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Investing in our Future: DCEG’s Path to Enhancing Diversity, Equity, Inclusion, and Accessibility

, by Jennifer K. Loukissas, M.P.P., Jackie Lavigne, Ph.D., M.P.H., Anil Chaturvedi, Ph.D.

Enhancing diversity, equity, inclusion, and accessibility (DEIA) benefits everyone in an organization. Experts in organizational management have demonstrated that diverse workgroups produce more creative problem-solving and imaginative approaches to the scientific enterprise.

To foster the potential of individuals from groups traditionally underrepresented in the sciences, we must commit to becoming anti-racist, combat unconscious and implicit bias, and strive for equity, inclusion, and access. Key characteristics of inclusion are the availability of equitable opportunities for career growth and the ability for individuals to contribute meaningfully to the mission of the organization. Accessible work environments ensure that employees can thrive regardless of physical, sensory, and mental health differences and further ensure that these characteristics are not a barrier.

In this article we pause and reflect on the accomplishments to date in DCEG, the activities underway, and the challenges on the path to increasing DEIA and becoming anti-racist.

Equity Origins in Gender Parity

Equity, Diversity, and Inclusion (EDI) have long been core values of the National Institutes of Health (NIH) and the National Cancer Institute (NCI). From our inception, DCEG has prioritized gender parity, which was built upon three foundational factors. First, a generation of female scientists in leadership positions championed junior female scientists and ensured gender equity. Second, leaders in DCEG and the scientific community supported female scientists with family responsibilities by providing flexible schedules and extended timelines for tenure-track investigators. Lastly, increases in the number of women earning degrees in epidemiology and genetics hastened gender balance across the field. Female scientists are further supported by peers who they elect to serve as Women Scientist Advisors.

With the hiring of Jackie Lavigne, Ph.D., M.P.H., to direct the Office of Education (OE) in 2007, DCEG expanded beyond gender to focus on recruiting and retaining individuals from groups traditionally underrepresented in the biomedical and scientific workforce. While we have borrowed some of the approaches to gender parity, a series of events in 2020 galvanized the community and stimulated a series of steps to re-orient the journey. In addition, the work of Professor Ibram X. Kendi has inspired many across the Division to take up the mantle of becoming anti-racist.  

Commitment to Recruitment, Training, and Retention of a Diverse Scientific Workforce

Dr. Lavigne has actively expanded our recruitment efforts via new NCI programs, attending professional and scientific meetings such as the Society for Advancement of Chicanos/Hispanics & Native Americans in Science (SACNAS) and the Annual Biomedical Research Conference for Minoritized Scientists (ABRCMS), participating in the NIH High School Training and Enrichment Program (HiSTEP), and encouraging fellows to compete for diversity-focused training and leadership opportunities. In 2018, the NCI Center to Reduce Cancer Health Disparities (CRCHD) launched the Intramural Continuing Umbrella of Research Experiences (iCURE) Program, which supports mentored research experiences for qualified students and scientists from diverse backgrounds in the multidisciplinary intramural research environment of the NCI. DCEG has welcomed iCURE scholars every year; our fifth cohort arrived this fall.

The result has been a steady increase in the diversity of our fellows—at present, close to one-third identify as belonging to racial or ethnic groups underrepresented in the sciences. These successes have been recognized by colleagues in the scientific community. 

While these activities were underway through OE, the 2020-2025 DCEG Strategic Plan also prioritized the pursuit of a diverse workforce through recruitment and retention. Two new positions were established to support that goal. In 2021, Anil Chaturvedi, Ph.D., senior investigator in the Clinical Genetics Branch, was appointed as the Senior Advisor for Faculty Development to enhance diversity across scientific ranks by aligning recruitment with high-need areas; develop scientific, career, and leadership skills of investigators and staff; and foster an inclusive, equitable, accessible, empowering, and nurturing work culture as we pursue scientific excellence. He is working closely with Dr. Lavigne, Hannah P. Yang, Ph.D., Sc.M., Associate Director, Branch Chiefs, the DCEG Promotion and Tenure Review Panel, and search committees to ensure diverse applicant pools to fill current scientific openings. This fall, the Division hired DEIA resource specialist Erica N. Johnson, Ph.D. Working in collaboration with this team, Dr. Johnson will strengthen outreach for recruitment, enhance DEIA knowledge and activities, and develop and implement monitoring and reporting processes.

