When California voters passed Proposition 209 in 1996 to ban state institutions from considering race, sex, or ethnicity in admissions or hiring decisions, the number of black and Hispanic students Dentistry in the University of California system has plummeted.
A quarter of a century later, UC campuses still struggle to recruit and retain diverse students, including the University of California, San Francisco, which offers graduate programs in dentistry. , medicine, pharmacy and nursing.
“We’re not going back to 1996,” said Dr. Renee Navarro, UCSF vice-chancellor for diversity and outreach.
The public research agency introduced language as a factor in enrollment, invested in the community long-term, and launched recruitment campaigns targeting underserved populations much earlier in the process. education. Navarro said these efforts have yielded only modest results.
Approximately 6% of UCSF’s students are black and 15% are of Hispanic or Latino, according to a university report. According to census data, these figures are disproportionate to California’s increasingly diverse population, which includes 7% Black, 5% biracial, and 40% Hispanic or Latino.
However, the University of California’s diversity, equity, and imperfect inclusion strategy could provide a framework that higher education and health care institutions will have to repeat if the Supreme Court rejects it. give up affirmative action. The High Court is considering reversing precedent dating back to 1978.
The legal question is whether public or private institutions that receive federal funding can use race as a factor in determining whether an applicant is eligible to enroll. Lawsuits against admissions practices at the University of North Carolina and Harvard University have been ongoing since 2014.
The plaintiffs are a group of students who claim that their chances of admission are unfairly reduced because schools consider race and ethnicity. The Supreme Court, which heard oral arguments on the matter on October 31, is expected to issue a ruling early next year.
In a summary of sentiments in court, the University of California joined dozens of other organizations that warned that removing affirmative action would hamper their efforts to attract the same proportion of applicants. Black and Hispanic members. The organizations argued that removing race-based considerations would reduce the number of Black and brown clinicians in the healthcare workforce, which would impact patient care. core.
“Preventing medical educators from continuing to consider diversity in enrollment will not only impoverish the educational experience of all future healthcare professionals; it will actually pay cost lives and degrades many others,” the summary said.
Leaders in higher education and healthcare are pondering how to sustain progress on workforce diversity — a key factor in addressing health disparities — and implement new recruitment strategies. Some fear that a legal reversal would set them back decades.
Dr Joseph Flaherty, president of the Western Atlantic University School of Medicine in Freeport, Bahamas, and former dean of admissions at the University of Illinois Medical School, said: harmful.
Immediate impact
A UCLA-University of Pittsburgh study published this year found that minority students enrolling in medical schools fell by nearly a third within five years in nine states where affirmative action bans have be done.
If expanded nationally, enrollments would drop as healthcare and higher education institutions have struggled to recruit and retain people of color for clinical roles. .
Last year, nearly 10% of medical students identified as black and 12% as Hispanic or Latino, according to the Association of American Medical Colleges. These numbers have increased by 2 to 3 percentage points since 2014 but still do not reflect the demographic structure of the country.
According to data from the Bureau of Labor Statistics, a larger percentage of black and Hispanic health care workers are found in lower-paying jobs and a smaller percentage in roles medical. Of registered nurses, 13% were Black and 9% Hispanic or Latino, while about 8% of doctors were Black and 9% Hispanic or Latino last year.
Research has demonstrated that a diverse workforce improves clinical outcomes and patient experience scores. For example, hospitals are more likely to receive a higher Consumer rating for providers and healthcare systems when patients are connected to doctors who understand or relate to the principles of health care. their personal calendar.
Geoffrey Young, senior director of healthcare workforce transformation at the Association of American Medical Colleges. “It has dire consequences moving forward.”
In a separate summary sent to the Supreme Court, the American Medical Association, AAMC and other trade groups wrote that allowing the number of Black and brown clinicians to decrease would be detrimental to care for patients, especially for those from underserved communities, where these service providers are often practical. “For high-risk Black infants, having a Black doctor equates to a miracle drug: It more than doubles the baby’s chance of survival,” the organizations wrote. writing position.
Because of such outcomes, health systems have focused on diversity, equity and inclusion as they build their workforces. In a Deloitte survey of health system and insurance company CEOs, more than half identified health equity as one of their top three strategic priorities — and enhancing engagement. Internal diversity is the first step. Amid greater workforce challenges, healthcare organizations have relied on higher education institutions to send them more professionals of color.
HCA Healthcare acquired the Galen School of Nursing in 2020 to establish a nurse supply system for its 184 hospitals. Since then, the health system’s multi-campus nursing school based in Nashville, Tennessee has partnered with historically Black colleges and universities to recruit from their undergraduate programs.
CommonSpirit Health of Chicago kicked off a 10-year, $100 million recruitment initiative with Morehouse Medical School in Atlanta to increase the diversity of physicians. In addition, the National Football League is partnering with the nation’s four historic Black medical schools to increase the number of Blacks in sports medicine.
Fran Roberts, a former nursing school dean turned consultant who chairs the board of trustees of the Galen College of Nursing, said. “We need all the help we can to support the healthcare workforce that reflects the patients we care for,” she said.
Alternative strategies
Race-neutral strategies for college admissions are far less effective than affirmative action, says Navarro. As a result, educational institutions and healthcare employers will have to get creative if the high court rescinds race-based criteria.
Those solutions should focus on eradicating racial disparities broadly, Young said. “Medical and medical education in itself is a microcosm of the wider society. So, until we address and acknowledge the impact of systemic racism on people study, I think we’ll probably continue to have this problem,” he said.
Health systems and higher education institutions may need to start hiring earlier — even in elementary schools — and target underserved communities. They can also invest in community-based health equity initiatives, Navarro said, and are clear about incorporating inclusion into their organization’s mission.
Provider groups can also launch apprenticeships, offer scholarships, or develop partnerships with HBCUs or Caribbean schools that typically attract more diverse students, Flaherty said. “People will show their ingenuity and try to keep diversity moving forward. Because I think the goal of it is still there and still important,” he said.
