Ten recommendations to increase Black representation within pharmacy organization leadership

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While the year 2020 was filled with uncertainty and doubt, it is clear that we are in the midst of hyperturbulent times. The deaths of George Floyd, Breonna Taylor, Ahmaud Arbery, Rayshard Brooks, and others have ignited national conversations and action on racial injustice and discrimination. Additionally, the coronavirus disease 2019 (COVID-19) pandemic has exposed healthcare disparities, particularly in the Black community.^1,2 These significant events, while different, have revealed several inequities within the social determinants of health that have been long-standing issues in this country. More specifically, they have served as an illumination of the interrelationship between social/community context (discrimination), economic stability (occupation and income) and the healthcare system (access, quality, and utilization). Discrimination, whether blatant or systemic, can influence Black individuals’ occupational roles, their contributions to financial burdens, and their likelihood of being exposed to, and appropriately treated for various diseases, including COVID-19. Several healthcare professions, including pharmacy, have recognized that diversity is fundamental in providing safe, equitable, and effective healthcare.^3-7 Despite efforts led by multiple pharmacy organizations to address the lack of diversity and inclusion of historically marginalized racial groups, including Blacks, the pharmacy profession’s demographic profile continues to fall short of mirroring the US population.^7,8 For example, while Blacks constitute approximately 13% of the US population, in 2019 they represented only 9.3% of all enrolled pharmacy students.⁸ Furthermore, while extensive data on racial and ethnic demographics for pharmacy residencies are not publicly reported, in the only racial and ethnicity data available, Blacks accounted for 6.2% of all residency positions affiliated with US colleges and schools of pharmacy.⁸ This underrepresentation in pharmacy schools and pharmacy residencies ultimately translates into a shortage of Black pharmacists and subsequent lack of representation in national pharmacy organization leadership. Reasons for the underrepresentation are multifactorial. Nevertheless, decreased representation is not related to the ability to lead, as there are several notable examples of Black pharmacists willing and capable of leadership at the national level. Historically, multiple pharmacy organizations were founded in the 19th and early 20th centuries, an era fraught with legalized discrimination against Blacks and other historically marginalized racial groups. This sparked the creation of separate organizations focused on the needs of the minority community. Notably, the National Pharmaceutical Association (NPhA), founded in 1947 by Dr. Chauncey Cooper with a commitment to representing the views and ideals of minority health professionals on critical issues affecting healthcare and promoting racial and health equity, is led by a predominantly Black leadership team. Since its inception, all NPhA presidents have been Black, cementing years of successful leadership opportunities for minorities. NPhA leadership and advocacy continue to the current day. Following the tumultuous racial events in the summer of 2020, NPhA led the unprecedented collaboration of 14 national pharmacy organizations in taking a stand against racial injustice through the issuance of a joint statement and an action plan.^9,10 Irrespective of NPhA’s functionality as the premier pharmacy organization focused on mitigating health disparities prevalent in minority populations through community outreach and education, there continues to be discordance in minority involvement in large, majority-based pharmacy organizations. Historically, pharmacy has had a few notable Blacks in large majority-based national pharmacy organizations, including Wendell T. Hill, Robert D. Gibson, Mary Munson Runge, Bruce Scott, and Lawrence B. Brown. Nevertheless, there is still limited Black representation within national pharmacy organization leaderships.