Gabriel Garcia, Cathryn L. Nation, and Neil H. Parker
In fiscal year 2001–2002, Americans spent more than $1.4 trillion on the cost of health care (CMS, 2003). Despite this staggering investment, an estimated 41.2 million individuals were uninsured and another 92 million lacked adequate access to care (Mills, 2002; KFF, 2002). Not surprisingly, a disproportionate number of these more than 133 million people live in inner cities, rural areas, low-income neighborhoods, and communities with large numbers of minority residents. The diversity of the U.S. population continues to grow, yet the lack of diversity among its health providers is striking by any measure. Recent bans on affirmative action, together with persistent inequities in educational opportunity for many poor and minority students, pose major challenges for schools seeking to diversify their classes. In the face of these realities, a growing sense of urgency has emerged. Evidence regarding race- and ethnicity-based disparities in health status is mounting, and the need to increase diversity in the health workforce as a strategy for improving the nation’s health is both logical and clear.
This paper builds on previous work undertaken by the authors as part of the Medical Student Diversity Task Force appointed by University of California President Richard C. Atkinson in October 1999 (UCOP, 2000). The paper uses medicine as a model and starting point for examining admissions practices and institutional strategies for increasing the diversity of health professions classes. It begins with a review of the increasing diversity of the population and the profound disparities in health status among racial and ethnic groups as an imperative for change. A commentary about the responsibilities of U.S. medical schools for training clinicians,