Supporting diversity, equity, inclusion, and belonging to strengthen and position the veterinary profession for service, sustainability, excellence, and impact

Mary Jo Burkhard College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Sandra Dawkins College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Sue E. Knoblaugh College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Caroline El-Khoury College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Dondrae Coble Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH

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Raphael A. Malbrue Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH

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Emma K. Read College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Lisa M. Greenhill American Association of Veterinary Medical Colleges, Washington, DC

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Rustin M. Moore College of Veterinary Medicine, The Ohio State University, Columbus, OH

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Abstract

Advancing equality and equity in society is creating positive change, and the time has come to critically evaluate veterinary medicine, which, by all metrics, lacks diversity. To keep pace with increasingly diverse demographics and recent surges in pet ownership among all racial/ethnic groups, significant efforts to enhance diversity, equity, inclusion, and belonging (DEIB) must occur in veterinary colleges and the profession. Recruiting more underrepresented students, building pipelines for diverse faculty/staff, and creating inclusive, welcoming environments where all can thrive are critical steps toward enhancing DEIB within our organizations and profession. Our goal is to share experiences and lessons learned from our intentional commitment to strengthen DEIB, with the hope that our journey will be helpful to others. Increasing diversity in the veterinary profession will be facilitated through removing barriers, creating inclusive work environments where all people feel they belong, and ensuring fair and equitable hiring and personnel management practices. These steps should in turn improve access and quality of veterinary care, ensure we are more representative of the communities we serve, increase revenue, and preserve the human-animal bond.

“You cannot change any society unless you take responsibility for it, unless you see yourself belonging to it, and responsible for changing it.”

– Grace Lee Boggs

Abstract

Advancing equality and equity in society is creating positive change, and the time has come to critically evaluate veterinary medicine, which, by all metrics, lacks diversity. To keep pace with increasingly diverse demographics and recent surges in pet ownership among all racial/ethnic groups, significant efforts to enhance diversity, equity, inclusion, and belonging (DEIB) must occur in veterinary colleges and the profession. Recruiting more underrepresented students, building pipelines for diverse faculty/staff, and creating inclusive, welcoming environments where all can thrive are critical steps toward enhancing DEIB within our organizations and profession. Our goal is to share experiences and lessons learned from our intentional commitment to strengthen DEIB, with the hope that our journey will be helpful to others. Increasing diversity in the veterinary profession will be facilitated through removing barriers, creating inclusive work environments where all people feel they belong, and ensuring fair and equitable hiring and personnel management practices. These steps should in turn improve access and quality of veterinary care, ensure we are more representative of the communities we serve, increase revenue, and preserve the human-animal bond.

“You cannot change any society unless you take responsibility for it, unless you see yourself belonging to it, and responsible for changing it.”

– Grace Lee Boggs

Viewpoint articles represent the opinions of the authors and do not represent AVMA endorsement of such statements.

Introduction

Enhancing diversity, equity, inclusion, and belonging (DEIB) is of paramount importance to the veterinary profession. We share our experiences and lessons learned at The Ohio State University College of Veterinary Medicine (OSU-CVM) to illuminate one of many paths to increase DEIB in our profession. Our approach is not the only way or even the best way; rather, we share how we have enhanced DEIB within our College, while acknowledging we are on a continual journey of learning and enrichment. Our goal is to demonstrate that with intentionality and commitment, veterinary academia—and moreover the profession—can enhance diversity and foster an environment where everyone feels they belong and can thrive.

Efforts to advance equality and equity are creating positive changes in society, and we seek similar progress for veterinary medicine—a profession topping The Atlantic’s 2013 list of the “33 Whitest Jobs in America.”1 Despite the US being more diverse than ever,2 the 2021 Bureau of Labor Statistics reports that 93.3% of US veterinarians are White, 5.6% are Asian, 4.7% are Hispanic/Latinx, and 1.2% are Black.3 Veterinary graduates also reflect a lack of diversity. In the 2019–2020 academic year, 75.9% of veterinary students were White, 7.5% Latinx/Hispanic, 5.5% Asian, 3% Black, and 4% multiracial.4 Black, Latinx, Asian, Native American, Alaska Native, and Native Hawaiian and Pacific Islander populations are considered underrepresented (URM) in veterinary medicine. Along with 22% who identify as URM, the nation’s 2019–2020 veterinary student enrollment included male (18.1%) and first-generation (FG) college students (26.3%), who are considered URM in veterinary medicine (URVM) by the American Association of Veterinary Medical Colleges (AAVMC).4

Lack of diversity can result in unwelcoming or even hostile learning environments. “A Profession in Crisis: Discrimination in Veterinary Medicine,” a video released during the height of the Black Lives Matter movement, gave voice to people of color who have experienced abuses in the profession.5 Derogatory comments, microaggressions, and reprimands and retaliation against those who dared speak out are difficult to hear but represent an indictment of the current state of our profession. Although this may not be the experience of all people of color in veterinary medicine, this video gives credence to many who have lived such experiences.

