Getting to the Root of the Matter

Different Americas based on Race: Reforming the Science and Healthcare Workforce explores what’s wrong and steps to make things right

Scientific Session 2020 kicked off Saturday with a live Main Event that presented a rapid stream of stats, data, and details supporting our nation’s racially driven health inequalities. The session, aptly titled Structural Racism as a Public Health Crisis, ideally complemented the American Heart Association’s (AHA) new policy statement that flags structural racism as a major driver of health disparities.

Lisa A. Cooper, MD
Lisa A. Cooper, MD, Bloomberg Distinguished Professor, general internist, social epidemiologist, and health services researcher at the Johns Hopkins Bloomberg School of Public Health

One of the session’s keynote speakers was Lisa A. Cooper, MD, Bloomberg Distinguished Professor, general internist, social epidemiologist, and health services researcher at the Johns Hopkins Bloomberg School of Public Health. In a nutshell, she addressed the excellent imperative for and the current state of diversity in the science and healthcare workforce. She led off by discussing the root causes for a lack of diversity in the sciences and healthcare workforce. She then segued into potential solutions, including interventions that target both individuals and organizations.

Dr. Cooper began by clearly stating the facts:

Diversity and inclusion are not only the right thing to do, they're also the smart thing to do. The reason is because they lead to improved academic and workforce environments, organizational and academic excellence, improved access to care, and reductions in health care disparities.”

All this happens, she added, because more diversity within the academic or workplace environment encourages better educational experiences and higher ratings of preparedness by learners, more creativity, and increased innovation. Also, it’s been observed that patients and physicians communicate better in a diverse environment.

However, Dr. Cooper added, “We are far from where we need to be to meet this imperative.”

For example, the doctor cited a study that says Asian and White men make up about 35% of undergraduate medical degrees and 43% of biomedical doctorates. However, they make up more than 80% of full professorships in academic medicine. Here’s another sobering stat: Blacks make up 13% of the US population, yet they represent 6% of medical school matriculated graduates, 4% of physicians, and 4% of medical school faculty.

Consider this state speaking to structural racism among practicing health professionals. “Blacks, Hispanics, and American Indians are underrepresented among not only physicians, but also among registered nurses, primary care physicians, and psychiatrists, while Whites and Asians are generally overrepresented,” Dr. Cooper explained.

Now leadership and academic medicine also reflects low proportions of African Americans, with Blacks representing only 3% of department chair positions in academic medical institutions.

As for the root causes of lacking diversity in science and the healthcare workforce, Dr. Cooper pointed to candidate pools from which leaders are chosen. Often these pools are based on referrals from existing position employees or leaders, she noted. “Focusing only on referrals from within the organization inadvertently puts African Americans candidates at a distinct disadvantage and reinforces the status quo.”

So, what does the “status quo” lead to? It could result in a drained talent pool. Dr. Cooper referred to one study that says, “only 43% of our underrepresented minority faculty plan to be at the institution within five years.” 

Not wanting to leave her AHA Scientific Session audience in a “hopeless state,” Dr. Cooper did offer a few closely watched programs that are addressing the challenge of racial parity in the science and healthcare workforces. Each effort, she said, comes down to a thoughtful focus on recruitment, pipeline barriers, retention, and senior leadership.