In an Era of No Affirmative Action: The Right Reasons for Diversifying The Health Workforce

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The Supreme Court’s rejection of race being considered for admission criteria at two of the country’s most storied universities, Harvard and UNC Chapel Hill, will have devastating implications for the diversity of our healthcare workforce pipeline.

Of course, the Court’s ruling changes the landscape of our colleges and universities, but any progress made towards supporting a healthcare workforce that is more representative of the population has been essentially lost.

Underrepresented groups including Black, Hispanic and Native American individuals, make up roughly 34% of the U.S. population, but only 19% are registered nurses, 12% are physicians, 11% are pharmacists, and 10% are dentists – a stark underrepresentation of the population it serves.

The disparities gap in our healthcare workforce at every level is significant, coupled with a widening gap in health disparities for communities of color, these two facts should get the immediate attention of healthcare administrators and leaders.

As the founding dean of UC Irvine Public Health, home to one of the largest undergraduate public health student bodies in the field where more than half of our graduating class are first-generation college students, I want to share evidence around the importance of a diverse workforce in the healthcare profession.

There are a multitude of reasons why a diverse healthcare workforce will result in better health for everyone, but I’ll focus on three factors:

First, in the context of healthcare, a diverse workforce is better equipped to understand and respond to the needs of diverse patient populations. Research consistently demonstrates that patients who receive care from healthcare providers of similar backgrounds experience better health outcomes. Affirmative action policies facilitate the recruitment and retention of individuals from marginalized communities, leading to a more culturally competent healthcare workforce. It’s a positive cycle that benefits everyone in the entire system – down to the patient and provider. More equitable outcomes could save the American economy up to $1 trillion per year, as a result of supporting a diverse healthcare workforce. For example, the Sinai Health System uses community health workers to help children disproportionally affected by asthma in Chicago and an estimated $3 to $8 in health care costs are averted for every $1 spent on the program.

Second, education plays a vital role in promoting health literacy and empowering individuals to make informed decisions about their health. A diverse and well-educated healthcare workforce not only expands the pool of healthcare professionals but also contributes to community development and health promotion initiatives, ultimately improving public health in the communities that need the most support. A randomized control trial with 1,300 black men who were treated for hypertension with either black or non-black male doctors reported that black doctors could reduce the black-white male gap in cardiovascular mortality by 19% resulting in longer lives and increased saving to the health care system. Furthermore, individuals from diverse backgrounds working in healthcare serve as role models and mentors, encouraging communities of color to access healthcare – ultimately breaking down barriers including structural racism for the next generation to be welcomed into critically important health professions.

Third, a more diverse healthcare workforce not only brings fresh perspectives to problem-solving but also encourages underrepresented communities to seek medical care. Affirmative action does not undermine meritocracy; instead, it fosters innovation, creativity, and a more empathetic understanding of others. It’s long been known that diversity of thought leads to innovation, which benefits both the public and private sector.

As a public health issue, affirmative action serves as a vital step toward creating a fairer, more inclusive society that values the health and well-being of all its citizens. Without affirmative action policies, we will need to prioritize diversity – and it will be critical that healthcare and academic leaders, policymakers, and our collective society recognize the profound impact of fostering a culture of diversity and inclusion in every level of education and training.

As best said by Justice Ketanji Brown Jackson: “The takeaway is that those who demand that no one think about race (a classic pink-elephant paradox) refuse to see, much less solve for, the elephant in the room — the race-linked disparities that continue to impede achievement of our great Nation’s full potential.”

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