Veterinary medicine is missing out on the benefits of DEIB increasingly realized within the corporate sector. A 2015 McKinsey & Company report found “companies in the top quartile for gender or racial/ethnic diversity are more likely to have financial returns above national industry medians.”6 Diverse teams consistently perform better by focusing more on facts, processing facts more carefully, and finding better solutions to complex problems.7 Benefits of diversity have also been documented in education8 and health care.9

Lack of DEIB in veterinary medicine makes our nation’s animal populations vulnerable.10 In production medicine, limited veterinary diversity combined with greater numbers of Black and Latinx workers and a large percentage of immigrants and refugees can create communication challenges that impact animal care.11 When it comes to pet care, people with disabilities, mixed-race families, and gender non-binary families have limited access to culturally-competent veterinary care, regardless of zip code.12 US pet owner demographics are changing as the White population proportionally decreases and pet ownership increases, especially in Latinx communities.13 The National Association for Black Veterinarians founder told Time magazine, “the industry could suffer financially if it doesn’t keep up with the needs of the changing pet-owning population.”10

Promoting Mutual Understanding of DEIB Challenges and Terminology

To enhance DEIB, we must understand potential barriers: (1) lacking awareness regarding biases; (2) opting out of difficult conversations for fear of saying/doing the wrong thing; (3) thinking DEIB does not apply to me; (4) exhibiting prejudices, stereotyping, microaggressions and biases, or letting actions go unchecked; (5) failing to understand and hold others accountable for organizational cultures and expectations; (6) thinking that promoting DEIB is lowering standards, using quotas or giving preferential treatment; (7) demonstrating jealousy, envy and defensiveness; (8) lacking awareness of the privilege that some individuals or groups have; and/or (9) resisting change or disruption of the status quo.14 Organizations must address these barriers while learning to identify and understand their own unconscious biases.15

It is crucial that people in marginalized groups do not feel responsible for carrying the burden of educating others. Our communities, educational environments and professional organizations retain many historical features that create social advantages, benefits or degrees of prestige for certain groups not readily available to others. Examples include health-care disparities, differential banking loan rates, award nominations, and requirements for veterinary school application such as hours of large animal experience that may create barriers for those from urban areas. We must utilize our positions, roles, and privileges to create an equitable and just playing field for all.16,17

Veterinary medicine needs a mutual understanding and common vocabulary of DEIB. The AAVMC glossary of DEIB terms serves as a starting point.18 We have adopted and expanded upon definitions below (Figure 1).

Figure 1
Figure 1

Pictorial illustration of the broad context of diversity and inclusion and the important differences between inequality, equality, equity, and justice in the context of veterinary medicine. Top panel illustrates the importance of fostering an environment that is welcoming of diversity in its broadest sense (gender, age, race/ethnicity, physical characteristics, religion, abled, language, and LGBTQ+) in a veterinary hospital reception area. Bottom panels denote the difference between inequality, equality, equity, and justice within a veterinary hospital exam room. With inequality, people do not get what they need to access the patient for examination and auscultation; with equality, each person gets the same thing (same height of stool or ramp) regardless of whether they need it or not to access the patient for examination and auscultation; with equity, each person gets what they individually need, including a different height ramp and step stool and the addition of a sitting stool; and with justice, each person gets what they individually need and barriers are removed, which in this case means the table is lowered to the height of the person in the wheelchair, the table is at a height that enables the person’s legs to fit under the table, and the height of the sitting stool is adjusted and the step stool removed accordingly to facilitate similar access to the patient by all 3 individuals, without them having to reach, stretch, or stoop.

