Foundational DEI Knowledge

The following definitions explain DEI-related terminology and themes. They are adapted from the Ford Foundation through a Creative Commons Attribution 4.0 International license.

Diversity:

• Definition: Includes all the ways in which individuals differ, encompassing the various characteristics that make one individual or group different from another.
• Operationally: The representation of all our varied identities and differences — collectively and as individuals.

Equity:

• Definition: Equity goes beyond equality (equal treatment of all people), to include the elimination of barriers and upliftment of marginalized groups, producing truly fair treatment, access, and opportunity for all people.
• Operationally: Seeks to ensure fair treatment, equality of opportunity, and parity in access to information and resources for all. When applied to health, this concept is often referred to as health equity.

Inclusion:

• Definition: The quality of welcoming, respecting, valuing, and providing opportunities for full participation for all individuals and groups.
• Operationally: Builds a culture of belonging by actively inviting the contribution and participation of all people.

The following terminology, compiled by APTA's Student DEI Project Committee using various resources, defines emotional, cognitive, and behavioral biases.

Bias — implicit versus explicit:

• Explicit: The traditional conceptualization of bias. With explicit bias, individuals are aware of their prejudices and attitudes toward certain groups. Overt racism or homophobic comments are examples of explicit biases.
• Implicit: Describes attitudes or stereotypes held toward individuals or groups of people without conscious knowledge.

Stereotypes, prejudices, and discrimination:

• Stereotypes: Generalized beliefs about an individual or group of people. It is an expectation that people might have about every person of a particular group.
• Prejudices: Preconceived judgments or opinions on another person that is not based in logic or actual evidence.
• Discrimination: Acting on feelings of prejudice, to treat people unfairly, based on the group(s) or class(es) to which they belong or are perceived to belong. People may be discriminated against because of race, gender, age, religion, sexual orientation, and other qualities.

Micro versus macro aggressions:

• Microaggression: An indirect, subtle, or unintentional act of discrimination against a member or members of a marginalized group.
• Macroaggression: An overt and intentional act of discrimination directed toward a member or members of a marginalized group.

Social determinants of health:

• The conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. There are five domains:
  1. Economic stability.
  2. Education access and quality.
  3. Health care access and quality.
  4. Neighborhood and built environment.
  5. Social and community context.

DEI Resources

• APTA DEI Infographic
• 13 Self-Education Recommendations to Improve Diversity, Equity, and Inclusion
• APTA Cultural Competence Resources
• American with Disabilities Act

APTA Policies Related to DEI

• Affirmative Action
• APTA Commitment to Being an Anti-racist Organization
• APTA Commitment to DEI
• APTA Commitment to Increasing Diversity, Equity, and Inclusion
• Cultural Competence
• Nondiscrimination

“The point of being an LGBTQ provider is not to figure out who is transgender, who is lesbian, or who is gay. The point is to provide health care services that are inclusive of people of all gender identities, even when you don’t know what that gender identity is.” — Rhoda Astronomo, PT, DPT

Foundational Anti-Racism Knowledge

The following identifies anti-racism-related terminology and topics, compiled by APTA's Student DEI Project Committee, using various resources.

Race, ethnicity, nationality:

• Race: Any one of the groups that humans are often divided into based on physical traits regarded as common among people of shared ancestry.
• Ethnicity: Of or relating to large groups of people classed according to common racial, national, tribal, religious, linguistic, or cultural origin or background.
• Nationality: A legal relationship involving allegiance on the part of an individual and usually protection on the part of the state, a people having a common origin, tradition, and language and capable of forming or constituting a nation-state.

Racism, systemic/structural racism:

• Racism: A belief that race is a fundamental determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race, the systemic oppression of a racial group to the social, economic, and political advantage of another.
• Systemic/structural racism: An infrastructure of rulings, ordinances, or statutes promulgated by a sovereign government or authoritative entity, whereas such ordinances and statutes entitle one ethnic group in a society certain rights and privileges, while denying other groups in that society these same rights and privileges because of long-established cultural prejudices, religious prejudices, fears, myths, and xenophobias held by the entitled group.

Anti-Racism Resources

Learn how to create and advocate for a more inclusive, anti-racist working and learning environment. Use these resources to increase your cultural competency, enhance your PT/PTA practice, and increase your awareness of anti-racism.

