Society and culture around us are evolving at a rapid rate, especially when it comes to diversity in the United States. In the 2020 census, the number of people who identify as Asian, Hispanic and multicultural grew significantly while the population of individuals who identify as white decreased for the first time in American history.
As American diversity increases even more rapidly than researchers had predicted, the need for more diversity in health care grows continually more pressing. While there has been progress, there is still room to grow when it comes to racial and gender diversity in various fields of health care. There is also a pressing need for greater representation in health care leadership positions.
What are the concrete benefits of greater diversity among health care providers? How about for patients and the community at large? What are some of the ways diversity in health care can be cultivated, and what might the outcomes be? Let’s find out!
Needed: Health Care Professionals of All Backgrounds
Ethnic diversity in the United States has undergone a major shift over the past three decades. For example, the percentage of white Americans has decreased from 75.6% of the population in 1990 to 57.8% in 2020—a drastic change over a period of just thirty years.
The trends are only expected to continue. America is projected to have a majority nonwhite population by 2050. But professional fields—namely health care—have been slower to see corresponding diversity.
For example, the Association of American Medical Colleges reports that, in their most recent findings, active physicians who identified as Black or African American made up 5% of all active physicians. However, around the same time, the United States Census Bureau reported that people who identified as Black or African American comprised 13.4% of the overall population. Similarly, while Hispanic individuals made up 18% of the overall population, they only represented 5.8% of active physicians.
The same goes for nurse practitioners. Nurse practitioners who identify as white make up 81% of all nurse practitioners. Black or African American nurse practitioners only make up 5.2% of all nurse practitioners. This may be slightly better than for physicians, but Hispanic and Asian groups are comparatively less represented as NPs.
Diversity benefits health care systems
Over the past several years, studies have shown that diversity produces a wide range of positive effects among communities, companies, social settings and student bodies. One of the places where benefits of diversity shine is within the health care system.
Increased cultural competency
There are many dynamics of cultural competency in health care, including religious belief systems, family norms, socioeconomic status and language. Health care providers understanding and acknowledging differences and respecting key cultural concepts can make a positive difference for patients who identify with those cultures.
Understanding the trust level that various groups of people have in the health care system can also be a vital piece of knowledge when providing care to a patient. For example, lack of trust in health care providers and the health care system is common within the African American community, and not without cause. In the mid-1900s, for example, researchers conducted what is now known as the USPHS Syphilis Study at Tuskegee. Participants were African American men, and the researchers conducting the study failed to collect their informed consent, told them they were being treated for "bad blood," and withheld penicillin from those suffering from syphilis. Medical research has since implemented numerous checks and balances to ensure that populations are not discriminated against or treated inhumanely in research, such as IRB protocols and ethics committees.
Acknowledging past failures and cover-ups, as well as identifying steps taken to conduct research and provide medical treatment honestly and ethically, can help health care providers cultivate stronger patient relationships with mutual trust and respect.
When it comes to non-English speakers, Health Affairs reports that 36% of hospitals don't have adequate systems in place for translation services. The ability to communicate clearly and with cultural competence isn't just a matter of good customer service, it can be a matter of life and death.
By both cultivating a more diverse health care workforce and improving access to medical translators, our society can experience better communication that reduces errors brought about by miscommunication.
Better patient outcomes
Patients tend to experience more positive outcomes when they are served by a diverse team of health care professionals. The Robert Graham Center found that patient-clinician racial concordance—in other words, a patient and their clinician sharing the same race—led to better patient outcomes including:
- Lower emergency department use for Asian and Hispanic patients;
- Lower health care expenditures for Asian, Hispanic and Black patients; and
- Lower rates of hospitalization for Hispanic patients.
Similarly, studies have shown that racial concordance could be a factor in reducing mortality rates. One paper's findings suggest that Black physicians could diminish the Black-white male gap in cardiovascular deaths by 19%. Another study showed a significant, positive effect on survival of acute myocardial infarctions (AMI), which women tend to be less likely to survive, when the women suffering from AMIs were treated by female physicians or by male physicians who have experience working with female colleagues or treating more female patients in the past.
