A growing body of literature indicates that universal access to health care may do little to improve health status if public education and other essential social support systems are underdeveloped (Starfield, 1991; Pappas et al., 1993). The education of health professionals is strongly influenced by the quality of public education, which is in a period of great change. If the United States wants to compete as a first-class economy, it is imperative that it develop its human resources to much higher levels of skill and competence. Especially important will be developing the talents of minorities, who along with white women and immigrants, will constitute almost 90 percent of the new growth of our workforce for the rest of this century (Action Council on Minority Education, 1990).
Unlike the reform movement of the post-Sputnik era, which sought to increase the numbers of highly trained young people who were talented in science and engineering, the current focus is on "Science for Every American" (Ebert, 1993). Higher-quality schooling for everyone will make a difference in preparing more students for entry into professional and technical training. To avoid widening the existing gap, every effort is being made to broaden the base of competence in science and mathematics education in an inclusive manner. This approach could create more opportunities for minorities and eliminate some of the existing barriers to professional development.
Science and mathematics are important core subjects in preparing for the health professions, but the committee did not limit its attention to them. Its deliberations pointed to the belief that learning cannot take place effectively outside a context of racial diversity. Effective learning for today's social, economic, and intellectual challenges can take place only in environments that allow for understanding the total human experience. Quality education must now mean promoting interaction that allows people to see each other from their own cultural vantage points (Jennings, 1989). These interactive settings may result in the questioning and challenging of traditional economic, cultural, and political arrangements.
Before change can happen, the underlying issues and facts must be understood. The next chapter looks at what happens to students throughout their educational years and how it eventually affects minority participation in health professions.