Pipeline Programs in the Health Professions, Part 1: Preserving Diversity and Reducing Health Disparities by ProQuest


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Pipeline Programs in the Health Professions,
Part 1: Preserving Diversity and Reducing
Health Disparities
Sonya G. Smith, EdD, JD; Phyllis A. Nsiah-Kumi, MD, MPH; Pamela R. Jones, PhD, MPH, RN;
Rubens J. Pamies, MD, FACP

                                                                     author affiliations: Health Services Research & Administration (Dr Smith,
 Background: Racial and ethnic minorities are underrep-              associate vice chancellor for academic affairs, chief student affairs officer,
 resented in the health professions. Affirmative action and          associate professor), Community-Based Health–College of Nursing, Health
 educational pipeline programs play a vital role in increasing       Promotion, Social & Behavioral Health–College of Public Health (Dr Jones,
                                                                     assistant professor), University of Nebraska Medical Center (Dr Nsiah-Kumi,
 the diversity of health professions, addressing educational
                                                                     assistant professor, internal medicine-pediatrics; Dr Pamies, vice chancel-
 opportunity gaps, and reducing health disparities. Part 1 of        lor for academic affairs; dean of graduate studies, professor of medicine),
 this 2-part series discusses the need for educational pipe-         Omaha, Nebraska.
 line programs to assist underrepresented minorities (URMs)          corresponding author: Sonya G. Smith, EdD, JD, Associate Vice Chancel-
                                                                     lor for Academic Affairs, Chief Student Affairs Officer, Associate Profes-
 in entering the health professions and the importance of
                                                                     sor, Health Services Research & Administration, University of Nebraska
 these programs in developing a cadre of diverse providers           Medical Center, 984250 Nebraska Medical Center, Omaha, NE 68198-4250
 to reduce health care inequality.                                   (sonyagsmith@unmc.edu)

 Methods: Part 1 presents an overview of diversity in the med-
 ical and health care workforce, educational enrichment              Background

 programs, key components of successful pipeline programs,                    ffirmative action is one of the most misunder-
 and notable pipeline examples for underrepresented stu-                      stood and highly controversial phrases in aca-
 dents at the University of Nebraska Medical Center. Rec-                     deme, and its role in enhancing the health pro-
 ommendations for improving and developing pipeline pro-             fessional pipeline continues as an emotionally charged
 grams are also included. Part 2 reviews affirmative action          debate among academic medicine, the courts, policy
 case law and legislation along with recommendations for
                                                                     makers, and the American public.1-5 Today, emerging
 maintaining and reviewing diversity pipeline programs in
                                                                     demographic shifts and widening economic and social
 light of recent anti–affirmative action challenges.
                                                                     divides further shape this debate.
                                                                         Nevertheless, despite contention over affirmative
 Conclusion: Pipeline programs are an important strategy for         action programs and the true need for cultural compe-
 addressing the shortage of URMs in the health professions.          tence training, research still demonstrates that racial and
 Anti–affirmative action initiatives threaten the existence of       ethnic minority health providers are more likely to serve
 these student preparation programs and the ability of our           medically underserved communities and underrepre-
 nation to produce physicians of color and other health care         sented minority (URM) patients than their white coun-
 providers who are more likely to serve in underrepresented          terparts.6-10 URM dentists and psychologists are also
 communities and work to reduce related health disparities.          more likely than their nonwhite peers to work in urban
 Programs at universities and academic medical centers               and other areas with a higher proportion of racial and
 must develop innovative partnerships with underserved               ethnic minorities.1 Consequently, increasing the number
 communities, adopt strategies that demonstrate a strong             of minority health practitioners in these underserved
 commitment to increasing racial and ethnic minorities in the        communities must play a major role in reducing health
 health professions, and develop viable funding mechanisms           disparities and addressing issues of health care access
 to support diversity enrichment programs.                           for at-risk populations.1,11
                                                                         All health care professionals, regardless of race and
 keywords: health disparities n children/adolescents n               ethnicity, have an important obligation in the care and
 minorities n education                                              treatment of URMs. However, URM patients have a higher
                                                                     likelihood of selecting health care providers of their own
 J Natl Med Assoc. 2009;101:836-840                                  racial or ethnic background.1,6 In other words, URMs have
                                                                     a distinguishably different pattern of health care utilization

836 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION                                                  
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