was due to inclusive research, including people like Prof Mahendra Patel setting up the Centre for Research Equity at Oxford.

https://www.nihr.ac.uk/documents/nihr-challenge-maternity-inequalities-funding-call/35654

https://www.nuffieldtrust.org.uk/news-item/inequalities-in-midwifery-continuity-of-care-during-pregnancy

https://www.nhsrho.org/news/new-research-identifies-gaps-in-ethnicity-research-in-maternal-care/

@newmummycwharf1 no-one said listening was not important. That is not unique to black women, any woman who has been pregnant could probably tell you similar stories. The perception of differing pain thresholds, if I remember it correctly, said black staff also had that perception.

The point was that the emphasis was placed entirely on listening. The mere suggestion of using the data to investigate the reasons was deemed racist because it would distract from the idea that the NHS was systemically racist. These comments were made about the taskforce set up to look at the reasons

"The taskforce has been welcomed by some, including charities Tommy’s99 and Sands.100 However, Tinuke Awe said the failure in the original press release to specifically acknowledge the considerably higher mortality rate for Black women in particular, had upset and angered many stakeholders.101 Amy Gibbs emphasised the need for the Taskforce to address the issue of racial bias in the maternity system,102 and Dr Ekechi hoped that the Taskforce would focus on the “social and structural drivers that underpin the poor quality of health and poor outcomes”.103 "

So lets not have unbiased research and action, lets just decide in advance what the causes are.

The same thing happened with covid - lots of comments about how deprivation caused the higher death rates, something we now know to be influenced by genetics. A particular gene being more common in those of asian origin has been identified and once you know about that you can look for different strategies on things like vaccination, drug treatment and likelihood of needing ICU. If you persist in saying everything is racist then you dont do the necessary research.

HR as a profession is somewhat prone to fads - the CIPD’s Personnel Today in the UK and the Harvard Business Review in the USA are always publishing articles on the latest studies and developments that could potentially revolutionise HR and make organisations see the value in having HR with a seat at the table. Some of it is sensible, some of it is pure spin created to ensure that HR execs can justify their salaries, and some of it is overcomplicating things with theory and/or ideology that should be practical.

Indeed - these are real issues that need addressing. They is work to try and correctly classify including binary etc. But unfortunately, many opt out....

100% there was an article in the lancet a few years ago that was a study on women*

*and those who identify as women.

fucking terrible data collection obviously.

In clinical research- biological men are not counted as women. That would not be inclusive. The genetic drivers have not changed because of how you identify.

It's just a matter of time...

https://www.skynews.com.au/lifestyle/health/victorian-government-accused-of-insulting-women-with-inclusive-approach-to-pain-study-seeking-input-from-biological-males/news-story/d5e2346b1be14f9a6594dcc1380bee75

It gets tricky when nhs records, birth certificate and passport are all altered from male to female. Clinical audits are usually done using records, not face to face. I am glad I am long retired.

I agree. But also the US history with slavery and segregation, where Black women were not allowed to vote till 1965, where Black people could not get fair access to mortgages till 1968, could not attend the same school or university as White people until the 60s - means all of these issues of oppression are relatively recent and these students were starting from a very depressed starting point. Affirmative action was an effort to even begin to address those issues.

In the recent supreme court ruling, they acknowledged this was the initial basis of the race-based quota provision in the 1970s which was due to end in 2028 anyway.
This is not the case in the UK - so trying to follow what happens in the US is not useful here

In clinical research- biological men are not counted as women. That would not be inclusive. The genetic drivers have not changed because of how you identify.

However I can see areas where there may be issues. Eg a dermatology study where you are not doing any genetic testing and a biological man ticks female and the researcher agrees because they do look female and present as female.

More studies are breaking this down further so participants can tick the various gender options so the research is robust and accurate

The DEI issue in the States is down to White males who feel their privilege is threatened by the support being given to others.

This is the biggest load of bs I've seen for a while, and if you believe that I really have no reason to give any credence to any other parts of your analysis.

It does not happen naturally. It really does not. London has a population of almost 50% people of darker skin tones - yet the recognition of disease in these skin tones is recognised to be abysmal.

Examples include Black babies being diagnosed as cyanotic when that is just what their lips look like when first born. In London.

It was only in 2020 that a move has been made to address this in medical school curriculums.

The DEI issue in the States is down to White males who feel their privilege is threatened by the support being given to others. That is understandable - if the pot is finite and we are talking about better access for others - ultimately it will translate to less access for them or their offspring. Doesn't mean equity is not a worthy goal - it is and will always be. Those that inequity favors will have to accept that status quo is changing. Uncomfortable truth

Or the fact that women metabolise some drugs differently to men and therefore outcomes can be different and without involving more women in research - health outcomes for women are negatively impacted

...

