Twenty-five percent of the U.S. population is composed of underrepresented groups, yet these minorities represent only 10 percent of the individuals in health professions and are growing very modestly. Hispanics account for 12 percent of the population, but only 2 percent of nurses and 3.5 percent of physicians. Less than one in 20 doctors or dentists are African American, even though one in eight persons in the United States are African American.
Increasing the number of underrepresented groups in the health professions can help address health care disparities by both improving access and responding more effectively to minority population needs. Studies have shown that minority health care professionals are more likely to work in underserved areas, and there is also evidence that race concordance—defined as shared racial or ethnic identities between clinicians and patients—is related to patient reports of satisfaction, participatory decision making, timeliness of treatment, and trust in the health system.
The House bill directly addresses this issue. It provides scholarships and loan repayment support for individuals from disadvantaged backgrounds serving in the health professions, and it grants funding for the Health Careers Opportunities Program, which supports schools that recruit and train individuals from disadvantaged backgrounds to work in the health professions. The bill also establishes a grant program at HRSA to promote health care professionals’ cultural and linguistic competence.
The House bill has several provisions that look to reduce health disparities through the provision of language services. The Secretary of HHS is required to develop a demonstration program to promote access for Medicare beneficiaries with limited English proficiency by providing reimbursement for culturally and linguistically appropriate services. The program would also conduct a study on the extent to which Medicare providers utilize or make available language services and ways that Medicare should develop payment systems for language services. A second study requires the IOM to examine how the provision of language services affects quality of care, access to care, reduction in medical errors, and related costs or savings.
The Senate bill establishes demonstration grants to create increased opportunities for low-income individuals and other entry-level workers to receive education, training, certification, and professional development for occupations in health care by providing financial aid and supportive services such as child care. These are programs that will assist with increasing workforce diversity.
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