Minority Health and Health Care in the U.S.
Disparities in health care access and quality among different racial and ethnic groups are widespread and well-known. These disparities occur in health insurance coverage, access to providers, prevalence of chronic disease, overall health status, and more. For instance, in its annual National Health Disparities Report, the Agency for Healthcare Research and Quality (AHRQ) analyzes 300 different health process, outcome and access measures across a wide variety of conditions and settings throughout the population. The latest report found that "disparities persist, especially for poor and uninsured populations in all priority areas." It goes on to say, "Blacks experienced worse access to care compared with whites for 52% of the measures."
Some Major Areas of Health and Health Care Disparity
Research Workforce Diversity
One way to address these disparities in health care access and quality is to bring more diversity to the ranks of health services researchers because their findings inform the policies and regulations that ultimately govern the delivery of health care. Different life experiences and cultural perspectives result in richer ideas and findings more relevant to the country's highly diverse population of patients.
The need to increase the ethnic and racial diversity of this research workforce is widely recognized. In 2007, a study documented a lack of diversity among health services researchers, a particularly important issue given the increasing diversity of the population. That imperative is why the Leonard Davis Institute of Health Economics established the Summer Undergraduate Minority Research (SUMR) program 20 years ago.
According to a recent report from AcademyHealth, the professional organization that supports health services and policy research, “diversity of opinion and perspective produces better evidence” because “individuals who grew up exclusively in majority culture and its privileges are making discriminatory decisions about people who are not like them.”
Where does the field stand now in terms of diversity and inclusion and where are things heading? AcademyHealth conducts a regular membership survey that includes questions about race and ethnicity. Between 2007 and 2011, positive trends emerged: Blacks went from 3.4% of the health services research workforce in 2007 to 6.9% in 2011; Hispanics had smaller gains, increasing from 2.1% in 2007 to 3.7% in 2011.
Part of the challenge to making further progress is the basic underrepresentation of minorities further up the pipeline: In 2010, 31.9% of Hispanics and 38% of blacks were enrolled in college, compared to 43.3% of whites and 62.2% of Asians. Historical trends are promising, but the gap remains significant. Such demographic trends are a built-in limitation of pipeline programs that focus on minority undergraduate students.
The chart below gives us insights into how far away we are from a truly representative health services research workforce:
One thing from all of this data stands out: the extreme underrepresentation of Hispanics/Latinos among health services researchers. Hispanics/Latinos are one of the fastest growing populations in this country, and at the current rate of growth, they will constitute 30% of the U.S. population by 2050. We have much work to do to adequately include their voices, perspectives, and talents in health services research.
Addressing the true underrepresentation of minorities in health services research will require pre-college programs as a long-term strategy to complement post-college efforts. We must prime the pump and well as widen the pipeline. Twenty years after starting the SUMR program, we are making progress but have substantial work ahead. We hope you, whether a student or parent or teacher, will be a part of this positive change.