Social Structures and Their Impact on Leadership Development for Women of Color in Occupational Therapy in the United States
Authors: Nirmul Ushentha , Cabrejo Pamela Talero 
Published: February 2025

Importance: Historical and contemporary social structures in the United States profoundly shape leadership development for women of color in occupational therapy, revealing systemic inequities.
Objective: To understand how social structures have shaped the leadership development of women of color leaders in occupational therapy in the United States.
Design: Building on Nirmul et al. (2023), the authors conducted a secondary qualitative analysis using Winker and Degele’s (2011) multilevel intersectional approach, examining organizational culture, mentorship, sponsorship, and professional organizations through eight narrative interviews.
Setting: Virtual multiregional interviews.
Participants: Eight English-speaking women of color self-identified as leaders in occupational therapy in the United States were included, representing diverse professional roles and career stages.
Outcomes and Measure: Steps 5 through 8 of Winker and Degele’s (2011) multilevel intersectional approach were used to analyze participants’ narratives, exposing social structures and their effects on mentorship, professional organizations, organizational culture, and sponsorship experiences.
Results: The analysis revealed that American White supremacy profoundly affects leadership development for women of color in occupational therapy. Key challenges included racialized social structures, institutional barriers, discrimination, anti-Blackness, patriarchy, performative diversity efforts, mentorship hierarchies, and financial constraints, highlighting structural inequalities within professional organizations, mentorship, sponsorship, and organizational culture.
Conclusions and Relevance: Diversity, equity, inclusion, justice, accessibility, and belonging initiatives must address social structural barriers by transforming organizational culture, diversifying mentorship and sponsorship, and fostering authentic inclusion through ongoing professional development to support leadership development for women of color.
Plain-Language Summary: This study investigated how social structures in the United States have influenced the leadership development of women of color in occupational therapy. Using data from a prior study, the authors analyzed the personal narratives of eight self-identified women of color leaders. Analysis revealed that American White supremacy profoundly affected the participants’ leadership journeys; this impact was evident in organizational culture, professional organizations, mentorship, and sponsorship. Key issues identified include anti-Blackness, institutionalized patriarchy, performative diversity initiatives, racial hierarchies in mentorship, and financial constraints. The study concluded that while diversity, equity, inclusion, and justice initiatives are essential, they are insufficient to overcome these social structural barriers. The authors advocate for intentional action to transform organizational culture, prioritize diversity in mentorship and sponsorship, and provide continuous professional development opportunities.
Positionality Statement: As described in Nirmul et al. (2023), both authors are immigrants from postcolonial countries and have been racialized in the United States as an Asian American (Ushentha Nirmul) and a White Latina (Pamela Talero Cabrejo). Their privileges have allowed them to engage in leadership development work, and they believe that an intersectional analysis is crucial for understanding both leadership development and daily living occupations.