• US Department of Arts and Culture: Honor Native Land: A Guide and Call to Acknowledgement
• APTA Cultural Competence Resources: Race and Ethnicity
• White Coats for Black Lives
• New England Journal of Medicine: Race and Medicine
• Mind the Gap – A Clinical Handbook of Signs and Symptoms in Black and Brown Skin

Foundational LGBTQIA+ Knowledge

The following terminology describes LGBTQIA+-related topics, compiled by APTA's Student DEI Project Committee, using various resources. 

• Sexuality: A person's identity in relation to the gender or genders to which they are typically attracted; sexual orientation.
• Lesbian: Describes a woman who is romantically and/or sexually attracted to other women.
• Gay: Often used as an umbrella term to describe a person who is romantically and/or sexually attracted to other members of their own sex; used in reference to lesbians and gay men.
• Bisexual: Describes a person whose romantic and/or sexual attraction is not limited to one particular gender.
• Pansexual: Describes a person whose romantic and/or sexual attraction is not dependent on gender.
• Asexual: Refers to a person who does not experience sexual attraction toward other people.
• Assigned sex: The sex assigned to an infant at birth, based on the child’s visible sex organs.
• Gender: An individual’s identity and self-perception, with regard to the binary social constructs of masculinity and femininity.
• Cisgender: Describes a person whose sex and gender assigned at birth are in alignment.
• Transgender: Describes a person whose personal identity and gender do not correspond with the sex they were assigned at birth. (This is not indicative of their sexual orientation).
• Transgender man: A person who was assigned female at birth but identifies as a man; sometimes referred to as female-to-male.
• Transgender woman: A person who was assigned male at birth but identifies as a woman; sometimes referred to as male-to-female.
• Nonbinary: Describes any individual whose gender identity aligns with neither man nor woman, but falls outside the socially constructed gender binary. 
• Intersex: Describes an individual born with both male and female biological sex characteristics.
• Queer: Historically, the word "queer" originated as a slur but is being reclaimed by some members of the LGBTQ+ community as a gender-neutral umbrella term for any non-cisgender or non-heterosexual person.

LGBTQIA+ Resources

Learn how to create and advocate for LGBTQIA+ inclusion in your workplace or school with these resources.

• CDC: LGBT Health Services
• APTA Cultural Competence Resources: Gender Identity and Expression
• Seven Resources To Inform Your Practice With LGBTQ+ Patients and Clients
• Five Ways To Be an LGBTQ Patient Ally
• We Owe it to our Patients - and Each Other - to Honor Pronouns
• GLAAD: LGBTQ Resource List
• PT Proud: Introduction to LGBTQ+ Competency: Handbook for Physical Therapy
• The Genderbread Person: A Teachable Tool for Breaking Down Gender and Sexuality Concepts Into Bite-Sized, Digestible Pieces

Deepen your understanding of DEI issues and further your cultural competency with the following resources.

Courses, Podcasts, and Videos

• APTA Learning Center: DEI Courses
  More than a dozen courses cover foundational concepts, guidance for clinicians, understanding culture, allyship, and more. A highlight is APTA’s six-part DEI Certificate Series, which introduces learners to bias, microaggressions, population health, the Americans with Disabilities Act, treating a gender-diverse population, and improving diversity in the physical therapy profession. Participants will engage in self-reflection throughout the series to apply concepts to their clinical and personal lives with the goal of creating more inclusive and diverse environments.
• Five Short Videos: Implicit Bias and Cultural Competence in Health Care
  Learn about implicit bias and cultural competence in health care, and get recommendations for mindfulness, empathy, and self-reflection.
• APTA Video: DEI Discussions: Race and Racism
  APTA's first in a series of discussions about diversity, equity, and inclusion. This discussion focuses on race and racism in physical therapy. 
• CNN/"Sesame Street" Video: Racism Town Hall
  CNN’s Van Jones and Erica Hill partner with “Sesame Street” for Coming Together: Standing Up to Racism, a town hall for kids and families.

