In California and across the nation, the Affordable Care Act (ACA) brought historic increases in coverage to people that have long been left out of the health care system, namely communities of color. Nearly 2 million African Americans and 4.2 million Latinos gained health insurance.
With this expanded population able to get preventive care, they need access to health care professionals. African American and Latino doctors are more likely to practice in communities of color and areas underserved by physicians. Studies have shown that patients are more likely to seek out doctors with a similar background for treatment.
If we truly want coverage to translate into healthy equity, we will now need to focus on making sure communities of color can get the care they need from health care professionals ready to serve. To make that happen, I propose focusing on one particular trend that could impact the health of our nation: the lack of diversity in higher education and decline of students of color in medical education.
Perhaps one of the biggest reality checks was released by the Association of American Medical Colleges late last year— the number of Black males applying to and attending medical school in this country has declined significantly since 1978. The number of Latino graduating physicians across the country is not much better. If we do not increase the number of African American, Latino, Native American, and other underrepresented groups serving as healthcare professionals, we will not be able to keep pace with the newly insured. Ultimately, the stagnation, and in some cases, downward trend, in the number of African American and Latinos entering medical school impedes our ability to achieve equitable access to care.
The fifty-year history of the South Los Angeles institution I am proud to lead, Charles R. Drew University of Medicine and Science(CDU), can point to a few lessons—training diverse healthcare professionals has been part of our DNA. In August 1965, the Watts Revolt erupted as community leaders no longer tolerated the unjust lack of services available. In recognition of the structural inequality and social barriers, Governor Pat Brown created the McCone Commission and prescribed two fundamental resources—increased educational opportunities and increased health services for the Watts and South Los Angeles community. Visionary founders created our institution as a University committed to diversity in our student body and faculty. By recruiting students from underserved backgrounds, our community has had a stronger cohort of health professionals who are better prepared to relate to patients who need them the most. There have been three key ingredients to this work: pipeline programs, a supportive environment, and investments.
Pipeline programs can expose young men and women to health careers as an option. When you never see a physician who looks like you, you never know that you could be a physician, too. This is critically important in a time where African American and Latino students continue to lack equal access to a high quality education and still lag far behind their white peers in reading and math proficiency, high school rates, and college completion. In California, 61.6 percent of black males and 67.4 percent of Latino males graduate from high school compared to 81.6 percent of white males. Medical schools can be leaders in sponsoring pipeline programs to encourage minority students to complete high school and consider careers in medicine. For more than twenty years, CDU students have volunteered at the Saturday Science Academy, providing minority youth exposure to the fields of math and science. Over the years, we have found 90 percent of students in the program attend college— an incredible mark of success.
The second ingredient to diversifying physicians is a supportive on-campus environment. Over the past few years, more and more young African Americans and their allies at universities across the country have been protesting for inclusive campus climates and increased faculty diversity. This is just as important at health professional training institutions. Support systems and safe spaces are critical to student success and allow all students to feel comfortable pursuing every opportunity available on campus. I believe it is a University responsibility to signal that we are there for students of every background.
And finally, we need investments to increase diversity. Higher education is an investment that not all have the means to afford. Black male interviewees in the AAMC study cited that the costs of medical school and debt as deterrent to pursuing medicine as a career. Scholarships are a key ingredient to recruit and retain students of color who may not otherwise have the financial means to pursue a medical or other health professions degree.
California is the largest “majority-minority” state. That means the future of California depends on our ability to recruit and train a diverse workforce who are more likely to serve in communities of color. We hope to join with others to continue to support young leaders of color in the pursuit of medical and health professions education. A diverse physician workforce is a key to moving us closer to the goal of health equity.
David Carlisle is President of Charles R. Drew University of Medicine and Science.