Facing Discrimination At A Top Public Health University

As I read “More talk than action,” a new study published in the Lancet on how women and ethnic minorities are being held back in schools of public health, I relived the personal experiences that led me to leave academia.
The study, conducted by 10 female researchers, was an investigation into gender- and ethnicity-related differences in career progression at the 15 highest-ranked social sciences and public health universities in the world. The conclusions were grim: In all of the universities, even though women outnumbered men at the junior level, the representation of women declined in middle and senior academic levels. Ethnic minority women like me had a double disadvantage in their career trajectories that made them almost nonexistent at the highest levels of academic seniority.
The report brought back for me memories of all the awkward and impalpable situations I encountered as an assistant professor at the London School of Hygiene and Tropical Medicine — the sixth-ranked school in this study. As one of the data points in this study, I know the findings of discrimination are true. Individual and institutional prejudice hinder ethnic minority women from succeeding in academia more than it hinders any other group.
I am a Nigerian-American woman and an infectious disease epidemiologist. The majority of my professional life has been dedicated to preventing and controlling infectious disease outbreaks in Africa, Southeast Asia, and the Middle East. Before I began working at the London School, I trained at the U.S. Centers for Disease Control and Prevention and advised the World Health Organization and several national ministries of health.
When the London School hired me as an assistant professor in 2016, I discovered that I was an anomaly — I did not meet another black woman assistant professor at the school for some time. I felt that my colleagues and the master’s degree students often questioned my knowledge and abilities. When I stood at the front of the class to teach, I noticed people looking expectantly at the door like they were waiting for the real professor to enter. One of my supervisors focused on my style of working rather than my competence or performance. I started to question my confidence and became anxious when I had to teach or speak to colleagues.
“More talk than action” and other evidence, such as a study of minority researchers, validated those feelings. In that study, 72 percent of minority researchers in the U.S. (defined as women or people of color) reported workplace barriers relating to ethnicity and 26 percent reported barriers related to their gender.
Another problem incubated in schools of public health and hatched in the field of global health practice is inclusion of minorities for tokenistic purposes. I was often surprised at how my ethnicity, age, and experience had been central to my team’s success but was rarely acknowledged.
I was once asked to support an expert mission to Cameroon as part of an otherwise all-white team. Even though I was the sole African on the trip, I was not meant to have a leadership role. My colleagues had heard that Cameroon was a bilingual country and assumed, incorrectly, they could get by with English. Because I was the only member of the team who spoke French, I ended up running the mission with very little assistance. When we reported back to the funder, neither my contribution nor leadership were mentioned.
For another example of tokenism gone wrong, look no further than the recently launched investigation at the World Health Organization, the lead health agency of the United Nations, in response to an allegation of “systematic racial discrimination against Africans.” The UN’s mission of cultural and racial equality and respect for diversity makes it the eminent example of institutional inclusivity, but the persistent claims of racism at WHO, an organization meant to improve equity in health, generates skepticism in how ingrained this mission is in the WHO’s staff and leadership.
More worrisome are the potential downstream effects of this institutionalized racism — the potential harm that can be done to the beneficiaries of WHO’s important work if inclusivity is merely a façade.
To prevent another decade of this problem, the next batch of global health leaders must see, experience, and learn to value diversity in their universities.
Well-meaning non-minority colleagues have helped me throughout my career. I acknowledge and value their efforts. But if such individual efforts aren’t connected to wider solutions, they will be undermined by the deep, systemic forces of racial and gender discrimination.
The most glaring systematic barrier to a successful career in academia that I saw was the absence of ethnic minorities, both men and women, in senior and leadership positions. The Lancet study found that at my former employer, where the majority of research is conducted in low-and middle-income countries across Africa and Asia, only 15 percent of the staff at the assistant professor and higher levels are ethnic minority women compared to 39 percent non-ethnic minority women. And at the highest levels of seniority, such as professor, reader, or chair, ethnic minority women made up only 9 percent.
Since the authors of the Lancet report included anyone with a non-British or non-Anglo-American surname as an “ethnic minority,” the proportion of brown and black bodies in these staff positions is actually much lower.
The study also provided sound evidence of gender bias in promotion at public health universities. While ethnic minority men and women both had low representation in seniority categories, only the proportion of ethnic minority women sharply dropped between middle and senior levels.
With this discouraging realtiy, up-and-coming public health researchers like I once was find it difficult to envision a promising academic career. They often do not receive mentorship and access to opportunities at the same rates as their white colleagues do. And even if there are mentors, structural barriers like poverty, exclusion, and cultural perceptions experienced by ehtnic minorities may lower the effectiveness of cross-cultural mentoring relationships. 
This was a recurring issue when I was in graduate school. Several of my fellow students, particularly from Africa and the Caribbean, felt that they could not speak openly to their supervisors. These students had weaker mentorship relationships, which led them to miss out on career advice or to be put forward for other opportunities. I know of at least one student who did not finish her Ph.D., due in part to persistent misunderstandings with her supervisor.
The Lancet article ends with a call to action for universities to do more than talk about diversity. The authors recommend including diversity scores in university ranking systems, such as the Times Higher Education World University Rankings. I hope this recommendation translates to practice.
Even if it doesn’t, I want the authors of this study to know they have done more than they set out to do. They gave me, and I suspect many other ethnic minority graduate students and academics, something we rarely receive: validation that our perceptions and experiences are grounded in truth.