Study Highlights Need to Improve Diversity Across Healthcare Professions

One concern that has been consistently raised in the healthcare professional community is whether or not the race, ethnicity, and sex diversity of students in US health professions programs is an accurate representation of the age-adjusted population. In fact, it was determined that it is strongly influenced by cultural, socioeconomic, and legal factors, including a recent US Supreme Court ruling on using race in college admissions.^1-6

Establishing diversity is a popular goal for all healthcare–related degree programs as it presents the opportunity for a reduction in health disparities, healthcare delivery to be boosted, and to meet the needs of a diverse population.^7,8 From a macro level, over the past 15 years, on average, racial and ethnic diversity in multiple US regions has increased by 1% to 5%.⁹

In an effort to further investigate this, a study published in JAMA Network Open assessed the diversity of students in Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD), and Doctor of Pharmacy (PharmD) programs, focusing on tendencies surrounding underrepresented minoritized groups (American Indian or Alaska Native, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander) and sex compared to the overall age-adjusted US population (ages 20-34).¹⁰

Data were pulled from 2003-2019 Association of American Medical Colleges, American Association of Colleges of Osteopathic Medicine, American Dental Education Association, American Dental Association, and American Association of Colleges of Pharmacy applicants (594,352), with analysis performed from 2003 to 2004 and from 2018 to 2019.

Descriptive statistics were utilized to observe trends in the proportion of individuals from underrepresented minority (URM) groups, race, ethnicity, and sex among students applying to, matriculating into, and graduating from health professions programs, which were analyzed alongside a similar age group in the US Census population.

A representation quotient (RQ) was applied,¹¹ which is the ratio of the proportion of each subgroup to the total population of applicants, matriculants, or graduates relative to the proportion for that subgroup within the US Census population of similar age. The breakdown is as follows:

• An RQ of 1 signifies that the percentage of the subgroup is the same as the proportion for that subgroup within the US Census population of similar age.
• An RQ less than 1 stands for lower subgroup representation than the proportion for that subgroup within the US Census population of similar age.
• An RQ greater than 1 suggests higher representation than the US Census population of similar age.¹¹

Each subgroup’s longitudinal trends on RQ are reported over time with corresponding 2-sided P values and 95% confidence interviews (CIs), with statistical significance set at P <.05.

The analysis found both an increase in underrepresented minoritized groups in most health professions programs—along with a lower percentage of male students—compared with age-adjusted US Census data.

According to the study’s authors, “these findings suggest that progress has been made to increase racial, ethnic, and sex diversity among students in most health professions programs, but additional strategies are needed to achieve a more representative health care workforce.”

References

1. Coleman AL, Lipper KE, Taylor TE, Palmer SR. Roadmap to Diversity and Educational Excellence: Key Legal and Educational Policy Foundations for Medical Schools. Association of American Medical Colleges; 2014.

2. Yanchick VA, Baldwin JN, Bootman JL, Carter RA, Crabtree BL, Maine LL. Report of the 2013-2014 Argus Commission: diversity and inclusion in pharmacy education. Am J Pharm Educ. 2014;78(10):S21. doi:10.5688/ajpe7810S21

3. American Association of Colleges of Pharmacy. Preparing pharmacists and the academy to thrive in challenging times: 2021-2024 strategic plan priorities, goals and objectives. Published July 2021. Updated April 2023. Accessed January 3, 2023.

4. Dady N, Mungroo KA, Young T, Akinsanya J, Forstein D. Diversity in osteopathic medical school admissions and the COMPASS program. J Osteopath Med. 2021;121(2):157-161. doi:10.1515/jom-2019-0260

5. Greenway RA, Scott JM, Loveless EC, Bigham RR, Simmer-Beck ML. Evaluation of a pipeline program at strengthening applications, increasing diversity, and increasing access to care. J Dent Educ. 2021;85(5):642-651. doi:10.1002/jdd.12508

6. American Dental Education Association. Statement of ADEA policy on diversity and inclusion. March 15, 2016. Accessed January 3, 2023. https://www.adea.org/policy_advocacy/diversity_equity/pages/diversityandinclusion.aspx

7. Montgomery Rice V. Diversity in medical schools: a much-needed new beginning. JAMA. 2021;325(1):23-24. doi:10.1001/jama.2020.21576

8. Fernandez A. Further incorporating diversity, equity, and inclusion into medical education research.Acad Med. 2019;94(11S):S5-S6.

9. US Census Bureau. Measuring America’s people, places, and economy. Accessed September 29, 2021. https://www.census.gov/library/measuring-america.html

10. Daniel Majerczyk, PharmD; Erin M. Behnen, PharmD; David J. Weldon, PhD; et al JAMA Netw Open. 2023;6(12):e2347817. doi:10.1001/jamanetworkopen.2023.47817

11. Lett E, Murdock HM, Orji WU, Aysola J, Sebro R. Trends in racial/ethnic representation among US medical students.JAMA Netw Open. 2019;2(9):e1910490. doi:10.1001/jamanetworkopen.2019.10490