Balancing the Scales of Opportunity Ensuring Racial and Ethnic Diversity in the Health Professions (1994) / Chapter Skim
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1 Introduction
1 Introduction
Pages 11-20
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From page 11... ...
industries, including health, unless we can adopt policies that support the development of human resources within our diverse ethnic populations (Quality Education Project, 1990; Gore, 1993~. Past arguments for this kind of national call were based on a moral imperative for social equality and justice, but these arguments have sometimes proved inadequate to sustain the momentum for creating social change in institutions that provide opportunities directly or serve as channels to education and employment.
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From page 12... ...
Using the population parity model, African Americans, Native Americans, Mexican Americans, and mainland Puerto Ricans are unde~Tepresented in the health professions. Within each racial or ethnic subcategory, significant differences can be found.*
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From page 13... ...
In recent years, however, mounting social and political pressures calling for major reform of the nation's health care system added yet another dimension of timeliness and urgency to the issue of enhanced minority representation in clinical practice and teaching. As part of his health care reform plan, President Clinton has articulated the importance of developing a medical workforce to better reflect the nation's present and future health care needs.
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From page 14... ...
In an environment of demographic changes and major reforms in health care and in education, the nation cannot afford to fail in generating valid opportunities for minorities to significantly contribute to its social and economic productivity. Minorities, if given the opportunity to participate effectively in the health professions, can contribute to a more equitable and productive society, and help the United States maintain a position of economic and moral leadership in the world.
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From page 15... ...
Being of a racial or ethnic minority is highly correlated with underuse and less appropriate use of health care services as well as with worse outcomes. Compared to whites, African Americans and Hispanics have fewer doctors' visits, are more likely to use the hospital emergency department or outpatient clinics as their regular source of care, and have higher rates of morbidity and mortality from preventable diseases (Institute of Medicine, 1988, 1990; Billings
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From page 16... ...
In an issue of the Journal of the A Mexican Medical A ssociation devoted to this topic, the council points out that Hispanics are the fastest growing minority group in the United States; Hispanic subgroups need to be considered separately; and poverty, lack of insurance, and level of acculturation are the greatest impediments to health care for this population (AMA Council on Scientific Affairs, 1991~. While a host of factors socioeconomic, genetic, cultural, and institutional determine an individual's health status and use of health care services, a starting point to improving minority access may be to increase the supply of minority physicians.
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From page 17... ...
Increased diversity of health professionals has the potential for leading to better and more efficient patient care for minorities. Timely access and strong patient-provider relationships may diminish health care costs through improving patient compliance, decreasing emergency room episodes, and reinforcing behavioral and lifestyle changes that reduce or eliminate risk factors, such as smoking (Edwards, forthcoming)
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From page 18... ...
There also appears to be an especially disturbing lack of minorities in senior faculty positions particularly at the level of deans and senior academic officers in our health science institutions. Professional associations such as the Association of Academic Minority Physicians articulate these concerns at the national level.
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From page 19... ...
An increasing acknowledgment of the primary care physician's importance in health care is emerging, and it is reflected in Medicare's new resource-based, relative value scale payment structure and in the pivotal role given to primary care in all of the major health care reform proposals. Higher percentages of young African-American and Hispanic physicians choose primary care specialties than either white or other young physicians (Cohen et al., 1990; Ginzberg et al., 1993~.
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From page 20... ...
The next chapter looks at what happens to students throughout their educational years and how it eventually affects minority participation in health ~ . professions.
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