unlikely that we can completely fulfill the projected needs, but, still, much can be done to begin to close the gaps.

Aside from concerns about the total numbers of health care workers with geriatric competencies, the composition and distribution of the health care workforce for older Americans should also be considered. This includes racial and ethnic diversity as well as the geographic distribution of professionals trained to provide care to older adults.

Racial and Ethnic Diversity

The committee commissioned a paper on the increasing diversity of older populations (Yeo, 2007) and found that the diversity of the workforce is important for several reasons. First, minority patients often prefer to be treated by health care professionals of the same ethnic background (Acosta and Olsen, 2006; IOM, 2004; Mitchell and Lassiter, 2006; Tarn et al., 2005). Second, a provider from a patient’s own background may have better understanding of culturally appropriate demonstrations of respect for older populations and may also be more likely to speak the same language (in the case of bilingual providers). Finally, providers from minority populations often account for most of the services provided to underserved populations (HRSA, 2006a). For example, while only 3.4 percent of dentists are black, they treat almost two-thirds (62 percent) of black patients (Mitchell and Lassiter, 2006).

While older adults are more diverse than ever before, the younger generations training to care for them are even more diverse (see Chapter 2). The pattern of this diversity, however, will not necessarily match up with the pattern of diversity among older Americans. Table 4-2 demonstrates, for example, that there is significant diversity among resident physicians in geriatrics, but the percentage of white residents (39 percent) is much lower than the percentage of whites in the elderly population, and the percentage of Asian residents (42 percent) is much higher that the percentage of Asians in the elderly population.

Geographic Distribution

The distribution of both professionals and older adults varies widely across the country. Since both of these populations may be unevenly distributed across regions, states, and local communities, different areas may have different workforce needs. The committee commissioned a paper on state profiles of the U.S. health care workforce (Mather, 2007). This report showed there is an average of 443 dentists per 100,000 population aged 65 and older in the United States, but this ratio varies widely among the states. There are 759 dentists per 100,000 older adults in New Hampshire, but



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