researchers, and leaders who will collectively meet the needs of the public follows. The paper briefly reviews the history of affirmative action and recent challenges that affect admissions. The medical school admissions process is described in detail, with a focus on strategies and best practices essential to recruiting and enrolling diverse classes of students. Special commentaries for clinical psychology, nursing, and dentistry are also provided. Across the health professions, however, the authors concur that institutional commitment, strong leadership, support for comprehensive strategies, and thinking “outside the box” have never been needed more urgently.

DIVERSITY IN THE HEALTH PROFESSIONS

The Demographic Imperative

Major advances in science and technology have enabled the quality of medical care to improve for many individuals. Notwithstanding these achievements, significant disparities in health status continue to exist between white people and other racial and ethnic minority groups. In a landmark report issued in 1985 by the U.S. Department of Health and Human Services (DHHS), these disparities were described in terms of excess deaths for six health conditions: cancer, cardiovascular disease and stroke, chemical dependency, diabetes, unintentional injuries, and infant mortality (DHHS, 1985). Fifteen years later in 2000, the Surgeon General reported that minority groups continue to have substantially higher morbidity and mortality associated with the same and other health conditions as their white counterparts. These gaps were so great that a national Race and Health initiative was launched by DHHS in 1998. The project was recently expanded and incorporated as part of Healthy People 2010, a national public health initiative calling for the elimination of these disparities by 2010.

For many individuals, race- and ethnicity-based disparities in health status are compounded by reduced access to services, lack of adequate insurance, and inadequate availability of physicians and other health-care professionals. Among the nation’s more than 284 million people (U.S. Census Bureau, 2003), an estimated 133 million lack adequate access to care (Mills, 2002; KFF, 2002). In California alone, more than 4 million residents live in 165 areas designated by the state and federal governments as medically underserved or as health professions shortage areas (Grumbach et al., 1999). Nationally, this number jumps to a stunning 56 million (BHPR, 2003). Although differences exist in the criteria used by state and federal agencies to make such designations, health professions shortage areas, overwhelmingly, are home to poor and minority communi-



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