Diversity Emergency in California’s Health Care Work Force

New America Media , News Report, Viji Sundaram, Posted: Jun 13, 2008

Editor’s Note: California is an increasingly diverse state but its health care work force is lagging behind in diversity. Experts address how to increase minority enrollment in medical schools reports Viji Sundaram, health care editor for New America Media.

SAN FRANCISCO – A Chinese-American woman who took her elderly mother to a local hospital was asked by the doctor to serve as an interpreter for her. “Ask your mother if she is sexually active,” the doctor told her. The younger woman looked shocked and embarrassed. In her culture, she told the doctor, daughters never ask their parents such questions.

“Lots of physicians ask custodians to do interpretations,” noted City College of San Francisco Dean of Health Linda Squires-Grohe, pointing to an “obvious need” for a culturally diverse and – equally important – culturally sensitive health care work force.

Squires-Grohe was speaking at the Commonwealth Club of California, where she and two other higher education leaders were honored by The California Wellness Foundation for their efforts to overhaul the state’s health care system. Each of the winners received $25,000.

The other two honorees in this year’s annual Champions of Health Professions Diversity Awards were Juanita Barrena, professor of biological sciences and director of the Science Educational Equity program at California State University in Sacramento, and David Hayes-Bautista, professor of medicine and director of the Center for the Study of Latino Health and Culture at the University of California, Los Angeles. Hayes-Bautista is also an internationally recognized researcher on the culture and health of Latinos.

“These three leaders have proactively addressed barriers to entering higher education and training programs, and developed support systems that have ensured the success of thousands of students who are now delivering culturally competent, language-proficient health care,” noted The California Wellness Foundation President and CEO Gary L. Yates in a press release.

Health work force diversity is important to improving the health and wellness of Californians, who are growing more ethnically and racially diverse even as they grow older. State birth records indicate that for the first time in modern history, most of the babies being born in California are Latino. Nearly one-third of Latinos in the United States lives in California, and will make up a large part of the state’s future economic engine.

Yet few additional educational opportunities are afforded them as they graduate from four-year institutions of higher learning.

Barenna said that while the statewide Master Plan for Higher Education did a good job initially with transferring students from community colleges into four-year institutions, it doesn’t speak to advancement from undergraduate to graduate or professional schools.

“There need to be more ways of bringing together the leadership of community colleges, the California State University campuses and the University of California to develop seamless mechanisms for students to move from one place to another,” she said.

The Science Educational Equity program Barenna directs at Cal State Sacramento has helped to break down barriers to higher education and careers in the sciences and health professions. In fact, she pointed out, “My best scientific talent and health care professionals come out of community colleges.”

Squires-Grohe said she is convinced that community colleges, considered by many to be in the bottom third of the higher education system, reach their full potential when they collaborate with such partners as community-based organizations, governmental organizations, unions and high schools. The results she has seen from Community Health Works, a partnership she developed between City College and San Francisco State, bears that out, she said. Additionally, her welcome back program helps foreign-born health professionals find new careers and employment in U.S. health care fields.

Hayes-Bautista said that because very few community college students – 95 percent of whom are Latino, African American or American Indian – transfer to a four-year institution, the program he founded began a “pipeline program” from the community colleges, with financial support from The California Wellness Foundation.

He said that every medical school graduate has the option of learning Spanish and working in underserved areas such as the city of Bell in Southern California. There, 95 percent of the population is Hispanic, and there are only 19 doctors for every 100,000 residents. That stands out in stark contrast to Beverly Hills, an affluent city only 10 miles away, where there are about 2,025 doctors for every 100,000 residents, less than 5 percent of whom are Latinos, Hayes-Bautista said. Most physicians graduating from college these days, he asserted, do not want to take their skills to poor communities.

After peaking in 1992, enrollment in medical schools has been steadily decreasing for Latinos, African Americans and American Indians. Hayes-Bautista said he believed there are various ways to overcome the low minority enrollment in medical schools and the reluctance of most physicians to serve underserved populations. One solution is for medical schools to recruit students from those undeserved areas, he said.

“If you want more (health care workers) in Bell,” Hayes-Bautista said, “why not get a student from Bell, rather than one surfing in Santa Monica?”

Related Articles:

Study Reveals Health Care Woes of Asian Americans

Ethnic Seniors Lost in America

California HMOs to Provide Interpreters

Dangerous Translations - Rx for Trouble



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