®
The Welcome Back Initiative
Integrating Highly Qualified Immigrants into the US Health Workforce
José Ramón Fernández-Peña, MD, MPA
Initiative Director
WES Forum
New York, November 12, 2009
Who We Are
• Our mission is to build a bridge
between the need for more
culturally and linguistically
diverse health professionals and
the untapped resource of
immigrants trained in a field of
health in their country of origin
who are living in the US.
• The Welcome Back Initiative
currently includes centers in
California, Massachusetts, Rhode
Island, Washington, Maryland,
Texas, and New York
Why?
“The lack of minority health
professionals is compounding the
nation’s persistent racial and ethnic
health disparities.”
(Sullivan Commission, Sept. 04)
Composition of Selected Health Professions
by Race and Ethnicity
American
White Black Hispanic Asian/PI
Native
(%) (%) (%) (%)
(%)
General
Population * 65.6 12.2 15.4 4.5 0.8
MD 73.0 5.0 4.0 17.0 0.1
DDS 89.0 1.0 2.0 7.0 0.1
RN 82.0 9.0 3.0 6.0 0.4
PharmDS 76.0 6.0 3.0 14.0 0.3
LPN 73.0 19.0 4.0 3.0 0.8
*1.5% of the population is of two or Data Source: HRSA, US Census 2008 Population Projections
more races.
Immigration Facts
• Immigrant numbers and growth rates are significant. The
foreign-born population in the United States tripled in the past
four decades and currently totals about 37 million, or nearly 12
percent of the total population.
• By 2010, the foreign-born population is expected to increase to
43 million, or 13.5 percent of the total population.
• In 2000, two-thirds of all the foreign-born lived in the
traditional "big six" immigrant states (California, New York,
Texas, Florida, Illinois, and New Jersey), down from three-
quarters in the decades before 1995.
US Census Bureau
• From 1990 to 2000, the foreign-born population grew by 145
percent in 22 "new growth" states, compared to 57 percent
average growth nationwide.
• The biggest growth between 1990 and 2000 occurred in the
Southeast, Mountain, and Plains states, led by North Carolina
(274 percent), Georgia (233 percent), Nevada (202 percent),
Arkansas (196 percent), and Utah (171 percent).
• The foreign-born averaged 25 percent of the population in
central cities in 2000, with the highest percentages in Miami
(60 percent), Los Angeles (40 percent), and San Francisco,
San Jose, and New York (all above 35 percent).
• More immigrants now live in suburbs (12.8 million) than in
central cities (9.8 million).
US Census Bureau
• In 2007, twenty-seven percent of foreign-born
U.S. residents possessed at least a four year
degree and 11 percent of immigrants possessed
advanced degrees – a greater proportion than
the 10 percent rate among native-born
residents.
U.S. Census. (2009). Educational Attainment in the United States. Washington. 3.
• In February 2009, while the rest of the
economy shed 681,000 jobs, the health care
sectored gained 27,000 new jobs. The need for
nurses is particularly acute. Nation-wide, in
2008, the vacancy rate for nurses was
estimated to be approximately 8 percent, or
135,000 RNs.
American Association of Colleges of Nursing. (2009). “Nursing Shortage Fact Sheet.” Last
accessed 6/7/09 at http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm.
Professions - All Centers
Other includes: psychologists, speech therapists, pharmacists, midwives, physical
therapists, social workers. Total Participants: N= 9,346 as of 3 rd Quarter. 2009
.
Working In Health? - All Time in the US
Centers
Gender
N= 9,346 as of 3rd Quarter, 2009
English Level
Heard About WB?
(Self- Reported)
44% of Participants
are Latino
60% of Participants
are Latino
60% of Participants
are Latino
62% of
21% of Participants Participants are
are Latino Latino
14% of Participants
are Latino
Individual level Barriers
• English Language Proficiency
• Time & Economic Issues
• Lack of Familiarity with US Health System
• Loss of Professional Identity
Structural Barriers
Complexity of Licensing Processes
Inconsistent Messages from Educational
Institutions
Complex Bureaucracies (Abroad and US)
Conflicting Interests of Key Stakeholders
Outcomes (through 3 rd Quarter, 2009)
• 2,212 Validated their Credentials
• 1,253 Passed Licensing Exams
• 679 Obtained License in their Original
Professions
• 533 Obtained Advancement in Health Career
• 1,477 Obtained Employment in the US Health
Sector for the First Time
• 82 MDs Accepted into Residency Programs
Welcome Back Initiative
San Diego
WBC
Los Angeles Boston
WBC WBC
Rhode
Denver
Island
WBC
WBC
San
Francisco
WBC
Puget
Phoenix?
Sound
WBC
WBC (WA)
Suburban
New York
Maryland
WBC
WBC
Alamo Area
WBC (TX)
Welcome Back Centers
San Francisco, CA Hosted by City College of San Francisco & SFSU (415) 561-1833
San Diego, CA Hosted by Grossmont College (619) 409-6417
Boston, MA Hosted by Bunker Hill Community College (617) 228-4226
Providence, RI Hosted by Dorcas Place (401) 273-8866 ext 155
Puget Sound, WA Hosted by Highline Community College (206) 878-3710 ext 33
Suburban Maryland Hosted by Montgomery County DHHS (240) 777-1004
Alamo Area, TX Hosted by Alamo Community College District (210) 485-0245
New York. NY Hosted by La Guardia Community College (718) 482-5498
www.welcomebackinitiative.org