Inclusion, Diversity, Equity and Access

The Academy of Nutrition and Dietetics believes supporting equitable access to food, nutrition and other lifestyle-related services includes incorporating and valuing a diverse spectrum of lived experiences and cultivating a nutrition and dietetics practitioner workforce that enhances and contributes to all areas of practice.

Impact Goals:

• Establish infrastructure and resources to achieve optimal and sustainable IDEA outcomes
• Increase recruitment, retention and completion of nutrition and dietetics education and leadership at all levels for underrepresented groups
• Cultivate organizational and professional values of equity, respect, civility and anti-discrimination
• Advance food and nutrition research, policy and practice through a holistic IDEA lens

A forward-looking and accessible nutrition and dietetics profession supports individuals from historically underrepresented groups and empowers practitioners to address systemic inequities while amplifying the voices of individuals who hold a variety of diverse characteristics.

A diverse health care workforce is proven to improve patient satisfaction, health communication and access to care for patients belonging to historically underserved populations,¹ yet the nutrition and dietetics profession is predominantly female and non-Hispanic white.² This imbalance in the health care workforce is not unique to dietetics. In fact, almost all health care professions included in the American Community Survey are comprised of a greater share of white practitioners than the U.S. workforce as a whole, demonstrating underrepresentation of people of color.³ Despite the need for diverse practitioners to serve a diverse public,^4,5 there has been little change in this area over the last decade.² In recent years, the health care workforce overall has increased in racial and ethnic diversity faster than the field of dietetics; however, these increases have been heavily concentrated among entry-level, lower paid occupations.^1,6 In recognition of the potential positive impacts of a more diverse workforce, the White House released a National Strategy on Hunger, Nutrition and Health that committed to a number of efforts to strengthen and diversify the nutrition workforce.⁷

To achieve a representative and diverse nutrition and dietetics workforce, students from historically underrepresented groups must be encouraged to pursue careers in the field of nutrition and dietetics. Furthermore, training and education needs to be supportive, inclusive and culturally humble, individualizing care to client culture and background.^3,8,9 Efforts to diversify the profession require a current understanding of the demographics of practitioners and students, including race and ethnicity, disability status, gender identity, sexual orientation and other factors, as well as the intersectionality of these factors, so that efforts to expand diversity can be monitored over time.^10,11 The Academy recognizes the need for recruitment, retention and completion of nutrition and dietetics education at all levels for historically underrepresented groups, and therefore supports students of diverse backgrounds at every step of the process.^3,12,13

Increasing workforce diversity requires resources and tools to assist students from historically underrepresented groups in applying for and completing dietetics (and higher education) programs. Academy support is provided by IDEA grants for dietetics education programs and Academy groups, such as affiliates, dietetic practice groups (DPGs) and member interest groups (MIGs),¹⁴ in addition to scholarships from the Academy's Foundation. Educational institutions are encouraged to facilitate students' sense of belonging through repeat, positive interactions with their educational communities,¹⁵ increased faculty diversity,⁹ providing education on diverse patient populations,¹⁶ and encouraging students to pursue further education and credentialing. Additionally, the Academy recognizes the importance of having diversity of thought and action among its leadership, which requires pathways for members from diverse backgrounds to serve and advance within the Academy.¹³

Over the next several decades, the U.S. population will become more diverse, specifically in terms of race, ethnicity, disability status, gender identity and sexual orientation.^4,5,17,18 This highlights a necessity for clinicians to demonstrate a deeper understanding of the cultural, food and nutrition needs of a greater variety of individuals in the United States.^19,20,21 Increasing evidence-based cross-cultural learning at all levels of practitioner education is one way of addressing the disparities in access to health care that have long been documented.^22,23,24

The Academy and its organizational units, from committees to DPGs and MIGs, continuously work to provide practitioners with cultural humility training to serve diverse audiences,^20,25 with the understanding that culturally humble care extends beyond race and ethnicity to also include ability, age, creed, culture, gender, gender identity, political affiliation, religion, sexual orientation, size and socioeconomic characteristics.^13,26-31 Furthermore, by gaining cultural humility, dismantling power imbalances and promoting equity, RDNs and NDTRs are better equipped to provide quality care while addressing systemic inequalities.^32,33 To this end, the Accreditation Council for Education in Nutrition in Dietetics has strengthened its accreditation standards regarding diversity, equity and inclusion, while also addressing educational practices.³⁴

Inherent to a comprehensive organizational IDEA strategy is a commitment to promoting health equity through all avenues. As a result, the pursuit of health equity is incorporated into all the Academy's strategic plan focus areas. More information on social determinants of health can be found in Well-Being and Prevention; for health disparities and equitable access to nutrition care services, see Nutrition Care and Health Systems section; and for work to improve access to safe and healthful diets, see Nutrition Security and Food Safety section.

The Academy's leadership and membership are strongly committed to developing and implementing strategies that produce positive and tangible achievements in the areas of IDEA. To ensure the public receives knowledgeable, expert care, the Academy initiates and supports focused efforts to recruit, retain and advance the careers of a diverse workforce of nutrition and dietetics practitioners, while working to support and collaborate with educational institutions and other organizations to remove systemic barriers and foster evidence-based, IDEA-focused training and education across diverse populations.

See references.