Reflections on Increasing Diversity in the Health Professions

By Saba Brelvi, TCWF program director

The California Wellness Foundation (TCWF) has been making grants to increase diversity in the health professions for almost four years. At this juncture, we’re taking an opportunity to reflect on the need for a diverse health care workforce in the state and our rationale for prioritizing this topic, on the decisions we’ve made on how best to address this issue, and on the tremendous work done by organizations we have funded to support youth and adults from traditionally underrepresented backgrounds in their efforts to pursue careers in health. It has taken us a significant amount of time to become familiar with the terrain and to get to know the players in these efforts. We’ve had some early successes and have learned important lessons that will guide us in future grantmaking. The need for increasing diversity in the health professions often flies below the radar of policymakers, advocates and other funders. Nonetheless, we are committed to continuing these efforts, firm in the belief that diversifying our state’s workforce is critical to improving the health of all Californians.

As is evident in almost any health facility in the state, the physicians, nurses, dentists and allied health professionals of California look distinctly different from the Californians whom they treat. While one-third of the state’s 36 million residents are Latino, only four percent of doctors, six percent of dentists, and four percent of registered nurses (RNs) in the state are Latino. African-Americans account for six percent of the state’s population but only account for three percent of its doctors, less than two percent of its dentists and four percent of its RNs. While some Asian and Asian-American groups are well-represented in certain health professions, others are underrepresented; for example, although the state has more than 65,000 Hmong residents, only a small handful of Hmong men and women are trained as physicians.

A growing body of evidence indicates that a racially and ethnically diverse cadre of health professionals is beneficial on multiple levels. (Studies cited in this article are listed in the bibliography.) Providers of color increase access to care for underserved Californians because they tend to practice in minority and low-income communities more than their peers. They are able to provide care that recognizes and accounts for the cultural beliefs and mores of their patients. They can serve as role models and mentors for racially and ethnically diverse students who may not have access to other health professionals, and they can contribute to the fields of health and medicine by ensuring that the priorities of underserved communities are considered in decisions regarding research, funding and education.

Research is slowly emerging to suggest that all students attending universities and professional schools benefit from a diverse educational community. In 2003, Justice O’Connor wrote in the majority opinion for Grutter v. Bollinger, an affirmative action case at the University of Michigan Law School, that a critical mass of racial and ethnic diversity was “in the compelling interest” of both the nation and the university.

Finally, increasing diversity in the health professions is an important workforce development strategy as well. Jobs in the health care sector, particularly among the allied health professions, are among the fastest growing in the economy, and they provide employment opportunities that pay a living wage. The business imperative for increasing diversity in the health professions is also clear. In addition to ensuring that the underserved will be better able to receive care, thus bringing down health care costs, employing a diverse group of providers will competitively position health care institutions that are marketing their health plans to California’s “majority minority” population.

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