Greater financial success
Studies show that health care systems perform better financially when they are made up of diverse teams. Diversity leads to better performance, which in turn creates more efficiencies, reduces errors and increases profits. As health care disparities are reduced through, in part, greater diversity in health care, hospitals and health care systems can spend less money on repeated visits and errors.
Student bodies benefit from diversity
Studies show that diversity during the schooling and higher education years can have a positive effect. Research points to a long list of specific benefits for students, institutions and society at large when it comes to diverse student bodies on college and university campuses.
Students who attend universities or colleges that have diverse student bodies benefit from positive outcomes like improved racial and cultural awareness, enhanced critical thinking ability and greater satisfaction with their higher education experience. They also experience positive effects on their cognitive development and leadership skills.
Diverse college and university campuses tend to cultivate a workforce with higher levels of cross cultural competence. These campuses often feature more diverse curricula and promote substantial research on racial and gender issues.
Diverse campuses also bring about benefits to whole societies. In fact, promoting diversity in health care is often listed as one of the reasons to prioritize increased diversity in higher education. Other benefits include reduced racial biases in communities, more meaningful relationships and more productive, creative teams.
How to bring about more diversity in health care
Both higher education institutions and health care systems can be part of cultivating more diversity in health care. Consider some of the ways that leaders can help bring about more racial and gender diversity in health care.
The American College of Healthcare Executives offers several recommendations for increasing racially diverse representation in health care professions. Their ideas include:
- Promoting health careers through school programs and community organizations to diverse populations
- Offering internships, residencies, and mentoring to racially and ethnically diverse students
- Developing "strong outreach mechanisms" that emphasize college recruitment efforts to attract diverse populations to health care fields
One study notes that, while health care professionals are becoming more diverse over time, it’s still the case that most people of color in health care positions are in entry-level or lower paying jobs. The study notes that social, academic, and financial support can help bring about greater diversity in general and especially in higher positions.
Increasing diversity in health care settings when it comes to gender has several dynamics. For example, while women make up the vast majority of the global health care workforce — 70%, in fact — they only comprise 25% of the senior roles. When it comes to nurse leadership, men tend to be promoted more quickly than women.
Current nurse practitioners and physicians are skewed in different directions with regards to gender, but new professionals entering the field signal growth toward better balance. The percentage of women physicians has grown to 36.3% while men are 17.1% of nurse practitioners. However, men are joining nurse practitioner programs at higher rates and 2019 was the first year where women made up a majority of the medical school student population.
By both advocating for a higher number of men in the field of nursing and working toward greater female representation in health care leadership, health care systems can ensure better representation for all.
The benefits of diversity in health care leadership
Along with increasing overall diversity, there are similar benefits to increased diversity in leadership positions. The vast majority of health care system and medical school leaders are both white and male. Diversity and inclusion in these leadership roles can be part of forging the way to better health care for all people.
Experts recommend a few approaches to promoting diversity in health care leadership, including:
- Decision makers questioning whether their leadership concepts are narrowed, stereotyped, or biased against diverse populations
- Institutions publicizing career advancement opportunities with diverse populations in mind
- Intentionally recruiting nurses for boards of all kinds
Through greater representation in leadership positions, diverse populations will be better able to thrive in all aspects of the health care system.
Be Part of Promoting Health Care Diversity
If you want to be part of bringing about increased diversity within the health care system, Texas Woman's University is an excellent place to start. As one of the nation’s top ethnically diverse institutions, Texas Woman's University’s student body is currently 57.9% ethnic minorities.
Our faculty members are actively engaged in reducing health disparities and advocating for greater representation—such as Assistant Professor Dr. Jennifer Woo who was recognized by the National Institutes of Health for her research into vitamin D status, symptoms and pregnancy outcomes in women of color. Ngozi Mbue, PhD was also recognized by the NIH director for her research involving diabetes monitoring for African-American veterans.
At Texas Woman's University, diversity is considered one of the Core Values fundamental to who we are and what drives our actions and the University also promotes a space of inclusion, where differences are welcomed.
Through the Texas Woman’s University Master of Science in Nursing – FNP online program, you can prepare to lead the health care of the future.