Blacks, Latinos and Native Americans severely underrepresented in health workforce

In 2019, Blacks, Latinos and Native Americans were severely underrepresented in the health care workforce, a trend that shows limited signs of improvement, according to a study published today by George Washington University researchers.

"Our findings suggest that Blacks, Latinos and other people of color have been left behind when it comes to the health professions," Edward Salsberg, senior research scientist and co-director of the Health Workforce Diversity Tracker project at the GW Fitzhugh Mullan Institute for Health Workforce Equity, said. The Fitzhugh Mullan Institute for Health Workforce Equity is based at the GW Milken Institute School of Public Health.

Salsberg, who is the lead author, said the study is one of the first to measure the representation of Blacks, Latinos and other minorities in the current workforce and compare it to the diversity of the future workforce across health professions. The findings are important because minority health professionals play a critical role in efforts to reduce the disproportionate burden of diseases, including COVID-19, among communities of color.

"By building a more diverse health workforce, the United States would improve access and improve outcomes in underserved communities and for high-need populations," Toyese Oyeyemi, a co-author and a co-director of the Diversity Tracker project, said.

The researchers relied on publicly available data from the American Community Survey and the Integrated Post-Secondary Education Data Systems to estimate the current racial and ethnic profile of ten health professions. The analysis focused on the largest health diagnosing and treating professions, including doctors, nurses and pharmacists.

The team also developed a health workforce diversity index. The index compares the representation of minorities in each profession to their representation among the working age population. In addition, it compares the diversity of recent graduates to the diversity of the population age 20 to 35.

Here are the key findings of the study:

• In 2019, about 12.1% of the entire U.S. workforce was Black. In contrast, among the 10 health professions studied, Black representation ranged from 3.3% for physical therapists to 11.4% for respiratory therapists.
• Among the 10 professions studied, the diversity index for Blacks in the workforce was .54. A diversity index of one represents parity: the diversity of the workforce is equal to the diversity in the profession. An index that is .54 means that Blacks are very underrepresented in the health professions.
• Strikingly, the composite diversity index for Blacks among graduates in the 10 professions was also .54, indicating that the future health workforce is unlikely to have greater representation in the future. In fact, in five of the 10 health professions studied, the representation of Blacks in the pipeline (new graduates) was less than in practice, indicating the future workforce may be even less diverse in those professions.
• In 2019, Latinos accounted for 18.2% of the U.S. workforce. At the same time, Latino representation in the health professions ranged from 3.4% for physical therapists to a high of 10.8% for respiratory therapists, resulting in an overall diversity index of .34. According to the diversity index, Latinos are also significantly underrepresented in the health professions.
• Native Americans accounted for 0.6% of the overall U.S. workforce in 2019. Their representation among the 10 health professions studied ranged from the low of zero to just 0.9%, resulting in underrepresentation and a diversity index of .54.

The analysis also looks at recent graduates of health professional programs to determine whether many newly minted graduates are from minority groups. A more diverse group of new graduates might change the trajectory of the past, the authors said.

However, the team found that, despite minor improvements in the diversity index of recent Latino graduates, most health professions have not changed much when it comes to diversity.

"These findings show that the health workforce roles that require post graduate education training suffer from a significant underrepresentation of minorities that lags behind their representation in the general population. This trend is unlikely to change unless we devout attention and resources to fix it," Maria Portela, a co-author and co-director of the Diversity Tracker project, said. "Our hope is measuring, tracking and regularly publicizing the lack of diversity in the health professions will raise awareness and visibility of these disparities and encourage organizations, states and individual institutions to enact change that will benefit the whole community," added Portela, who is also chief of family medicine for the Department of Emergency Medicine at the GW School of Medicine and Health Sciences.

The study, "Estimation and Comparison of Current and Future Racial/ Ethnic Representation in the US Health Care Workforce," was published online March 31, 2021 in JAMA Network Open.