While we have made progress within our trainee population, to accelerate diversity among senior scientists, DCEG piloted the Multi Principal Investigator Search (MPIS). This mechanism aims to recruit established, tenure-eligible scientists into our scientific program and workforce at senior levels. Dr. Jonine Figueroa, a Latina scientist whose research includes studies of breast cancer risk in Black women, has been hired through the MPIS and will join the Division as a senior investigator in early 2023.

Advancing Health Disparities Research Across the Division

The DCEG strategic plan also emphasized the need to expand our research on cancer health disparities. Division leadership convened an ad hoc Advisory Group, made up of experts from DCEG and colleagues from the NCI and NIH more broadly, to advise on the realistic scope of distinctive goals, including flagship initiatives, deliverables, and resource requirements. Their recommendations are expected in the coming months. Meanwhile, a number of descriptive studies are already underway: investigating cancer risk among transgender individuals, inequities in cancer mortality risk, premature mortality across race, ethnicity, socioeconomic status, and geographic location, and worrisome trends in uterine cancer mortality among Black women.

To encourage novel investigations, the Division has initiated and participates in new competitive funding awards: the Fellows Cancer Health Disparities Research Award, launched in 2021, and the Center for Cancer Research (CCR)/DCEG Health Disparities Flex Award. Trainees conducting health disparities research have been recognized with funding awards from the National Institute on Minority Health and Health Disparities

Concurrent with the strategic planning process, the fellows identified the need for a platform to explore important research questions in health disparities, including but not limited to cancer. In quick succession, they launched the Fellows’ Cancer Health Disparities Interest Group (CHDIG) in February 2020 and planned the Annual Fellows’ Scientific Symposium to focus on research on underrepresented groups that spring. In 2021, together with investigators from DCEG, CCR, and CRCHD, fellows helped to coordinate the third NCI Symposium on Cancer Health Disparities exploring inequities in rural and Native populations, financial toxicity, and evidence-based strategies to reduce disparities. This year, the topic for the Annual Fellows’ Scientific Symposium was health disparities and environmental justice.

The CHDIG works closely with the DCEG Cancer Health Disparities Working Group (CHDWG), established in the summer of 2020. This year, together with the Center for Cancer Research Health Disparity Steering Committee, the working group and interest group co-organized the first intramural health disparities workshop. DCEG experts also participated in NIH's Health Disparities Interest Group workshop.

Weaving DEIA into the Fabric of DCEG

In addition to their ambitious scientific activities, fellows have led several important initiatives to support DEIA in the workplace: the 2018 Annual Fellows' Survey identified opportunities to improve organizational culture, encourage discussion of topics related to DEIA, and address gaps in interpersonal communication that were having a negative impact on their well-being.

Spurred by these findings, DCEG fellows conceived of and launched the Inclusivity Minute Project (IM), well before the establishment of the NIH UNITE initiative and the NCI Equity and Inclusion Program (EIP) or Equity Council. The success and popularity of the IM Project is evidenced by its syndication across the NCI: IMs are regularly featured in NCI leadership messages to staff and the NCI Equity and Inclusion newsletter (subscription via GovDelivery), and the IM Project appears on the NCI website’s list of Equity, Diversity, and Inclusion Blogs. 

While subsequent Fellows' Surveys indicate improvements, it is clear we still have work to do. With each year of data, we identify opportunities to grow and learn in response to the information that fellows share with us.

