IOM Report Provides Road Map To Medical Workforce Diversity

There is a large gap between the rapidly growing minority populations in the United States and their representation among health professionals, in particular registered nurses (RNs), psychologists, and physicians, according to an Institute of Medicine (IOM) report titled “In the Nation’s Compelling Interest: Ensuring Diversity in the Health Care Workforce.”

The IOM is a component of the National Academy of Sciences, an independent organization chartered by Congress to advise the government on scientific matters.

According to the report, Latinos constitute 12 percent of the general population, but make up only 2 percent of RNs, 3.4 percent of psychologists, and 3.5 percent of physicians. And, while 1 in 8 Americans is African American, fewer than 1 in 20 physicians or dentists is African American.

While Asians and Pacific Islanders make up 20 percent of medical graduates, which exceeds their representation in the general population, in some communities Asians still have problems getting access to mental health care and medical and dental attention, according to the report.

Why is diversity among health professionals important? The report noted that minorities are more likely to serve in minority and medically underserved communities, improving minority access to health care. Diversity also contributes to “greater patient choice and satisfaction, better communication between health professional and patient, and better educational experiences for all students while in training.”

Organizations representing the health professions have made an effort to recruit more minorities, but they have had limited success, said the report.

For example, only 7 percent of all psychiatry residents in the United States in academic year 2002-03 were African American and 7 percent were Latino, compared with 55 percent for whites, according to the “Census of Psychiatry Residents 2002-03” by APA’s Office of Graduate and Undergraduate Education.

The IOM report urges government officials and educators to take steps to recruit more African Americans, Latinos, and other minorities to the medical profession. The report offered these suggestions on how to accomplish that goal:

• Health education institutions should include an applicant’s race, ethnicity, and language skills in admission decisions and have minorities represented on admission committees.

• Congress should increase funding for programs to increase diversity in the health care workforce.

• Health profession accreditation groups should encourage schools to recruit minorities, stress the value of minorities in health care, and include minorities on their boards.

“I commend the IOM report for linking together increasing diversity in the health care workforce with cultural competence and eliminating health care disparities among minorities,” said Francis Lu, M.D., chair of APA’s Council on Minority Mental Health and Health Disparities, in an interview with Psychiatric News. “These three areas are interrelated and should be addressed together when discussing reforms.”

The council will address the IOM report when it meets at APA’s annual meeting in May, said Lu, who is also a professor of clinical psychiatry at the University of California, San Francisco.

Altha Stewart, M.D., chair of APA’s Council on Social Issues and Public Psychiatry and co-chair of APA’s Steering Committee to Reduce Disparities in Access to Psychiatric Care, told Psychiatric News, “I am pleased that the IOM report is focusing attention on the need for more diversity in the health care workforce, which relates to the 2002 IOM report on minorities and disparities in health care.”

Stewart continued, “Hopefully, the funding and resources will be made available to create more opportunities for minorities to practice and teach in underserved areas.”

Stewart, who is also president of the American Psychiatric Foundation, noted that last year the foundation created the Minority Mental Health Awards (Psychiatric News, June 20, 2003). In addition, the foundation recently initiated a small grant program to encourage APA’s district branches to attract more minority medical students into psychiatry.

The first grant was awarded last year to the Florida Psychiatric Society to sponsor medical students to attend the society’s scientific meetings. More grants are available to be distributed this year, according to foundation staff.

“APA has a long history of supporting minorities. With this funding, it is hoped that we can continue that tradition, enhance diversity, and reduce health care disparities,” Stewart said.

“In the Nation’s Compelling Interest: Ensuring Diversity in the Health Care Workforce” is posted online at www.iom.edu/report.asp?id=18287. ▪