gate the health care system more effectively; 5) ensuring aggressive enforcement of civil rights laws; 6) ensuring that health care providers can address the unique needs of expanding immigrant populations, many of whom have limited English skills; and 7) undertaking aggressive efforts to ensure that the health care profession reflects the growing diversity of the population.

Regarding the diversity issue, a number of steps have been taken to increase the pool of minority health practitioners. These measures include aggressive outreach and recruitment, “pipeline” programs that expose minority students at an early age to health sciences, and affirmative action programs that permit the use of race or ethnicity as one factor in the admissions process.2

These affirmative action programs have come under substantial attack. This paper focuses on legal issues surrounding efforts taken by the health care profession to expand the racial and ethnic diversity of the profession by employing affirmative action tools. Part one outlines why this affirmative action issue is so important. Part two traces affirmative action in higher education, from the seminal Supreme Court case of Regents of the University of California v. Bakke to the present. Although many pundits have opined that affirmative action is dead in light of recent court pronouncements and voter initiatives in California and Washington, these declarations ignore a number of significant developments in courtrooms, voting booths, and legislatures.

The reality is that the affirmative action landscape is indeed muddled, but there are plenty of developments that both sides in the debate can point to in making their case. For either side in this debate to declare victory simply ignores the totality of the evidence, and Part two discusses the current affirmative action landscape, including events that have occurred outside the courtrooms. Part three discusses measures that the health professions can take or support to enhance diversity, including but not limited to affirmative action-related interventions. There are a number of useful measures that health professionals can put into place to increase diversity and better ensure that the health profession can meet the needs of our increasingly diverse population.

Affirmative action means different things to different people. For purposes of this paper, affirmative action refers to measures designed to increase the number of qualified minorities in a particular program through a decision making process that includes the consideration of race and ethnicity among a number of factors. Affirmative action does not mean creating or permitting quotas, or providing opportunities for unqualified people.


For a further summary of various efforts undertaken by the medical profession to enhance diversity within its ranks, see American Association of Medical Colleges. 1980. A Plan for the Implementation of the Goals and Recommendations of the Report of the AAMC Task Force on Minority Student Opportunities in Medicine. Washington, DC: AAMC.

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