Confronting Challenges and Institutional Hierarchies as a Black Future RDN

By Ashley Berthoumieux

Admittedly, my journey towards becoming a registered dietitian nutritionist has not been consistently filled with unrelenting passion and enthusiasm, despite my vested interest in nutrition. I've always recognized the important role nutrition plays in chronic disease prevention and health promotion, but the past few years of my education and training have highlighted the fact that my wellness as a Black woman is not a priority to many practitioners in the field.

In December 2017, I presented the results of a survey I conducted as part of my capstone project for my master's degree. While my research included participants from a diverse group of racial and ethnic backgrounds to closely mirror the demographic makeup of the American population, the rest of the students in my class presented projects in which over 90 percent of their participants identified as white. I recall many of them laughing at the homogeneity of their sample and quickly moving to the next slide in their presentation, as if it were an insignificant afterthought. During such moments, I was not only hyperaware that I was the sole Black student in the room, but I was seemingly the only one who cared about conducting an inclusive survey. With yet another microaggression, one student thanked me for adding some diversity to his research by being the only Black participant in his survey.

My experience is not unexpected, given the racial distribution and inequalities that exist within the Academy's leadership and the dietetics profession as a whole. Less than 3 percent of RDNs are Black, and while there seems to be a push by the Academy to increase diversity and inclusion, there are still gaps in practice. I've noticed a theme from the classroom to the exam room in this field: there's not only a disproportionate number of white students and instructors in dietetic programs, but there's also a disproportionate amount of white RDNs seeing patients in the hospital while people of color are stacking trays in the sub-basement kitchen. This is clear institutionalized racism.

As I complete rotations in my dietetic internship, these trends start to take toll on my morale. My passion for healthcare occasionally morphs into disappointment over racial inequities that are perpetuated in this profession. Every role in health care and in the hospital is essential, but we cannot talk about diversity and inclusion when the conversation on nutrition is being dominated by white RDNs in the clinics, classrooms and conferences.

Nevertheless, there have been gains over the years of my training, and I do recognize that a number of white RDNs are taking the time to learn and grow when it comes to addressing social injustice within the profession. Notably, there are RDNs in my circle that have made the following efforts to combat this problem:

1. Bringing up the lack of diversity and inclusion in dietetics during meetings instead of staying silent on the matter.
2. Making simple yet meaningful statements, such as "I support you" and backing it up with an action plan to increase diversity, equity and inclusion in their programs or workforce.
3. Increasing BIPOC representation on program advisory boards and in leadership roles.
4. Creating presentations and webinars that include a diverse group of people in images.
5. Participating in diversity, equity and inclusion training on topics related to BIPOC and LGBTQ+ populations.
6. Demonstrating the same level of compassion and care to all patients, clients, students, etc.

These efforts show that ally-ship is most effective when it is not solely performative. Amplifying the marginalized voices of BIPOC and LGBTQ+ stakeholders strengthens the profession and brings a more holistic approach to the practice of nutrition and dietetics. It does not go unnoticed.

Overall, there are still strides to be made to truly improve diversity, equity and inclusion in our occupation — including lowering the educational and training costs to pursue this career path to avoid further gate-keeping privilege — but it's promising that many RDNs are trying to make meaningful change. It's time for all Academy constituents to be represented in spite of the profession's demographic distribution, and that evolution starts with each one of us.

This content originally appeared in Food & Nutrition Magazine^®.