Navigating the Catalytic Events of 2020 

While working from home in the spring of 2020 amid the global pandemic, many DCEG staff—like many across the United States—were traumatized by the brutal murders of George Floyd, Breonna Taylor, and others. In June, we reached out to the NIH Office of the Ombudsman to help us provide a space to talk, reflect, and consider productive strategies for engaging with each other on the serious events of that time. The Ombudsman’s office facilitated Division-wide discussions and an anonymous survey of staff which produced two important outcomes. First, a virtual suggestion box, which remains in use and served as the blueprint for the Anonymous Feedback Tool, operated by the NCI EIP. Second, the creation of what came to be known as the DCEG Anti-Racism and Inclusivity Working Group (ARIWG). ARIWG has evolved organically, and today hosts bi-monthly meetings for ongoing dialog and education with participants from every branch and across all career stages; everyone in the DCEG community is welcome and encouraged to join.  

Despite meaningful engagement with the Ombudsman’s staff around DEIA and the awareness-raising of the IM Project, the Annual Fellows’ Survey data in 2021 revealed instances of microaggression related to a person’s race, gender, and/or sexual orientation happening in parts of the Division, with similarly concerning feedback from representatives of the CHDIG and the DCEG Committee of Scientists. Once again, we turned to the Ombudsman staff, as well as experts in the NIH Office of Equity, Diversity, and Inclusion, and NIH Civil Program to help us navigate the way forward. In the fall of 2021 through early 2022, Ombuds staff facilitated dialogue with the entire Division in a town-hall style meeting and met with smaller groups at the branch and office level. Staff took advantage of training on topics like civility in the workplace and unconscious bias. 

The work to continue to educate ourselves about the importance of DEIA, become actively anti-racist, and engage in conversations or behavior change to foster the well-being of all employees is ongoing. With these actions and the hiring of Dr. Johnson, we are hopeful for even more progress in the future.

What Does Inclusion and Accessibility Look Like for DCEG?

The Division and other groups across the NCI have taken steps to ensure our workplace is inclusive of non-binary and transgender individuals. The NCI training directors advocated successfully for the establishment of a gender-inclusive bathroom, following the example of the NIH Clinical Center (facilities are located on the Shady Grove 2nd floor conference level). The leadership of the NCI and NIH are in the process of codifying a policy that would expressly communicate the right of all staff to use the bathroom that aligns with their gender identity.

Working within a federally managed building means that our facilities were designed to be fully accessible, as required by the Americans with Disabilities Act. Outside of the physical space, our digital content is accessible via a screen reader and optimized for low-vision and color blindness, and all video content is captioned. Staff in the DCEG Communications Team who have expertise in accessibility provide technical support to investigators in advance of posting research tools and other materials to the web. Reasonable accommodations are provided upon request for staff workspaces and at meetings.

Change at the NCI, NIH, and Wider Ecosystem

While these activities are helping to improve DEIA within the Division and help us become increasingly anti-racist, our work is far from complete. The NIH UNITE and NCI EIP are actively working on making structural changes to address inequities within extramural and intramural programs and in NCI-funded research. DCEG staff are active participants in the Equity Council and related working groups, and in the implementation of the NCI Racial and Ethnic Equity Plan (REEP); each NIH Institute and Center has developed a REEP in response to the UNITE “I” committee’s focus on changing the NIH organizational culture and structure to promote diversity, equity, and inclusion throughout the NIH workforce.

While this path is often steep with unexpected obstacles, back-tracking, and renavigating a regular part of the process, we are committed to building on our strong history as we strive to become anti-racist and push for DEIA. As these four qualities become ever more enshrined in the fabric of the Division, we want to ensure that our workforce feels heard and supported; each individual is happier and more productive; and our science benefits from novel viewpoints of investigators from a wide range of backgrounds, abilities, and cultural and life experiences.

Learn more about DEIA through these NIH resources.