Perceptions of the Minority Tax Experienced by Faculty and Students Underrepresented in Medicine at the University of Wisconsin.

INTRODUCTION: The minority tax in academic medicine can be defined as the additional responsibilities placed on underrepresented in medicine (URiM) faculty, staff, and students in the name of diversity. Often this looks like participating in additional diversity committees, recruitment efforts, and mentorship activities. These extra responsibilities often are not recognized, not included in promotions, and take time from other clinical, research, and traditional scholarly responsibilities. OBJECTIVES: There is a significant gap in the literature examining the experiences of URiM-identifying faculty and students in relation to the minority tax. Our goal was to do a quality improvement project to explore this gap through interviewing URiM-identifying faculty and conducting focus groups with URiM-identifying students, with the goal of making recommendations to help reduce the minority tax burdens to this community. METHODS: A scoping literature review on the minority tax burden in academic medicine was used to inform the development of questions to use in focus groups of URiM University of Wisconsin School of Medicine and Public Health (UWSMPH) students and interviews of URiM UWSMPH faculty members. After development of a facilitation guide, we conducted three 1-hour focus groups with 14 students who identified as URiM and did eight 30-minute interviews with faculty who identified as URiM. A codebook was generated using inductive analysis after reviewing transcripts. Coding was performed independently with 2 separate coders in order to ensure inter-coder reliability. RESULTS: Ninety-one percent of students and 62.5% of faculty endorsed experiencing the minority tax at UWSMPH. Faculty also reported increasing feelings of support due to UWSMPH programs that support URiM faculty. Students reported the minority tax being central to their role as URiM students. Both students and faculty reported that the additional burdens of the minority tax took time away from traditional scholarly activities that were essential for promotion (faculty) or residency (students). CONCLUSIONS: The minority tax burden experienced by URiM faculty and students may negatively affect their careers, as they note spending more time on activities that may not be valued for promotion. It is essential to address these burdens in order to achieve equity within the medical institution.

Combatting Anti-Vaccination Misinformation: Improving Immunization Rates of Black/African American Children at UW Health.

INTRODUCTION: Vaccine hesitancy is a rising public health threat, thwarting progress to reduce vaccine-preventable diseases. While drivers of racial disparities in childhood immunization rates (CIR) have been described, none have explored these disparities at UW Health, and few have highlighted the role of anti-vaccination (anti-vaxx) campaigns in the Black/African American (BAA) community. OBJECTIVES: This quality improvement study evaluates childhood immunization data for racial and ethnic disparities, identifies possible drivers, and proposes equitable solutions. METHODS: UW Health CIR were analyzed for racial and ethnic disparities between December 31, 2015, and December 31, 2019. A root cause analysis was done to explore potential drivers. An in-depth media review of targeted anti-vaxx campaigns was chosen for further exploration using "anti-vaccine leaders targeting minority becomes growing concern at NYC forum" as the initial search query template. Google Trend and literature searches were performed to understand questions BAA parents have about vaccines. RESULTS: UW Health data show significant increasing racial and ethnic disparities in CIR. As of December 31, 2019, the immunization rates were 90.74% for White children, 88.11% for Asian children, and 68.29% for BAA children. Media review suggests anti-vaccination leaders have increasingly targeted the BAA community with vaccine misinformation and skepticism. Analysis of vaccine-related queries suggest 8 core questions BAA parents have about vaccines. CONCLUSIONS: Health systems must assess their CIR for disparities and further dissect drivers to effect change. We focus on suggesting strategies to combat negative media campaigns, among others, to close the gap. Understanding of all factors is needed to develop effective interventions to reduce disparities in childhood immunization rates in the BAA community served by UW Health and beyond.