We’re very pleased to publish the following post on Embracing Human Variation written by our guest blogger Hillary Wilson. Hillary is committed to creating diverse, affirming artwork that includes people of different shades, sizes, and backgrounds. She has a Masters degree in Medical Illustration from the Johns Hopkins Graduate Program for Medical and Biological Illustration. Inspired by the rich diversity and variation of humanity, she strives to capture that sentiment in her artistic approach to both medical and fine art subjects, and in her work as a diversity consultant to companies and organizations.

Hillary Wilson self portrait. Image source: http://www.hdwilsonart.com/

Why is accurate diversity important in medical art and the field of medicine in general?  

Education and exposure  

Many people, including medical, students, professionals, and patients, aren’t exposed to enough accurate visuals of non-white body parts. This perpetuates gaps in knowledge that can lead to worse outcomes in people of color and can also lead to shame, misinformation, and people stigmatizing normal attributes.

Accurate and relevant information  

Diversity is also important in medical art and the field of medicine because it creates opportunities to recognize how medical conditions affect us differently. Since there is so much variation in humans as a species, it’s important to recognize these differences and provide relevant information that applies to different types of people. This variation encompasses more  than skin color alone. Differences in bodies can also lead to slight physiological differences and  trends in medicine that are important to keep in mind.  

For example, many people might not understand why razor bumps (see image below) are so prevalent in black men and so difficult to treat. Commonly shown hair follicle images depict straight hair, while hair follicles and hair shafts in hair that is very curly are actually C shaped. Such curved hair follicles and a predisposition for keloids—traits common in black men—can exacerbate an issue like razor bumps and make them difficult to avoid and treat.

Part of a series created to teach general audiences about black skincare, this illustration conveys important anatomical information about the C-shaped hair follicles that are typical of people with very curly hair. Anatomy books have historically depicted straight, linear hair follicles as standard. Such shortcomings in anatomical representation and understanding can lead to poor outcomes in medical care and treatment for non-white people. Image source: https://www.hwilsonillustration.com/.

Normalizing the reality of a diverse world  

Although a lot of communities can be fairly insular, in reality, the world is full of all kinds of people consuming media and using health resources. When there is more ambient diversity in these resources, they more accurately reflect the world we live in and the realities of the people in it. In short, diversity is important because it exists everywhere.

What are some of the barriers that may make it difficult for more medical illustrators and science communicators to include racial and ethnic diversity in their work?  

A fear of stereotyping, offending, or “doing it wrong”  

It’s a common fear that portraying different types of people will lead to stereotyping or offending people from these different groups, or that acknowledging the topic of race will  cause one to seem tone deaf, racist, or ignorant. Many may be open to depicting more diversity, but are afraid of what they don’t know, and worried they’ll seem racist. They may have an urge to disregard race and ethnicity entirely by creating blue, purple, or clear people, racially ambiguous people, or only portraying white people. Though well-meaning, this tactic can be harmful in counterintuitive ways. In attempting to account for everyone, it actually accounts for very few. A racially ambiguous person is still one person. A middle brown skin tone is still one skin tone. This approach also lumps features that don’t align with a Eurocentric framework into a general category of “stereotype.” Failing to acknowledge race and ethnicity can lead to media that fewer people find relatable, that lack important information, or that still unintentionally favor white people. 

There’s certainly a huge range of beneficial uses for glass bodies or didactic coloring, but it’s also beneficial to distinguish between making a conscious educational choice, and a choice rooted in avoidance. Many people aren’t racially ambiguous, and portraying a person who clearly represents a particular race or ethnicity isn’t necessarily stereotyping. It’s possible to notice and appreciate trends in features, while acknowledging that there’s always more variation you haven’t seen or considered. That’s perfectly okay. 

It’s also helpful to remember that many people can recognize and appreciate effort and thoughtfulness. Ask yourself “Am I doing my due diligence? Am I being thoughtful? Am I treating people with humanity?” Rather than, “Am I doing this right?”

Perceived difficulty  

It’s also common for people to think that increasing diversity in their body of work means they must create new work specifically to tackle it, that they have to replace a bunch of existing work, or that researching race and ethnicity is considerably more difficult than the typical research required in medical illustration and science communication.  

This implies that diversity is an accessory, or extra project, rather than something that can and should be woven into one’s work in general. It suggests that people who aren’t white must fit into certain subjects in order to be portrayed. 

It’s possible to make a conscious effort to understand that human variation is a constant reality  in our world, and that failing to acknowledge it can lead to media lacking a lot of significant information both visually and medically. Place diversity on the same level as other concepts that should be researched in order for information to be complete and reflective of reality.

These spheres show how to shade with a full range of light and dark using a variety of skin tones and pigmentations. Image courtesy of Hillary Wilson.

Not knowing when to include more diversity  

This goes hand in hand with a fear of stereotyping or offending, but with some subtle  distinctions. Many may hesitate to include more diversity in their work because they fear it’ll be  distracting, they think they need a reason for it, or they are worried they must get permission  first. 

This unfortunately suggests that white is the default and that other races and ethnicities must be there for a reason, or that they’re inherently distracting. 

When portraying people or body parts, you can make conscious decisions to portray diverse races and ethnicities when there is no specific reason. You don’t need to wait for an illustration depicting an ailment that is more common in people of color to depict them. Billions of people in the world aren’t white. It’s possible to celebrate the rich diversity of the world we live in just because it exists.

This patient information resource is a good example of how it’s possible to choose to depict a person of an underrepresented ethnicity without having a medically necessary reason to do so. Image source: https://www.hwilsonillustration.com/

So, what is a more constructive approach to diversity?

Try to show distinct people who could be real and relatable. Acknowledge different examples, rather than showing an idealized or generalized version of a person that tries to account for everybody at once. It’s impossible to account for every single human, and that’s okay. There’s no universal skin tone or bone structure that will reflect everyone. Variation exists everywhere, and that’s an exciting prospect. There are so many different ways to be a human.

Enroll in the S.P.A.R.K. online course and learn strategies for the visual communication of science!

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