Partnerships, Pipelines, Persistence: A Formula for Excellence and Preparedness

Since the early 1970s, the primary approach to diversifying the U.S. health care and biomedical workforce has been a heavy reliance on federal funding and dependable institutional models designed to prepare and develop historically underrepresented students and those from economically and/or educationally disadvantaged backgrounds for competitive graduate, medical and health professional schools (e.g., CDC Undergraduate Public Health Scholars Program). Summer enrichment programs, standardize testing preparation, research training, mentoring opportunities, precepting or shadowing experiences, and workshops are common on campuses, and their guidance are proven routes through which many students, benefitting from these opportunities, have travelled to become the nation’s frontline doctors, nurses, scientists, and public health professionals. As good as these programs might be, they are no longer sufficient on their own to maintain a diverse workforce. Challenges involving sustainability, accountability, and educational inequities remain of great concern. In addition, the health care workforce is not keeping pace with the increasing diversity of the U.S. population. Demographic trends such as an aging health care workforce, baby boomer retirements, long-term care needs, and shortages in the health professions accelerate these challenges. In medicine, underrepresented minorities (URM), including Black, Hispanic, and Native American active physicians, make up 11.1% of the U.S. health care workforce, compared with 56.2% Whites, 17.1% Asian, and 15% other or unknown. URM scientists constitute only 3% to 4% of medical school basic science tenure-track faculty. In academic nursing, minority faculty represent 17.3% of all faculty positions with Blacks (4%) and Hispanics (3%) holding fewer full-time professorships compared with Whites (81%). The percentage of active dentists by race include 3.7% Blacks, 5.6% Hispanics, 17.1% Asians, and 71.9% Whites. These percentages are disproportionately small given that racial and ethnic minorities make up 39% of the population and Blacks (13%) and Hispanics (18%) are 31% of the U.S. population (American Association of Colleges of Nursing, 2020; American Dental Association, 2019; Association of Academic Health Centers, 2013; Association of American Medical Colleges, 2019; Campos et al., 2021). This disproportion does matter. For many years, research has demonstrated that increased diversity in the health professions has positive implications such as improved patient choices, higher satisfaction, better health outcomes, and enhanced patient–provider communication. Furthermore, studies have shown that people of color are more likely to report poor quality of care specifically because of their race and ethnicity (Blewett et al., 2019). To put it simply, patients are more responsive to health care providers who look like them.