APTA Podcasts

• Fostering Allyship in DEI - Part 1
• Fostering Allyship in DEI: Part 2

Videos: Lynda D. Woodruff Lectures

• 2020: Who Do We Want to Be? Responsible Stewardship of Our Profession
• 2021: The Road to Success: Are We Ready to Change Directions?
• 2022: The Profession's DEI 'Disability' Must Be Addressed
• 2023: Without Us, We Are Not Complete: Proffering Pragmatic Solutions to Combating the Costs to Society of the Lack of Diversity and Representation in the Profession of Physical Therapy

Videos on Microaggression

If you're not used to experiencing microaggressions, it can be hard to understand what they are and why they're so harmful. In this session, the participants discuss their own experiences with microaggressions to help demystify them once and for all.

• Real Talk About Race: This Is How Microaggressions Show Up in the Workplace
  If you're not used to experiencing microaggressions, it can be hard to understand what they are and why they're so harmful.
• Real Talk About Race: Workplace Microaggressions: What Do They Look Like and How Do You Respond?
  This topic is so big that we had to come back for Part II.
• TED Talks to help you understand racism in America
  From passionate pleas for reform to poetic turns of phrase, these talks take an honest look at everyday realities of Black Americans and illuminate the way forward.
• Climate Scan Tools
  Use these climate scanning tools to help assess the DEI culture of your individual spaces and identify areas of improvement.
• Take a Test to Understand Your Implicit Bias
  Project Implicit is a 501(c)(3) nonprofit organization and international collaborative of researchers who are interested in implicit social cognition. Leverage their tests to find out your social and health-related implicit biases.

Apply your knowledge and passion. Here are ways to get involved and make a difference in your communities.

Opportunities Within APTA

• Set up an APTA Engage profile to get notified of volunteer opportunities.
• Join a chapter or section/academy DEI committee.
• Join APTA's Advocacy Network to stay up to date on advocacy opportunities.
• Seek volunteer community engagement opportunities at the APTA Combined Sections Meeting and other APTA events.
• Donate to make a difference:
  • PT Fund.
  • Foundation for Physical Therapy Research.
  • Physical Therapy Political Action Committee of APTA.
• APTA Academy of Leadership and Innovation PT Proud CommitteePT Proud’s mission is to improve health care access for LGBTQIA+ patients as well as empower LGBTQIA+ students, faculty, and clinicians within the physical therapy profession to influence health and well-being that is specific to sexual and gender minority populations. 

Opportunities Beyond APTA

Explore engagement with these groups that were identified by the APTA Student DEI Project Committee:

• Academy of Filipino American Physical Therapists
  The academy's mission is to promote unity, professionalism, and the advancement of Filipino American physical therapists through an academy of supportive fellowship, via the pursuit of clinical evidence, education, and career opportunities.
• The American Academy of Physical Therapy
  A not-for-profit organization whose mission is to provide relief to poor and disadvantaged African Americans and other minorities by promoting new and innovative programs in health promotion, health delivery systems and disease prevention, encouraging minority students to pursue careers in allied health professions, and performing clinical research directly related to health conditions found within minority communities.
• Cynergy PT (One Step Ahead Foundation)
  The Foundation provides Black and Indigenous people of color student-athletes and students pursuing careers in physical therapy a mentorship program that focuses on health and wellness, athletic development, academic and career mentorship, acquisition of college grants and scholarships, and community building.
• Explore the Magic of Motion, LLC
  A signature summit and consultation service, offering physical therapy exploration programs to the community and cultural competence education with an outreach toolkit for health care providers.
• Live & Grow Mentorship
  Mentorship for pre-physical therapy students applying to DPT programs, pre-physical therapy students starting directly after undergraduate graduation, students in a gap year, and career changers.
• National Association of Black Physical Therapists, Inc. ("Each One, Teach One" Mentorship Program)
  NABPT is a nonprofit organization with the primary focus of increasing opportunities for the African diaspora in physical therapy. The mentorship program involves fostering communication and a professional relationship between current physical therapists and physical therapist assistants with current PT and PTA students.
• Ujima Institute
  The Ujima Institute was founded by Lisa VanHoose, PT, PhD, MPH. As a physical therapist and researcher, she believes that individual and societal wellness ​requires village-like efforts. The Institute offers training to help people live an inclusive life or create an inclusive workplace.