key: cord-0796055-sy69fb9x
authors: Poppas, Athena; Albert, Michelle A.; Douglas, Pamela S.; Capers, Quinn
title: Diversity and Inclusion: Central to ACC’s Mission, Vision, and Values
date: 2020-09-22
journal: J Am Coll Cardiol
DOI: 10.1016/j.jacc.2020.08.019
sha: 4d508451fc317680cbec18c87400550139be21eb
doc_id: 796055
cord_uid: sy69fb9x

nan

D iversity drives excellence. Inclusion is central to the American College of Cardiology (ACC) and to our entire cardiovascular profession (1) . We cannot achieve our mission to transform cardiovascular care and improve heart health without embracing the central tenets of diversity and inclusion (D&I). Diversity should encompass a range of qualities that are visible, such as race and sex, and invisible, such as geography, socioeconomic status, and opinion. Inclusion means valuing differences and finding common ground. Hallmarks of inclusion include feeling valued, trusted, authentic, and psychologically safe in expressing differing opinions and tackling tough issues without penalty (2) .

D&I have been shown to be of significant benefit to individuals, organizations, and society (3). Indeed, optimal organizational performance requires D&I. An inclusive environment in the workplace is linked to employee engagement and retention. For example, organizations with gender diversity and stated human resources policies have less turnover; enhanced problem solving; and increased innovation, creativity, and perspectives. It is imperative that academic institutions foster D&I and equity with careful attention to pipeline barriers, retention, and leadership ascension of racial and ethnic minorities as well as women (4) . It follows that diverse and inclusive organizations have been shown to have improved financial performance and thrive during economically challenging times. Our specialty and our College cannot reach its full potential until diversity is evident from our fellows-in-training members to our Board of Trustees.

In cardiovascular medicine, racial and sex disparities in care persist despite decades of studying the problem and proposing solutions. Not only do minorities experience worse outcomes once heart disease is established, the underutilization of high-tech procedures in minority populations is staggering. Recent studies show that 91% of patients in contemporary coronary stent trials were White (5) . Although there is a suggestion that the worse outcomes in Black patients treated with coronary stents is due partially to social determinants of health, which may be outside of the cardiologist's control (6) , the fact that minority groups are less likely to be treated with effective cardiac medications and to be referred for cardiac rehabilitation at hospital discharge likely plays a role as well (7, 8) . Patient race appears to play a role in clinician decision-making (9).

In cardiovascular science and research, diversity among clinical scientists is crucial to ensuring that we ask the right questions, avoid ethical lapses in study design, and enhance trust with and engage with minority communities. New heart failure drugs have added powerful tools in the clinician's armamentarium, but the trials upon which their U.S. Food and Drug Administration approval is based included just 5% Black patients (10, 11 Force on each. The D&I Task Force (Figure 1 ) has achieved notable successes since its founding in 2017 (13) . Nevertheless, the current crisis makes it clear that that we need to do more to acknowledge and counteract the structural racism in our Education is also essential. We are building on our 

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