By Lauren Gaffney and Jane Hamblin
Louis W. Sullivan, M.D., former Secretary of the U.S. Department of Health and Human Services, and Lonnie R. Bristow, M.D., a former president of the American Medical Association and vice chair of the AMA’s Board of Trustees, addressed key ADEA leaders on increasing diversity in the health care professions on January 27 in Washington, DC. Drs. Bristow and Sullivan are chair and co-chair, respectively, of the Sullivan Alliance to Transform America’s Health Professions, which is also headquartered in Washington. [http://www.jointcenter.org/healthpolicy/commission.php ] Both men’s distinguished careers have included national leadership in health care issues.
During a thought-provoking presentation for the members of the Board of Directors and the members of the administrative boards of ADEA’s seven councils, Bristow and Sullivan touched on the myriad factors that have led to the alarming ethnic and racial disparities in the health professions today. According to Sullivan, while African Americans, Hispanic Americans, and Native Americans make up more than 25% of the U.S. population, they represent only 5% of dentists, 6% of physicians, and 9% of nurses. What’s more, racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities, even when access-related factors, such as patient’s insurance status and income, are controlled. (Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, 2002).
For the field of dentistry, especially for dental education, a key factor in overcoming these disparities is reevaluating the dental school admissions process, which currently relies heavily on DAT scores and GPA. For all of dental, allied dental, and advanced dental education, the speakers encouraged a means of evaluation that examines the entirety of a candidate’s credentials. Bristow, chair of the IOM committee that released the report In the Nation’s Compelling Interest in 2004, cited the importance of evaluating the “distance traveled” of a candidate, that is, interpreting scholastic achievements while taking into consideration:
- pre-college education,
- need for work while attending college for financial support,
- parental income and educational level,
- cultural and language barriers, and
- prior experiences with any type of prejudice.
Both Bristow and Sullivan stressed the importance of increasing the number of underrepresented minorities in the health professions because of the overall benefit to society. For everyone connected with dental and allied dental education, diversity in training settings “is associated with better educational outcomes for all students,” said Bristow. Additionally,
- racial and ethnic minority health care providers are more likely to serve minority and medically underserved communities, thereby increasing access to care;
- racial and ethnic minority patients report greater levels of satisfaction with care provided by minority health professionals; and
- racial and ethnic minority health care providers can help health systems in efforts to reduce cultural and linguistic barriers and improve cultural competence.
The Sullivan and Bristow presentation was received enthusiastically by the 50 ADEA leaders present. ADEA president Dr. Eric Hovland said, “Hearing from these noted, respected speakers has helped rekindle ADEA’s commitment to diversity in dental education.” Ms. Jorelle Alexander, a third-year dental student at the University of Louisville and secretary of the Council of Students, found the program inspiring, saying, “As a minority student, I am encouraged to hear diversity leaders speak about the need to reevaluate admissions practices. It is important that future students know that admission to dental school is not about mastering an exam, and that other aspects about them will be appreciated.”
While the task of increasing diversity in the health professions seems daunting, it can begin with changes at a grassroots level. Schools must develop mission statements that reflect a commitment to diversity and policies that value the importance of culturally diverse and competent care. Academic partnerships like the Virginia-Nebraska Alliance, a program created through the Sullivan Alliance, which links traditionally black colleges in Virginia, Virginia Commonwealth University, and the University of Nebraska Medical Center to provide academic and research opportunities for undergraduate minority students and faculty, helps get students in the pipeline. This is one of the most crucial steps in increasing the number of minorities in health care professions.
Leaders Follow Up with Diversity Workshop
As a follow-up to the presentation, the members of the Board of Directors and the Councils’ Administrative Boards participated with Drs. Bristow and Sullivan in a three-hour workshop to set diversity priorities. Following the speakers’ grassroots suggestions, the ADEA leaders discussed ways to begin increasing diversity at their home institutions, including creating early intervention programs for minority students in elementary, middle, and high schools that develop a culture of empowerment and provide academic and social role models. Other ideas centered on finding ways to engage admissions committees in re-examining admissions processes, the role of the DAT, and building academic bridges for minority students interested in the health care professions.
[For other follow-up information see Building a Collaborative Infrastructure for Diversity