an overview of the financial status of URM families, assess the costs of training, and show the negative impact of these costs on URM students’ pursuit of education. In addition, the chapter will assess the role of private and public sources of funding for health professions students, and examine issues regarding the financing of education. For a detailed review of publicly funded health professions programs that support URM students, the reader is referred to the commissioned paper, Public Financing of the Health Professions: Levers for Change, prepared by Karen Matherlee, which appears as an appendix of this report.

For purposes of this report, the study committee defines health professions educational costs as a formulation involving total educational and living expenses: including tuition and fees (which vary considerably across institutions, particularly between public and private health professions education institutions [HPEIs]); other educational expenses (including books, equipment, supplies, etc.); the number of years to degree completion; living costs (including rent, utilities, and other living expenses); and the costs of any specialized, prerequisite post-high school or post-baccalaureate preparation. The other side of this equation—financing of health professions training—can be described as a student’s financial resources (both personally and nonpersonally derived), as well as scholarships, loans, and other forms of financial assistance. Unmet financial need is therefore total health professions educational costs, minus student financial resources. This chapter attempts to describe educational costs, sources of financing of training, and unmet financial need, and how these factors affect URM participation in health professions education. This analysis is severely limited, however, by a lack of data regarding these factors, particularly in disciplines other than medical education, where financing issues are more thoroughly documented. This absence of data prevents a comparison of financing issues across health professions disciplines, because the factors identified above, such as tuition, fees, number of years to degree completion, and sources of financial aid, vary considerably across disciplines. The most useful perspective is therefore to examine the financial obstacles within each profession, rather than across professions.


Census figures indicate a large disparity in family income among various racial and ethnic groups in the United States (Figure 3-1) (U.S. Census Bureau, 2002a). Households headed by black and Hispanic individuals earn significantly less than either white non-Hispanic or Asian and Pacific Islander householders. In 2001, the median income for black and Hispanic families was approximately $34,000 and $35,000, respectively. In com-

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