Citation: Journal of the American Veterinary Medical Association 260, 11; 10.2460/javma.21.11.0477

  • Diversity—We embrace the fullest spectrum of diversity, including race/ethnicity; physical/mental abilities; gender, sexual orientation and gender identity/expression; parental, marital or pregnancy status; religious and political beliefs; military/veteran status; geographic, socioeconomic and educational backgrounds; challenges that have been overcome; other lived experiences; and different ideas, thoughts, values and perspectives. We believe the benefit of including and hearing all voices is to educate others to help eliminate bias and hate.

  • Intersectionality—We recognize the importance of intersectionality19 of different identities and unique experiences of marginalization, oppression and discrimination that can impact how a person self identifies and is treated by others. Recognizing that people can associate with more than one group or identity, including nonvisible characteristics, is important. For example, a person of color who also identifies with the LGBTQ+ community and as neurodiverse20,21 may be treated very differently than a person identifying with only one group.

  • Equity versus Equality versus Justice—Equality provides each person the same thing to be successful regardless of their needs, whereas equity provides each person what they need individually to be successful (Supplementary Appendix S1). Justice is removing barriers and providing people what they need to succeed.

  • Inclusion—Inclusion involves fostering an environment that promotes people feeling welcomed, comfortable, respected, valued, and supported to participate fully. An inclusive climate embraces differences and offers respect in words and actions for everyone.22

  • Belonging—Belonging results when DEIB goals are met and everyone feels welcome as their authentic selves, without consciously or unconsciously feeling the need to hide parts of their lives.23 People who feel they belong perform better, challenge themselves further, and are more resilient and satisfied.

  • Cultural competency, fluency and humility promote understanding and respect across cultures and a life-long commitment to self-awareness and the critique of power imbalances.2428

We expand upon the analogy that diversity is having a seat at the table, inclusion is having a voice at the table, equity is ensuring each person has what they need—adding the importance of clearing barriers that keep people from having a voice at the table and making sure voices are valued and utilized.2931 It has been said that, “Diversity is a fact. Equity is a choice. Inclusion is an action. Belonging is an outcome.”32 We extend this view as follows: “Diversity is a fact, Equity is a choice, Inclusion is an action, Belonging is an outcome, and Justice is the goal(Figure 2).

Figure 2
Figure 2

Graphic illustration of the interconnected relationship between diversity, equity, inclusion, belonging, and justice, and the importance of these overlapping values in creating an environment where all people feel they are welcome, comfortable, safe, respected, valued, and treated fairly and can thrive.

Citation: Journal of the American Veterinary Medical Association 260, 11; 10.2460/javma.21.11.0477

OSU-CVM’s Commitment to DEIB

Although aggregate data from the 2017 AAVMC Diversity Matters College Climate Survey was not published, 10% to 32% of OSU-CVM student-respondents reported one or more of the following (percentages varied across categories): racist, sexist, homophobic, or stereotypical comments disparaging religious affiliation or gender identity from students, faculty, or staff.33

In a 2017–2018 end-of-year survey, 80% to 85% of our students identified faculty as always or often respecting diversity; however, some raised concerns regarding perceptions of opportunities denied on the basis of race/ethnicity or sexual orientation or being called names or exposed to hurtful remarks. Students identified faculty and other students as most likely to engage in such behaviors, with 30% to 50% saying they did not report incidents because they appeared minor and 27% to 31% believing no action would be taken.

These results reconfirmed a need to intertwine DEIB throughout all we do. We recognized the interrelatedness of nurturing a culture of inclusion and belonging to promote the health and well-being of our people.34 We incorporated DEIB as a foundational principle in our strategic plan, weaving it through each of the plan’s six strategic goals (Supplementary Appendix S1). We established a Chief Diversity Officer as a direct report to the dean, created a College-wide DEIB Committee of faculty, staff and students, and an external DEIB Council to provide best practices and feedback on our DEIB programming.

When the AAVMC Climate Survey is repeated, we will compare data to the 2018 survey results to assess changes in the learning environment and the overall climate and will use the feedback to address concerns and opportunities. We are also addressing climate through the renewal process of our Be The Model strategic plan as it relates to culture and sustainability of our people, with a goal to identify measurable metrics to assess and address the working environment moving forward.

