Symptoms, Signs, Diseases, and Treatments: Getting to the Roots of Inequities in Engineering

Disclaimer: I am not a medical doctor. I have just spent more than my share of time in their company.

Years ago, I went to see an orthopedist because I was experiencing pain in my right hip. I remember him saying that he would not believe the x-rays he was looking at were mine if I was not sitting in front of him. Things were just that bad. He proceeded to tell me I would need a joint replacement, but was hesitant to do it because I was so young.

Instead, he prescribed pain meds and had me come back periodically for checkups so he could keep an eye on things. Taking the medicine covered up the pain, for the most part, but it did not fix the problem. I eventually got to the point where the doctor told me if I did not have surgery, the joint would break, and that would be even more problematic.

In the medical profession, signs and symptoms are differentiated from each other in that symptoms are only observable by the patient whereas signs are observable by both the doctor and the patient. My pain was a symptom. The damaged joint on my x-ray image was a sign, which, in part, led to the diagnosis of the underlying disease that was causing the pain. 

Treatments are most effective when they not only address the symptoms and signs, but also get to the source of the illness or disease. For example, one might take over-the-counter medicines to treat pain and fever plus a prescription antibiotic to treat the bacterial infection that is underlying. With more severe illnesses and diseases, surgery may be required as part of the treatment, as was the case with my hip.

We can look at our challenges with justice, equity, diversity, and inclusion in engineering education and practice in much the same way, and we need to train our students - our future engineers - with this in mind.

Lack of diversity is a sign that something is not working the way it should. It is something we see in the lack of representation of women, persons of color, persons with disabilities, persons who identify as LGBTQ+, persons from low-income backgrounds, and others in engineering programs, and ultimately, in the engineering workforce. Most institutions and organizations implement diversity efforts to attract and recruit students and employees from diverse backgrounds. These are akin to the over-the-counter medicine that treats the fever, but does nothing for the bacterial infection at the source. If people experience toxic climates and cultures, they are more likely to attrit due to unfair treatment and/or disparate outcomes in success.

So, recognizing that it is not enough to have more diverse people “at the table” or “in the room,” we then look at inclusion. Inclusion ensures people's voices and perspectives are heard. In engineering education and practice, it is crucial to have diverse thoughts and perspectives contributing to problem solving in research, design, operations, and other areas. I often say, we cannot effectively solve problems for a heterogeneous society with homogeneous problem solvers. And we cannot have the mindset that we as engineers have all the answers for the communities and end users we serve; we desperately need their input in the forms of shared vision and community-led or user-centered design rather than buy-in. Who knows better the needs of a community than the community members themselves?

While inclusion is important, it is still not enough. Sometimes everyone gets heard, or rather, gets to share, but people experience symptoms of isolation and marginalization because their knowledge, skills, perspectives and experiences are not valued and respected. This is where equity comes in. Examples include: recognizing and respecting the technical competence of women, persons of color, and others from traditionally marginalized identities in both performance evaluations and work assignments; holding everyone accountable for service work and for cultivating a culture of justice, equity, diversity, and inclusion rather than delegating this to people from marginalized identities; listening and taking seriously the voice of the sole Black woman on the team when she shares an experience of inequality or inequity, even though no one else has ever said anything before; and recognizing how difficult it is for colleagues and peers who are from traditionally marginalized identities, especially persons of color, to go about "business as usual" when they see people who share their identities face societal injustices and inequities, and have thoughts of “that could be me” on a daily basis. Equity in the forms of dignity, respect, and fairness have to be at the core of how we operate.

While equity is good for treating symptoms that are not always observed beyond the people experiencing them, we must go farther still.

To get at the root of the problem, we need to identify the illness or disease. For our treatments to be effective, they must eradicate the disease – the systems that create the problems in the first place; the policies, practices, designs, and misallocation of resources that perpetuate inequities in our profession and in our society. This is justice, which might look like an antibiotic treatment for some things. But for others, surgery is needed to completely cut out and reconstruct the affected area.

When we attend to justice - making the changes necessary to identify and eradicate systems that perpetuate inequities and inequalities, then the other pieces - equitable and inclusive engagement of people from all backgrounds and identities in problem solving and the improved representation of people in engineering from demographics that reflect the rich diversity of our society - can be achieved and sustained.