Ralph Ellison’s 1952 masterpiece novel, Invisible Man, compares and contrasts being black in America in the South and the North. Towards the end of the story, the protagonist asks, “Whence all this passion toward conformity anyway? – diversity is the word. Let man keep his many parts and you’ll have no tyrant states.”1 Fast forward 70+ years and diversity has been thrust into society’s mainstream, dentistry included. Wright et al. wrote an editorial for JADA (April 2021) titled “Elevating dentistry through diversity”.2 A recent CDA Essentials issue invited the deans of Canada’s 10 dental schools to comment on dental education. In their brief statements, no fewer than six deans explicitly referred to diversity or equity, diversity and inclusion (EDI) initiatives at their schools.3
Some groups are still badly underrepresented in dental schools and in dentistry (e.g. blacks), but does it matter? After all, if we are each more accepting of differences, then things like race and gender and sexual identity will matter less, and more patients will automatically be better off. But really, no. Equitable societal outcomes require intention and attention.
If we follow EDI’s intended logic, then hearing previously unheard viewpoints should lead to a greater rate of advancement in the dental sciences, a greater breadth of knowledge, and a wider, more targeted set of treatment options. Greater dentist diversity should also lead to more people seeking care (“like attracts like”). The COVID pandemic taught us that health outcomes and healthcare are neither equal nor equitable even when there is a common threat. In Canada through 2021, the mortality ratio from COVID for blacks was 2.2 times higher than for the non-racialized, non-Indigenous population.4 When considering race and healthcare, both delivery and utilization show differences that put racialized populations at a disadvantage.5 I’m not aware of a Canadian dental study that illustrates this point exactly, but there a lot of related studies, so including dentistry is not much of a stretch.6 Outcomes matter.
As healthcare practitioners, our mandate beyond primum non nocere is, or should be, to provide the best care possible equitably. If we each do a little something, then collectively, we’ll achieve a lot. Embrace EDI. Our communities with their “many parts” will benefit.
- Ellison R. Invisible Man. Second Vintage International Edition. Toronto: Random House of Canada; 1995.
- Wright JT, Vujicic M, and
- Frazier-Bowers S. Elevating dentistry through diversity. The Journal of the American Dental Association, 152(4): 253-255, 2021.
- CDA, Dental Education in Canada: The Deans’ Perspective. CDA Essentials, 9(6): 22-31, 2022.
- Gupta S and Aitken N. COVID-19 mortality among racialized populations in Canada and its association with income. Statistics Canada, released August 30, 2022. https://www.150.statcan.gc.ca/n1/pub/45-28-0001/2022001/article/00010-eng.htm
- Ben J, Cormack D, Harris R, and Paradies Y. Racism and health service utilisation: A systematic review and meta-analysis. PloS One, 12(12): 1-22, doi: 10.1371/journal.pone.0189900, December 18, 2017.
- Mahabir DF, O’Campo P, Lofters A, Shankardass K, Salmon C and Muntaner C. Experiences of everyday racism in Toronto’s health care system: a concept mapping study. International Journal for Equity in Health, 20: 74-89, 2021.
About the Editor
Peter Nkansah is a Dentist Anesthesiologist witha private practice in Toronto. He is a member of the editorial board for Oral Health, an Assistant Professor at the University of Toronto’s Faculty of Dentistry and Past-President of the Canadian Academy of Dental Anaesthesia.
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