OSU-CVM’s Steps Toward DEIB Progress

Recruiting and Admitting a Diverse Student Body

In 2015, URM students comprised just 10.2% of OSU-CVM—below average for US veterinary colleges. Student diversity has steadily increased for the classes of 2020 to 2025, resulting in an average of 30.2% URM, 22.4% male, and 26% FG students. Collectively, these URVM groups represent between 51%-70% of incoming classes, with each student counted only once even if identifying with more than one group (Supplementary Table S1). During the 2021–2022 academic year, the percentage of total students enrolled across the four-year program at OSU-CVM was 27.0% URMs and 23.4% males, compared with median/range values for enrolled students at all US colleges of veterinary medicine of 19.6% (6.9% to 76.1%) and 17.1% (range, 13.4% to 27.7%), respectively.35 These values have increased since our admissions process changes began in the 2015–2016 application cycle, which is notable considering an increase in our applicants over the last 5 years of 98% compared to a 54% increase nationally.

We use the standardized national application that does not include diversity indicators (eg, military/veteran status, disabilities, sexual orientation, and gender identity)36—while emphasizing a holistic review process that evaluates applicants on their academic profiles and certain non-cognitive factors, including motivation, character, communication and interpersonal skills, leadership, animal exposure, knowledge of the profession and ability to foster diversity. Since the 2016–2017 admissions cycle, we have worked to decrease bias by providing the minimum information necessary for file reviewers to make informed assessments. Everyone involved in the admissions process are required to take diversity and mitigation bias training and at least 2 implicit association tests to help mitigate bias.

File review and interview processes were uncoupled starting with the 2017–2018 application cycle. We increased file reviewers from around 40 to > 170 due to increased applications, to review all applicants meeting our minimum GPA requirement, and to ensure applicants are not interviewed by anyone who reviewed their file. We address the importance of DEIB during discussions with applicants who are offered an interview and during orientation and during a DEIB team-building activity and a diversity statement exercise. Each class also elects 2 DEIB Committee representatives.

We developed file review training modules and mock applications to create a consistent review process and standardized scoring rubric. Beginning in the 2019–2020 cycle, interviewers were only given access to applicants’ names. To further minimize potential bias based on applicants’ nonnecessary information, the admissions committee is considering other changes in upcoming cycles.

We removed the Graduate Record Examination in 2018 due to lack of evidence of the examination as a predictor of student success. A 2021 AAVMC report warns of its “unintended institutional racism, sexism, classism, and/or elitism across academic veterinary medicine—imparting unintended bias against candidates who might be marginalized based on race/ethnicity, gender, socioeconomic status, or geography.”37

In 2019, US veterinary applicants were 13.1% male and 24.4% URM.38 By comparison, students entering OSU-CVM were 26% male and 35% URM. According to AAVMC national data from 2020–2021, 18.2% of enrolled students were male and 22.8% were URMs; during the same period, OSU-CVM enrolled 23.4% males and 27% URMs.39 While becoming more diverse, our students have remained highly qualified, with similar average GPA and matriculation/graduation rates (Supplementary Tables S2 and S3) as prior classes.

In the last 6 years, we have increased participation in recruitment efforts (> 10,000) for Kindergarten through grade 12, through undergraduate students to build a pipeline of minority role models and increase exposure to the profession.40 URM applicants to OSU-CVM increased from 6% in 2009 to 2010 to 26.3% in 2020 to 2021, and the racial/ethnic diversity of incoming classes increased from 7.1% in 2009 to 2010 to 35.2% in 2020 to 2021. During this time, total applicants tripled, including a 13-fold increase in URM applicants and a 5-fold increase in URM accepting a seat in the class.

Because FG and URM students have more educational debt than their peers,41 we have worked to increase philanthropically derived scholarship dollars nearly 600%, from about $371,000 in 2015 to $2.55M in 2021, with both philanthropic and non-philanthropic scholarship dollars increasing substantially for URVM students (Supplementary Table S4).

We believe our DEIB efforts—which will continue to evolve as new best practices emerge and demographics shift—have led to recruitment of more URM students who have increasingly accepted seats in our program (Supplementary Table S5).

Building a Pipeline to Achieve Faculty and Staff Diversity

Building diversity among faculty is a major challenge for all US colleges of veterinary medicine. According to 2019 AAVMC data, only 18% of tenure track, 10.3% of clinical track, 12.5% of research track and 12.8% of administrative positions were URMs.4 We struggle with the same trends. In 2021, 82% of our faculty self-identified as White/Caucasian, with the majority of URM (18%) faculty having international backgrounds.

Increasing URM faculty who can serve as mentors is essential, as data suggests students from diverse backgrounds do better academically when they have faculty who look like them and have similar life experiences.42 However, the pipeline from admitted students to faculty members is long.

