Healthcare Industry Channel
 Diversity in the Industry
Diversity
Imperatives
The future of the American workforce will increasingly
depend on people of color - by 2050, one out of every two workers will
be nonwhite. With increasing awareness, the medical community and health
consumers understand that there exist glaring disparities in health care
delivery based on race, ethnic and cultural considerations. Many
programs and initiatives sponsored by the government, educational
institutions, philanthropic groups and health organizations address this
issue. The goal is to make the practice of medicine and other aspects of
health care more accessible, affordable and "culturally competent."
People of color
are desperately underrepresented in today's healthcare professions.(1)
However, African Americans, Hispanics and American Indians make up about
one quarter of the population, but only 10 percent of the nation's health
workforce.(2) And, in recent years the numbers of underrepresented
minority students in medical school has been on the decline. Fifty percent
of that decline has been due to anti-affirmative action measures in
a few states.(3)
Despite some two
decades of efforts to increase minority representation in medicine,
many minorities remain critically underrepresented at every level of
medicine. In 1997, black Americans, Hispanics, and American Indians/Alaska
Natives represented approximately 23.6 percent of the population, while
only 12.2 percent of all enrollees in allopathic medical schools were
underrepresented minorities.* (4) In a 2003 follow-up
report by the
Council
on Graduate Medical Education (COGME) that tracked disparities in
medical school education, the picture had improved somewhat. Among
underrepresented minority (URM) medical school applicants for 2001, 46
percent were accepted into medical school compared to 50.6 percent of
non-URMs. African Americans had the lowest acceptance rate, 42.8
percent, compared to 53.4 percent for Mexican Americans, 60.4 percent
for Mainland Puerto Ricans, 51.0 percent for Native Americans, 51.7
percent for whites, 51.1 percent for Asians. However, the report
recommended that a number of persistent obstacles must be addressed to
raise the numbers of successful medical students, including quality
early preparation, providing assistance with the increasing costs of
schooling, and other steps.
The report also identified select examples where corporate and
organizational assistance were effective efforts to improve the professional
pipeline, such as the Fellowship Program in Academic Medicine, funded by
Bristol-Meyers Squibb, and six
Centers of Excellence in
Women's Health, offering support to help improve minority women
faculty's career advancement opportunities.
Healthcare as an industry has turned its attention to
workforce diversity fairly recently, relative to some other
major industries. However, a number of its leading
organizations and employers have made considerable strides.
However, nearly all authorities agree that increasing
diversity in all aspects of the industry will be crucial to
providing healthcare to our rapidly changing population in
the future.
Diversity Snapshot
According to the Equal Employment Opportunity Commission
(reporting on figures through 2003),
the number of non-white workers in "Healthcare and Social
Assistance" occupations is less than half of their white
counterparts. White workers constitute 69.6 percent of
workers in this area, while non-white workers make up 30.4
percent.
As in other industries, disparities are particular apparent
in professional and high level managerial positions.
However, industry-wide hiring and
science education initiatives may be increasingly
raising the numbers of underrepresented worker groups.
White workers hold 84.5 percent of "Official and Managerial"
positions in the industry, compared to 8.5 percent Black
workers, 3.8 percent Hispanic, 3.0 percent Asian American,
and 0.3 percent American Indian.
Among workers represented in "Professional" positions (for
example, physicians, dentists, etc.), White workers make up
79.7 percent, compared with 8.6 percent Black, 3.6 percent
Hispanic, 7.7 percent Hispanic, and 0.4 percent American
Indian.
At the same time, the gender profile of the industry --
which here includes social services as well as healthcare --
may be seen as unusual compared to other industries.
Women workers by far outnumber men in this area. Women
constitute 79.1 percent of workers -- with White women
accounting for more than half of workers, at 55.9 percent.
According to the EEOC analysis, women outnumber their male
counterparts in all ethnic groups in both "Official and
Managerial" and "Professional" type positions.
For more detailed data tables, please see the
report,
2003 EEO-1 AGGREGATE REPORT - NAICS CODE 62 - HEALTH CARE
AND SOCIAL ASSISTANCE," at the
EEOC web site.
These disparities by race and gender are more or less
pronounced in analyses broken down by specific types of
healthcare employment. For example, in related
occupations in the areas of "Ambulatory
Health Care Services" and "Nursing
& Residential Care Facilities," men and nonwhite workers
may hold slightly higher percentages of "Official and
Managerial" and "Professional" positions. Meanwhile,
among workers at "Hospitals,"
where job growth tends to be lower and salaries tend to be
higher, women make up a greater percentage of the workforce,
at 79.5 percent, and White workers are more highly
represented in "Official and Managerial" and "Professional"
positions, and overall.
Diversity Initiatives
Almost every employer
says it's committed to diversity. But which ones actually are?