This is why inclusive Research teams and inclusive research designs are critical.

But if the research / data counts biological men as women in the name of "inclusivity", then it will be useless.

The US had racial quotas for its top academic institutions in a way that we never did. Agree we're getting some of their backlash but generally not for things UK companies have been doing.

Heaven knows there's enough sexism and racism here to tackle, it doesn't help if we judge US activities and superimpose that analysis on our problems.

Well this is why the data needs to be gathered and analysed rigorously and robustly. And when that has been done and evidence is found (after taking into account confounders), then solutions need to be devised. That is not the time for whataboutery or denial

Data is data - after you have analysed it and found significant correlations that remain significant after controlling for other contributors or even just identified contributors - then yes, it is time for action.

The issue in healthcare ( possibly also elsewhere but don't know much about the data elsewhere) is that we now have the data in some areas that clearly demonstrates inequity but we have not utilised robust implementation science methodology to address them.

So figuring out how to solve the problem is where we are. This is why you will not see any leader in the NHS saying racism does not exist or is not systematic. They may say the current solutions are duff - and I can't argue with that because I do not think they have been scientifically assessed or evaluated but not that it does not exist. Because if you are in the system - it is pretty glaring and the cost is immense. Both for staff and patients and infact - society at large.

Last example - correlation between long waiting list (contributed to by staff off sick with stress from bullying and harrassment) and reduced economic productivity.

It's not just the TRA stuff though. People are also very cynical and unhappy with a lot of the racial elements. Just look at where it has gone in the US - that's where DEI comes from and that's the trajectory.

Well I would say that ancestry is what ethnicity means. Your ethnicity is a description of who your ancestors were.

Race is not a useful scientific category really.

Although there are practical elements with a medical practitioner dealing with darker skinned patients which are relevant to teach, though that tends to happen naturally where there is a fair mix in the population.

This is true and ancestry and race are often used interchangeably though they mean different things.

Genetic differences (linked to ancestry) can influence how we metabolise drugs for instance - meaning some treatments work better on some than others. An example is people of Bangladeshi origin many of whom are not able to metabolise clopidogrel - which is commonly used to prevent secondary Cardiovascular events. Prescribing this treatment enmasse without this knowledge meant some heart attacks that may have been prevented weren't and the drug cost is wasted.

Or the fact that women metabolise some drugs differently to men and therefore outcomes can be different and without involving more women in research - health outcomes for women are negatively impacted

Etc etc

This is why inclusive Research teams and inclusive research designs are critical

I was worried that the backlash against the crazy TRAs would draw in and penalise other groups.

Many DEI initiatives have been hideously skewed towards the trans in recent years. Companies have adopted this for a range of reasons, including that this involves bugger all investment beyond marketing.

We still need DEI but we need sensible actions that support people in meaningful ways. This is more expensive for employers and brings less kudos than pretty flags.

This is a problem that stems out of the whole concept of systemic racism because people think it's a cause in itself, rather than a kind of generalized description of a set of actual, concrete causes.

And DEI is often quite shit for the same reason, they go on about systemic racism in the NHS, say, but don't actually look at the concrete causes - which exist if the phenomena is happening. Things don't happen without a cause.

Is it because of class differences, or individuals discriminating, or different cultural approaches to work for women? Are there confounding factors like age (which can be a significant one with race disparities.) There are all kinds of possibilities, but it's important to know which is relevant.

It's a lot like the concept of patriarchy in feminism, it tends to disguise the concrete causes, so people talk about it as if it's a thing out there by itself, acting on people.

I am old enough to remember helping with data collection around cervical cancer back in the 1980s. We asked women what their partner's job was. The rationale being that there might have been a connection with industrial or farming chemicals. A lot of women got very offended and refused to answer that question. In the end it didn't matter, but nobody knew what they were looking for at that time.

I will have a look at that paper, though not right now - but I am not sure why you wouldn't just answer the question.

Because actually, yes, it is about convincing people. If people think your method is ideologically biased and not supported by the data, they aren't going to support your DEI approaches, are they?

And they will be happy to see them go.

Quite a lot of people have become cynical about this because they have seen it at work in their own workplaces and that it has been either ineffective, or worse, unfair.. And also the kind of funding it seems to eat up, which is then not available for other things, and isn't a small amount of money in organizations either. It's a huge industry with a lot of people who really want it to continue.