Self-identified race/ethnicity of house officers (interns and residents) in 2021 was 20% URM and 80% White/Caucasian, which is lower than those matching into internships and residencies nationally in the same period: 27.3% URM, 70.8% White/Caucasian, and 1.9% undisclosed.43 Similar findings are seen among graduate students, with 33.7% and 66.3% identifying as URM and White/Caucasian, respectively. Increasing URM veterinary students, house officers, and graduate students will help establish a pipeline for URM faculty nationally, and will require a more holistic process, similar to our DVM student applicants.

We are also striving to increase diversity among staff, which will impact students and create a more inclusive atmosphere for hospital clients. In 2021, our staff self-identified as 85% White, 15% URM and 2% undisclosed. Compared to demographics of Columbus, OH (30% Black and 6% Latinx44), we have substantial opportunity to enhance staff diversity.

Community of Inclusion Certificate Program and Safe Zone Training

The core of our efforts is the Community of Inclusion Certificate Program (Supplementary Appendix S1), developed by the DEIB Committee in 2016. College members can earn up to three levels of certification: Partner (supports a community of inclusion), Ambassador (represents the community and expands the dialogue), and Champion (actively promotes a community of inclusion and facilitates the process). By the end of the 2020–2021 academic year, 389 certificates had been awarded to 305 College members, including 305 partners, 61 ambassadors, and 23 champions.

Several faculty and staff have completed Safe Zone training, which supports individuals and communities with minoritized sexual and/or gender identities.45 Display of Safe Zone stickers creates a visible and supportive network of allies within the campus community.

Creating an Inclusive and Welcoming Campus Including Affinity Groups

When diverse students, faculty, and staff arrive on campus, it is important they feel they belong. We have taken several steps to nurture an environment of belonging. For example, in a classroom building, the photos of full professor faculty since our 1885 founding were removed, scanned, and included in a searchable kiosk. This preserves our rich history while being cognizant of visual reminders that may feel unwelcoming to students who see very few, if any, professors who look like them.

Affinity groups enable connection and engagement with other College members and alumni sharing similar identities.46 Affinity groups include Dr. J.H. Bias Black Affinity Group, a student chapter of National Association of Black Veterinarians and a 2020 Insight into Diversity Inspiring Affinity Group recipient; Latinx; Asians in Vet Med; Parenting; Pride Veterinary Medical Community; and Women’s Veterinary Leadership Development Initiative. Groups for FG college students and First Nations/Indigenous populations are developing. The College also has an active VOICE (Veterinarians as One Inclusive Community for Empowerment) chapter, and we are pleased to participate in a student ambassador pilot program for the Multicultural Veterinary Medical Association with selection of 2 inaugural ambassadors.

Creating Safe Spaces for Diverse Opinions and Beliefs

We do not expect people to change their beliefs or understand those of others; rather we work to raise awareness and encourage individuals to suspend judgment, while respecting and valuing others for who they are. The College offers programming to discuss timely topics through respectful dialogue moderated by experienced facilitators, including “Open Spaces” for dialogue about difficult topics such as racism/racial injustices and “YOU MATTER” sessions for sharing and peer support.

Working to Counter Ableism

We work to counter ableism (eg, discrimination against individuals with disabilities) to provide students with disabilities—whether cognitive (learning), emotional, mental or physical (eg, vision, hearing, and mobility)—an environment and resources to be successful. Our liaison to the University’s Office of Student Life Disability Services connects students with documented disabilities to equitable educational experiences and appropriate accommodations for clinical and didactic learning.

Addressing the Hidden Curriculum

We are undergoing a curricular redesign process building on the AAVMC Competency-Based Veterinary Education (CBVE) framework,47 which provides opportunities to broaden DEIB and examine our hidden curriculum, including informal and unintended lessons students may acquire subconsciously.

Cultural competency, fluency, and humility were mapped to the Competency-Based Veterinary Education framework and included in our DVM curriculum regarding: (1) discrimination and implicit bias; (2) being an active bystander; (3) cultural humility and interprofessional education; (4) appreciating cultural and societal differences; (5) understanding the needs of people with disabilities; and (6) professional communications and ethical dilemmas. Communication modules include simulated client experiences with trained actors, incorporating situations that raise social awareness and build cultural competency.