When this channel was first launched, we cited a 2002
Fortune
survey that included Abbott Labs as the only organization in the healthcare field
ranked as one
of the 50 best companies for minorities. Their findings are
based on the percentage of new hires who are minorities, the percentage
of minorities in leadership roles, and the turnover rate of minorities
when compared to non-minorities. By 2006, the
Fortune survey's list of the 25 Best Companies to
Work for Minorities included 4 hospitals -- Baptist
Health South Florida, Methodist Hospital System,
Memorial Health, and Children's Healthcare of
Atlanta -- as well as the biotech giant Genentech,
whose related work includes research into diseases such as
cancer. Further, eight hospitals were ranked among the
top 25 companies for women in the
2006 Fortune survey. In the 2007 list, 16
healthcare or pharmaceutical research related companies were ranked among the
best employers overall, and Baptist Health S. Florida and (Houston-based)
Methodist Hospital System were ranked Number 1 and 2 on the
2007 Best Companies for Minorities list respectively. Increased attention to
workforce diversity among healthcare employers may be
responses to a few factors. On one hand, inclusiveness
in recruiting is sound practice for healthcare providers who
face labor shortages in such occupations as nursing care,
where demand is growing due to the needs of the aging baby
boomer population. On another, healthcare providers
are changing to meet the needs of the nation's shifting
ethnic demographics, including growing populations of recent
immigrants whose healthcare may involve workers with
specialized knowledge, research foci, language skills or
cultural fluencies. (See U.S. Dept. of Health and Human
Services report,
Changing Demographics and the Implications for Physicians,
Nurses, and Other Health Workers.) At the same time,
many healthcare industry employers have availed themselves
of the widening availability of specialized professional,
consulting and networking organizations that assist in
workplace diversity recruitment and development. In any
case, many leading healthcare organizations now routinely
rank in diversity listings such as those by Fortune,
THE BLACK COLLEGIAN, and other specialized media, and often
publish details of their organizational diversity
initiatives on their websites.
According to a two-stage study
by the American College of Healthcare Executives
(ACHE), entitled "A
Race/Ethnic Comparison of Career Attainment in Healthcare Management,"
moving up the ladder is fraught with barriers, although one
interesting fact emerged:
"The proportion
of top level management positions (defined as CEOs, COOs and senior
vice presidents) varies by gender. Among women, whites continue to
hold a disproportionately large share of upper level positions (35
percent) when compared to minorities (23 percent of blacks, 26 percent
of Hispanics and 15 percent of Asians). But where in 1992, white males
exceeded black males in top positions, today (1997), there are no important
differences in the proportion of top positions held by male managers
in the various race/ethnic groups."
The study goes on
to report that people of color face unfair treatment and advancement
opportunities due to "structural factors in the system embedded racism,
lack of organizational commitment to affirmative action, a paucity of
mentors and the influence of the 'good old boys' clique. Hispanics and
Asians also attribute career inequities to language and cultural differences."
Additional disparities were conveyed by black and Hispanic men who felt
their organizations were "not as fair relative to continuing education
opportunities as whites and Asian men."
Importantly, fewer
blacks and whites agreed that race relations in their organization were
"good" than they had five years earlier, and proportionately fewer women than
men thought so.
The work environment, in sum, continues to represent a fertile
place for possible explanations for the lower career attainments
of minorities in healthcare management. The study found that minorities
are recruited to the same level of jobs as whites, but that it
was white women in particular who were more likely than others
to rise to senior executive positions.
Disparities in the executive suite seem to have persisted
since that time. In ACHE's 2002 follow-up report, the
situation had changed only slightly.
"The proportion of top-level management
positions (defined as CEOs, COOs, and senior vice
presidents) varies by gender. Among women, a
disproportionately large share of whites continue to
hold top-level positions (40 percent) when compared with
minorities: blacks (26 percent), Hispanics (25 percent),
Asians (24 percent), and Native Americans (28 percent).
With one exception, a higher proportion of men than
women held top-level positions no matter what their
race/ethnicity. White men in top positions exceeded
minority men by a wide margin. Thus, 62 percent of white
men compared with 44 percent of black, 47 percent of
Hispanic, 34 percent of Asian, and 46 percent of Native
American men held top-level positions." (Report
PDF is here.)
The report further indicated a wide
disparity between whites and nonwhites in terms of their
careers' "starting place":
More white healthcare executives than minorities took
high-level first positions in the organizations for which they currently
work. Moreover, we saw that whites were promoted to higher-level positions
to a greater extent than their minority counterparts. Importantly, all of
the race/ethnic groups learned about the availability of their current
positions in very similar ways—notably, through their professional networks
and via promotions.
In
its
2006 report of its own demographics, ACHE reported that
among its 28,890 affiliates, members and fellows, the
overwhelming majority reported White/Non-Hispanic (88.8%),
followed by a distant 5.3% for Blacks, 2.8% for Hispanics,
2.6 % for Asian/Pacific Islander, and 0.5% for Native
American.
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