Academic medicine has focused heavily on race and gender in DEIB research—but socioeconomic background has received far less attention.
Nearly 1 in 5 anesthesiologists surveyed at a major academic medical center identified as coming from a disadvantaged socioeconomic background—and they reported significantly different workplace experiences than their peers.
In this survey study from Brigham and Women's Hospital, 18% of respondents met the NIH definition of "disadvantaged background" (DB), a standardized proxy for socioeconomic status. Compared with colleagues, DB-identifying anesthesiologists were more likely to report exclusion (55% vs. 20%), verbal harassment (42% vs. 23%), discrimination (21% vs. 8%), racial invalidation (33% vs. 11%), and being "othered" (45% vs. 20%).
On Likert-scale measures, DB respondents reported feeling less valued and more likely to perceive that they had to work harder than peers to receive equal evaluations and be recognized as academic physicians.
The study applies the NIH's formal DB definition—which captures factors such as financial hardship, limited parental education, or growing up in medically underserved areas—to examine workplace climate. The authors note that, to their knowledge, socioeconomic background has not been well studied within DEIB research on academic medicine workplace experience, and that the NIH definition enables more systematic study of this dimension.
The findings suggest that DB status may be an important, but undermeasured, dimension of diversity in academic medicine. As Cody R. Sain, MD and colleagues write, "economic background may intersect with other minority backgrounds often highlighted in diversity scholarship, including race, ethnicity, gender identity, and sexual orientation, resulting in intersectional identities uniquely vulnerable to adverse workplace climates"—a dynamic this study was not powered to fully examine.
Limitations are substantial: this was a single-center, single-specialty survey with a modest sample size, and the researchers note the potential for nonresponse bias. Larger, multi-institutional studies will be needed to better understand how socioeconomic background is associated with experiences across academic medicine.
Within this cohort, the pattern is clear: physicians from disadvantaged backgrounds reported more frequent negative workplace experiences and a lower sense of belonging.
The authors reported no competing interests.
Source: JAMA Network Open