The majority of DEIB curricular offerings are core elements for all students, however elective opportunities are available. In spring 2021, 20 students enrolled in our new “Veterinary Terminology en Español” course, 19 of whom identified as Hispanic/Latinx. Seventy-five percent of students reported “community outreach,” “maintaining Latinx family connections,” and “better serving diverse clientele” as reasons they enrolled.

Creating Opportunities for Students to Apply Their Learning

Since 2009, our Veterinary Medicine Outreach Program (Supplementary Appendix S1) has grown from providing veterinary care for pets of homebound individuals once or twice per month, to working with 9 different community organizations to care for the pets of homebound, homeless and low-income individuals, and those in elder care facilities. The opportunity to practice across the Spectrum of Care48 in low-resource environments helps raise social awareness, build cultural competencies, and instill civic responsibility.

“Walking the Talk”

College administrators must “walk the talk” whenever possible by actively participating in DEIB events at the College, university, and community, and within the veterinary profession. It is crucial that the leadership team address important issues in a timely manner by issuing statements in response to hate crimes, harassment, and other crises (Supplementary Appendix S1).

To expand DEIB leadership, effective July 2021, the College transitioned from having an associate dean oversee DEIB to having faculty and staff co-directors for the Office of DEIB who together oversee the DEIB program, Committee and engage with the Council. The Office of DEIB disseminates messages regarding culturally and socially relevant topics and provides information regarding resources to raise awareness, gain knowledge, and build cultural competencies.

Moving Forward

Change works best when it comes from many different sources, direction, and levels. We, and others, have utilized the Health Professions Higher Education Excellence in Diversity Award application process as an external assessment tool based on DEIB best practices and have been recognized as Health Professions Higher Education Excellence in Diversity award recipients for 5 consecutive years (2017 to 2021). DEIB often starts with addressing diversity where there are more objective metrics. Measuring EIB typically requires indirect and/or subjective measures such as climate surveys, retention rates, peer recognition, and others. Although there are no metrics that signify when an organization has achieved DEIB; success and sustainability of DEIB is a continual journey of reflection, reassessment, and re-commitment. The same is true for the veterinary profession at large. We look forward to working with others to advance DEIB to help secure a brighter future for the profession and those we serve by improving access and quality of care to clients and patients, meeting the veterinary needs of a broader population, and honoring the human-animal bond across all communities.

There are many ways organizations and professions can address DEIB. We provide our experience as an example of one path that has led to a substantial increase in the enrollment of URVM students. Whether adopting some of our approaches or developing your own, your commitment to DEIB is critically important to the future of the veterinary profession. Although this starts in veterinary colleges with pipeline building, admissions and creating a culture/climate where all students can thrive, it also extends into the profession—as DEIB will be essential for workplaces to recruit and retain a more diverse staff to serve increasingly diverse clients and communities.

Supplementary Materials

Supplementary materials are posted online at the journal website: avmajournals.avma.org

Acknowledgments

The authors thank members of the DEIB Committee and Council; faculty, staff, and student leaders of the College’s affinity groups; and College staff members, including Tim Vojt for graphic illustrations.

References

Contributor Notes

Corresponding author: Dr. Moore (moore.66@osu.edu)
  • Figure 1

    Pictorial illustration of the broad context of diversity and inclusion and the important differences between inequality, equality, equity, and justice in the context of veterinary medicine. Top panel illustrates the importance of fostering an environment that is welcoming of diversity in its broadest sense (gender, age, race/ethnicity, physical characteristics, religion, abled, language, and LGBTQ+) in a veterinary hospital reception area. Bottom panels denote the difference between inequality, equality, equity, and justice within a veterinary hospital exam room. With inequality, people do not get what they need to access the patient for examination and auscultation; with equality, each person gets the same thing (same height of stool or ramp) regardless of whether they need it or not to access the patient for examination and auscultation; with equity, each person gets what they individually need, including a different height ramp and step stool and the addition of a sitting stool; and with justice, each person gets what they individually need and barriers are removed, which in this case means the table is lowered to the height of the person in the wheelchair, the table is at a height that enables the person’s legs to fit under the table, and the height of the sitting stool is adjusted and the step stool removed accordingly to facilitate similar access to the patient by all 3 individuals, without them having to reach, stretch, or stoop.

  • Figure 2

    Graphic illustration of the interconnected relationship between diversity, equity, inclusion, belonging, and justice, and the importance of these overlapping values in creating an environment where all people feel they are welcome, comfortable, safe, respected, valued, and treated fairly and can thrive.

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