While African Americans, Hispanics/Latinos and American Indians together represent more than one-fourth of the US population, they comprise less than 9 percent of nurses, 6 percent of physicians and 5 percent of dentists. Although while a record 18,000 new students entered medical school in 2008, just under 2,900 were African American, Hispanic/Latino or American Indian. Meanwhile, by the middle of this century, the US population could be more than 50 percent nonwhite.
These statistics, from a Sullivan Commission on Diversity in the Healthcare Workforce report, point to a severe reality: As declining numbers of African Americans, Hispanics/Latinos and American Indians become doctors, nurses and dentists, the quality and availability of healthcare services for minorities suffer.
According to the Sullivan Commission, led by Dr. Louis W. Sullivan, former Secretary of Health and Human Services, minority groups receive poorer quality healthcare and experience higher mortality rates from heart disease, HIV/AIDS, diabetes, mental health and other illnesses. Minority children are more likely to die from leukemia than white children.
A 2003 Bureau of Labor Statistics survey shows that Hispanics comprise only 4.4 percent of all medical records and health information technicians, 2.8 percent of pharmacists and 1.3 percent of emergency medical technicians and paramedics -- this in a job category that employs 6.6 million people in the United States.
The survey also states that African Americans rank low in many positions, including physical therapists (2.6 percent), opticians (1.3 percent) and dental hygienists (less than 1 percent).
Asians, who make up 4.2 percent of the US population, are represented at that rate or higher in most healthcare segments -- particularly physicians and surgeons (16.1 percent), and clinical laboratory technologists and technicians (12.3 percent). However, they are underrepresented as licensed practical and vocational nurses (3.6 percent), dental hygienists (1.4 percent) and dispensing opticians (1.3 percent).
Administration is another area where minorities are scarce. In the mid-1990s, minorities made up 28 percent of the hospital workforce, says Rupert Evans, president and CEO of the Institute for Diversity in Healthcare Management. However, fewer than 2 percent of healthcare executives were members of any minority group. Less than 1 percent of CEOs were women, and most of them were nuns working in church-affiliated hospitals.
There's Some Progress
Nursing is one area of healthcare in which two other groups, older workers and those with disabilities, find opportunities. A study by nursing researcher Peter Buerhaus shows that part of the 9 percent increase in the nursing workforce from 2001 to 2002 was due to nurses over 50 returning to the hospital. Hospitals are making work environments more supportive for older workers. For example, some offer scheduling flexibility and reduced physical requirements.
The acute nursing shortage and recent innovations, like talking thermometers, have caused nursing programs and employers to reach out to men and women with a range of disabilities -- from vision and hearing loss to impaired mobility -- and focus on the tasks these workers can do.
Working to Recruit from All Backgrounds
Joan Reede, Harvard Medical School's dean for diversity and community partnership, cites several reasons for the disparity in the number of African American, Hispanic/Latino and American Indian healthcare workers. "If people never graduate from high school or college, they never get in the pipeline for professional school," she says. "But even those who are in the pipeline might not be accepted at the same rate as whites. Scores are important, but schools should also be looking at criteria like language, culture and an interest in serving poor and rural communities."
Harvard Medical School has developed programs that reach minority youngsters as early as elementary school. "If you're not exposed to science courses, mentors, after-school programs, internships or career choices, you won't think of a job in healthcare," Reede says. "It's hard to dream of things if you don't see possibilities."
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