It will take the collective wisdom and determination of committed people both within and outside of these institutions to press pause, get their leaders to reflect on the policies and practices that maintain inequity, and identify opportunities to do things differently.
Why Diversifying the Health Professions Matters for Everyone
We are committed to fostering a diverse workforce so every person, regardless of who they are or where they come from, can access the care they deserve to live a healthier life.
Imagine entering a hospital or clinic where the team delivering your care includes people who look like you, speak your language, and understand your culture and experiences. The staff comes from every race, ethnicity, gender identity, sexual orientation, economic background and includes people with disabilities who understand the importance of inclusive and accessible care. They see you not just as a patient, but as a unique person.
At RWJF, we believe in this future. We know that when the healthcare workforce mirrors the communities they serve, they can deliver better care which leads to improved outcomes. To get there and achieve our mission of dismantling structural racism and the many barriers it creates to health, we are driving changes to help ensure that our healthcare workforce reflects the diversity of our nation. This effort includes using evidence-based strategies to inform how institutions and systems can promote equity, creating career opportunities for all backgrounds, and ultimately transforming the health professions to make equity a reality in our lifetime.
How Diversity Benefits All of Us
Progress starts by shaking off misconceptions and depoliticizing conversations about the strategies that can help diversify our healthcare workforce. When we embrace diversity, everyone benefits. Think of it, as author Angela Glover Blackwell describes in “The Curb-Cut Effect,” like curb cuts in sidewalks. Initially designed to help people with limited mobility, these curb cuts also help parents pushing strollers, vendors pulling food carts, and tourists wheeling luggage.
The same holds true for diversity in healthcare. Research shows that diversity in the physician workforce improves outcomes for populations who have been marginalized: underrepresented physicians are more likely to practice in underserved areas and certain health outcomes such as infant mortality rates can improve when physicians and patients are the same race. And just like with curb cuts, efforts to eliminate health disparities among people of color, disabled people, and LGBTQIA+ people often benefit everyone. For example, studies show that strategies designed to address racial disparities in maternal health and mortality—such as providing doula care to expectant mothers and blood pressure cuffs to birthing people as they are discharged from the hospital—both reduce disparities for black and brown birthing people and improve health for birthing people of all races.
In addition to leading the charge to eliminate inequities, health professionals from historically marginalized backgrounds also contribute mightily to projects aimed at improving healthcare for all people. For instance, physicians of color have played a pivotal role in addressing some of the most urgent health issues of our lifetime—from developing a groundbreaking concept for a lifesaving vaccine against COVID-19 to creating nationwide violence prevention curricula for youth and supporting expanded use of treatment for opioid use disorder.
Further, we know that diverse teams perform better, including in creative problem solving and innovation. America needs the collective wisdom and talent of all of us who want to commit to the difficult job of healing—we cannot afford to leave out people whose contributions could benefit us all. Our individual wellbeing is connected to that of others in our communities and we all benefit from acting in solidarity.
Seeing Equity’s Promise in My Own Work
I saw this firsthand as a leader at the Massachusetts Department of Public Health, where I learned a lot about the power of fully committing to equity. The H1N1 pandemic brought huge disparities in infections and hospitalization rates for marginalized racial, ethnic, and income groups in our state. It was clear that to improve outcomes, we had to change our approach.
Our first step was to gather a cross-department group of leaders overseeing immunizations, infectious diseases, and health equity to develop a strategy. As a diverse team of people, each with their own way of looking at the world, we were able to get to the heart of the disparities. We agreed that equity had to be a priority to protect all residents.
Since vaccination was a major focus, the team had to address the skepticism and concerns that some residents in communities of color had about vaccines. To rebuild trust, we had to listen to their concerns grounded in a history of negative experiences with healthcare and public health. The team mapped out a strategy to deepen community engagement and partnership, which meant repairing longstanding breaches of trust and re-thinking how we operated. It worked. By confronting the structural barriers built into so many of our systems and reframing our approach to meet the specific needs of communities experiencing the greatest disparities, the team’s strategy helped protect residents across the state and supported the longer-term goal of fostering better health for all.
Transforming Leadership for Lasting Impact
This kind of structural change is possible when leaders prioritize diversity, equity, and inclusion (DEI) in healthcare and public health. To enable more of it and address the shortage of people of color in certain health professions, RWJF is increasing its investments toward a diverse healthcare workforce by 60 percent over the next three years. We are determined to close the diversity gap in the healthcare professions while also growing a generation of leaders from communities of color and other marginalized groups prepared to shape a future in which health is not a privilege for a few, but a right for all.
We will direct much of our forthcoming investment to academic institutions that have made significant contributions to diversifying the health professions—institutions like historically black college and university medical schools, and medical schools that serve large numbers of Latino and Native American students. We are also supporting groups of institutional change leaders and champions both within and outside academic healthcare settings who are dismantling racism in academic admissions and health professional training. From these partnerships, we will highlight effective DEI models, programs, and policies, and share lessons with institutions and advocates across the country.
While a commitment to diversifying the health professions is not new for RWJF, this approach, which emphasizes the roles of both individuals and institutions, is. We know that individuals alone can't undo deeply ingrained policies and patterns of behavior within organizations that provide care. We also know that it’s easy for institutions to operate largely on inertia, moving through familiar, well-worn grooves of behavior and decisionmaking instead of making the structural changes necessary to improve health. It will take the collective wisdom and determination of committed people both within and outside of these institutions to press pause, get their leaders to reflect on the policies and practices that maintain inequity, and identify opportunities to do things differently.
Only systemic changes, driven by both individuals and institutions, can root out the laws, policies, social practices, and expectations that place more value on some lives than others.
Envisioning the Future
That’s exactly what a diverse workforce can accomplish. By nurturing leaders who truly represent our country’s diversity, we will build a framework where everyone can trust that the care they receive will be sensitive, respectful, and high quality. By honoring lived experience, showing cultural humility, and tapping into the full measure of our collective strengths, we know we can create a healthcare system that helps everyone thrive. It may take a decade or more to harvest the full bounty of what we are planting today. But a systems-level approach to nurturing diverse public health, healthcare, and research talent is essential to achieving a healthier, more equitable future for us all.
About the Author
Lauren Smith is the vice president of Strategic Portfolios and oversees strategy development, implementation, and management of RWJF’s key focus areas, or strategic portfolios, which include Healthy Children and Families, Healthy Communities, Leadership for Better Health, and Transforming Health and Healthcare Systems programs.