Diversity in Wilderness Medicine 

– by Roople K Unia, MD

When Renita Fonseca was announced as the new CEO of the Wilderness Medical Society, I reacted with shock and delight. OTHER INDIAN PEOPLE LIKE OUTDOOR STUFF?! And not just like it, are organizing it? As I surveyed the audience from the back of the lecture hall at the most recent WMS conference in Midway, Utah, I spotted one of my people. An Indian doctor. Generally, as rare as spotting a seagull at the beach. Why then, the dearth of our kind at this conference? Why the lack of diversity altogether? If you read Outside Magazine or use Instagram, you know there’s a growing movement to bridge the #adventuregap, #colorthecrag and that #blackgirlsclimb. You can even witness the wonders of #brownpeoplecamping and they’re not just #doingitforthegram. 


A National Parks Survey referenced in this CNN article indicated that while our population is made up of 38% minorities, the percentage visiting the parks was only 22% minority. A 2018 survey by the Outdoor Foundation found that 146.1 million Americans participated in outdoor activities in 2017. White respondents had a 51% participation rate in these activities whereas Black respondents had a 34% participation rate.


So it’s not just that there’s a lack of diverse populations involved in wilderness medicine, there’s a lack of diversity in the outdoors. I’m not just talking about racial diversity either. The LGBTQ community has less representation, as do people with disabilities. 


I'm going to tell you my own personal sneaking suspicion as to why the wilderness medicine community is rather homogeneous. People are just not aware wilderness medicine is even a thing (see below for this unscientific surveymonkey poll I conducted.)


I asked friends and strangers alike to click through this survey. 74 people were game enough to respond.


76% of respondents identified as white or Caucasian, 8% as having a disability, 80% as heterosexual, 66% as female.  


Most people who clicked ‘other’ in terms of how they are involved in health care were wilderness first responders (WFR). This goes to show why acronyms can be problematic, as WFR was one of the selections to begin with, making my unscientific survey even less scientific.


As you can see though, we can make a few generalizations: 1) Hiking is very popular. 2) People love cat videos. 3) Many people would like to be one of us but had no idea that they, too, could be this cool.


But before I go jumping to conclusions, let’s examine the barriers keeping diverse people from getting outside. I started with my family, since many of them think I’m a complete nutter for doing what I do.


  • ‘My idea of camping is a 5 Star hotel!’
  • 'Ummm, bugs'
  • ‘Specifically, mosquitoes’
  • ‘you guys have to do something about your bear problem’
  • 'I went up that mountain with you and my knees have never been the same'
  • ‘our parents are not outdoorsy’
  • ‘I like the idea of it, just not the reality’
  • ‘I’m conditioned to the convenience of modern life with on demand entertainment and comfort in my surroundings’
  • ‘When I lived in Australia, I did a lot of outdoor things because they were so accessible but it’s harder where I live now’ 


I reached out to the founder of Diversifyoutdoors.com, Danielle Williams, to see what she had to say about the issue: “I think it’s a grab bag of excessive cost, lack of representation & lack of access going back generations for historically marginalized groups” she stated. “The adventure activities that get a lot of media and advertising coverage have very steep up-front costs to include alpine climbing, skydiving, kayaking and many other “adventure sports.” And so many People of Color enter these activities thinking that they’re “the only one.” For some folks that means challenge accepted, but they are the outliers. Most folks, regardless of race, feel more comfortable seeing faces that look like them”.


I also had the opportunity to speak with Justin Forrest Parks (yes that’s his real name), current director of diversity and inclusion for NOLS (National Outdoor Leadership School). See, I learned my lesson about acronyms. He too believes that in order for people to feel that they can participate in an activity, they first need to identify with other people participating in that activity.


 I read James Mills’ book The Adventure Gap which describes the coming together of the first all African-American team of climbers to attempt to summit Denali. In 2013, NOLS sponsored this team of 9 climbers ranging in age from 17-65. Mills details the personal history of each climber, how he or she came to love the outdoors, and delves into the history of the African- American mountaineers that came before them. He profiles Kai Lightner, a young African- American sport climber who was inspired by the progress of the expedition and who states his desire to inspire others: ‘I hope that more African American kids see me and know that it’s possible.” Here is the trailer of the award-winning documentary film, An American Ascent, based on Mills’ book. 


Therefore, the barriers to diverse people partaking in wilderness activities and by proxy, wilderness medicine, are:


Cultural – Exposure plays a huge role and if outdoor activities aren’t the done thing amongst a certain group of people, they certainly are less likely to invest time and resources in pursuing them. Organizations like the Sierra Club’s Inspiring Connections Outdoors break down those barriers by providing inner city youth ‘with outdoor recreational opportunities, leadership training, positive group experiences and environmental education, while imbuing in them a love of nature and the outdoors.’


Financial – Certain activities do have high up-front costs for things like travel and equipment, though borrowed equipment and shared travel can cut down these costs, as can learning from friends rather than paying for lessons.  


Social – If one’s social group is not inclined to participate in adventures in the wild, one may limit oneself to activities that are widely accepted by this social group such as ‘dinner’ or ‘movie-watching.’ However, if any member of the group bucks the trend and suggests and adventure film or a picnic in the park, it could be the first step towards engendering a love of the outdoors. 


Access – It may take hours or days of travel for some to reach the countryside, mountainside or seaside, thus limiting participation in countryside, mountainside or seaside activities. The outdoors, however, can be as close as the back yard or neighborhood park as a first taste. Safety can also be a concern and thus having a knowledgeable adventure buddy is always a good idea.


Physical – Those with physical disabilities or even a lower level of fitness may feel prohibited from participation in many outdoor activities, but for proof this doesn’t need to be the case, take a look at Maureen Beck kick some climbing butt in this video: 


Cross out ‘disabled’ and insert ‘differently abled.’ 


Awareness – lastly, as I mentioned above, people cannot do something if they are not aware it exists and thus the question then arises: what steps can we take to encourage diverse participation in outdoor activities and adventures, wilderness medicine, and steward the care of our natural treasures? 


Here’s my action plan:

        1) Tell people how cool it is

        2) Take them on adventures

        3) Bring them to conferences

        4) Tell them to invite their friends

        5) Rinse and repeat


I hereby take responsibility to harass my colleagues and friends to join the WMS and participate actively. I encourage you to do the same.


Sincerely, 

Roople K Unia, MD 

 

 

Published February 2, 2019

Volume 36, Issue 1

 

Roople K Unia, MD

 is a practicing neurologist in Bangor, Maine. She completed her medical training in Krakow, Poland, Neurology residency and Vascular Neurology fellowship at the University of Rochester in Rochester, New York, and Movement Disorders Fellowship at New York University in New York, New York. She is working towards her FAWM, because why wouldn’t you? In her leisure time, she climbs rocks and ice, skis, ice skates, hikes, camps, travels, teaches yoga and generally enjoys life.