Diversity in the health care workplace is not only important for the economic well-being of minority workers, but is also critical to improving patient care and to boosting the state's economy, experts said during the William A. Hinton Lecture and panel discussion on March 10 in Snyder Auditorium. The annual event was jointly sponsored by HSPH and the Massachusetts Department of Public Health.
William A. Hinton was one of the first African Americans to graduate from Harvard Medical School, where he later served as Clinical Professor of Bacteriology and Immunology. In the 1920s, Hinton developed the widely used Hinton Test for the diagnosis of syphilis.
Jane Edmonds
Paul Cote, Jr., Massachusetts Commissioner of Public Health, said that he found the health care disparities between blacks and whites to be particularly troubling. For example, he noted that blacks have a 20 percent higher mortality rate than whites and a 42 percent higher rate of diabetes.
At the same time, he noted that in 2000 just 37 African Americans graduated from the four medical schools in Massachusetts. "And this is just the tip of the iceberg," he said. "The disparity permeates the entire workforce."
Such statistics are especially disturbing in light of evidence that shows racial and ethnic diversity in the health care workforce is associated with improved outcomes for minority patients, noted keynote speaker Jane Edmonds, Secretary of the Massachusetts Department of Workforce Development.
She added that expanding diversity in the health care setting is also essential for improving the care of patients of all backgrounds.
Paul Cote
"We need as a state to make sure that we are tapping into the skill sets and talents of all people so we can make sure the health care industry as we know it can be competent, can be effective, and can provide the kind of services that all of us would hope to have," she said.
Harold Cox, Chief Public Health Officer for the City of Cambridge, pointed out that by 2050, half of the population of the U.S. will be made of minorities.
Yet, right now, he said, only six percent of nurses and nine percent of physicians are minorities.
"We need to be thinking about who is going to be providing the care," he said.
Beyond that, Edmonds noted that diversity is critical to the economic health of the state, which depends heavily on the health care industry. "I look at health care as the economic driver," she said.
Promoting diversity requires a wide variety of strategies and initiatives on the part of hospitals and other health care facilities, educational institutions, the government, private companies, and non-profits, the panel agreed.
Edmonds cited a number of statewide partnership initiatives designed to increase the skills of health care workers, including a "pipeline" program that has produced more than 260 nurses with B.S. degrees, as well as programs that provide mentoring, career coaching, and tutoring.
One program supported by the Department of Workforce Development is designed to improve the skill sets of low-wage nursing home workers. The Extended Care Career Ladder Initiative or ECCLI, has helped over 200 participant direct care workers advance from entry-level CNA positions to training that supports success in a Licensed Practical Nurse (LPN) program. In Worcester, the University of Massachusetts Medical School established a health/science academy at the high school in the city's poorest district, and it was later expanded to the middle and elementary schools in the district.
"Fourteen kids from Worcester were admitted to Holy Cross, and ten of them came from the health/science academy," said panelist Deborah Harmon Hines, Associate Vice Chancellor for School Services.
Panelist Alice Coombs, an anesthesiologist at South Shore Hospital, noted that she was born in the urban, mostly black and Latino community of Compton, Cal., but was encouraged by a mentor to apply to UCLA. "It became real to me when someone else thought that I could do it," she said.
Coombs was presented at the event with the William A. Hinton Award for her work in addressing racial and ethnic health disparities through ongoing education.
Edna Smith, past chair of the MetroWest Community Health Care Foundation, said it is not enough just to get more minorities into the health care field. They must be able to attain leadership positions too, she said.
"The challenge is being able to penetrate that glass ceiling," she said.
The Foundation has a number of diversity initiatives underway, including one that seeks to recruit minority physicians to MetroWest area hospitals.
"People want to be cared for in facilities where they see their culture reflected," she said.
Minorities have a better chance of advancing when they are working in institutions where managers are held accountable for developing and carrying out diversity plans, she said. "When rewards and pay are tied to those programs, it makes a difference," she said.
Cox, who was presented with the Rebecca Lee Award in recognition of his many years of leadership in the area of addressing disparities in the health status of minorities, said efforts to get more minorities into health care positions does not mean hiring less-qualified individuals.
"There is often the idea that when you hire folks of color, you are talking about getting people who are not quite as good," he said. "That is not the case."
--ML
Copyright, 2007, President and Fellows of Harvard College
