By Dr Chris Edmond
BEFORE I get into today’s column, can I ask you to take a moment to imagine someone successful in their career – perhaps a political leader, or a senior doctor, or a judge? Take a minute to really get a clear picture of them. Keep them in your mind – I’ll come back to them later.
Moving on, I would like to tell you about one of the most striking pieces of medical research I ever read, by Professor Steve Cole of the UCLA School of Medicine, California.
In his work in the 1990s, while studying the effect of social factors on immunology and genetics, Professor Cole found that gay men with HIV who were open about their sexual orientation suffered far fewer Aids-related illnesses than those who concealed their sexuality.
Being open about who they were was actually protective against physical disease.
Over the subsequent years, Professor Cole continued his work understanding the biological pathways to explain the finding, and showed that being socially inhibited (in other words, not being able to be yourself) contributed at a cellular level to chronic inflammation, diseases such as cancer, heart disease and depression, and the inability to fight infections such as HIV.
So why am I writing about this in the JEP? In my day job, this month has been focused on the topic of Equality and Diversity – International Women’s Day passed on 8 March and Neurodiversity Celebration Week is coming up next week. You may not realise it, but such events are key to improving the health of both employees and the businesses they work for.
Let me take you back to the ‘successful’ person you pictured at the start. The reality is that most of us will have pictured a middle-aged, middle-class white man, perhaps in a suit, perhaps with greying hair. There’s nothing wrong with you if you did – all this does is demonstrate the biases present in all of us. Such biases start in infancy with pictures of only white able-bodied people in children’s books, and slogans on boys’ clothing saying ‘Champion’ whereas the girls’ equivalents say things like ‘Be Kind’.
So now have a think about what it must be like if, like most people, you don’t fit the norm of what ‘successful’ looks like? What if English isn’t your first language, you are socially deprived, or you are transgender or disabled? What happens if you don’t see people like you in positions of power?
Psychologists have coined the term ‘code-switching’ for the adjustments in language that occur subconsciously in an attempt to ‘fit in’ – we try to change our behaviour to be like those around us, or how we feel we will be viewed most positively. We all code-switch to a certain extent, but we now know that not expressing your true self is actually psychologically and physically damaging to your health.
As someone who had free school meals and whose parents didn’t go to university, when I ended up studying medicine at an Oxbridge college I gained plenty of experience of code-switching. It’s only over time I learned it is OK to be my genuine self, and I was lucky enough to be a white, straight, man.
We know trying to ‘fit-in’ damages us as individuals. Now consider recruitment policies and political elections. We know that neurodiverse people, who make up around 20% of the population, can have difficulty with standard assessments and interview processes. We know that women can be reluctant to enter traditionally male-dominated industries.
We know that our biases as to what ‘success’ looks like mean that it’s far easier to be elected as a white man than as a woman of colour. As a result we end up with businesses and political systems where most people look, sound and think the same.
There are many studies that show the benefit in both business and politics of a diverse leadership and workforce – diversity in thinking leads to proven better outcomes. Take the example of Blockbuster Video, which folded having not taken the growth of Netflix seriously – perhaps with someone younger on the board of directors they might have recognised the power of streaming video before it was too late.
From the limited data available, we know in Jersey we have problems with a large gender pay gap, many people with disabilities being out of work, an unrepresentative States Assembly and poor mental health and high levels of stress throughout the community. We also have huge wealth inequality – shown to negatively impact both the poor and the rich.
Only by working to make our businesses, communities and our politics genuinely welcoming and inclusive will we create a society where everyone feels they belong. We could then benefit from the diversity of thought needed to address the social challenges facing us, and we would all end up healthier and happier for it.
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Dr Edmond is the founder and medical director of WorkHealth (CI) Ltd, a dedicated Jersey-based occupational health provider. He is also a director at Jersey Sport and adviser to the Jersey Community Foundation. He writes in a personal capacity.
