by Crystal Loucel
Because minorities are more likely to receive less and lower-quality health care and suffer higher mortality rates from cancer, heart disease, diabetes, HIV/AIDS and mental health illnesses than their Caucasian counterparts, there have long been calls to increase the number of minority providers to reduce these health disparities. Numerous studies have shown that patients are more likely to receive quality preventive care and treatment when they share race, ethnicity, language and/or religious experience with their providers.
The 2010 Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health found that a diverse workforce – and the diverse perspective it provides – contributes to enhanced communication, health care access, patient satisfaction, decreased health disparities, improved problem solving for complex problems and innovation. Moreover, the Health Resources and Services Administration (HRSA) has found that minorities could improve access to care in underserved areas more than nonminority providers (see The Rationale for Diversity in the Health Professions: A Review of the Evidence [HRSA, 2006]).
Yet minorities are still under-represented in the health care workforce generally and in nursing in particular. In 1908, when Israel Zangwill popularized the term melting pot to describe the American population, it was 89 percent white, 10 percent black and less than 1 percent Indian, Chinese, Japanese and “others.” Today’s melting pot is considerably more diverse, composed of more than one-third racial and ethnic minorities; moreover, the United States Census Bureau expects that portion to be more than half by 2050.
“Today the nursing workforce does not adequately reflect the diversity in the population including gender,” says Beverly Malone, CEO of the National League for Nursing. Latinos, African Americans, American Indians and Native Alaskans compose only 7.6 percent of the nursing workforce, a dismal figure compared to the 25 percent in the general population. UCSF’s nursing student population is doing a bit better – in 2009, the latest year for which data are available, these same groups composed 16 percent of the UCSF nursing student body – but there is certainly room for improvement. When Asian Americans are included, a 2008 HRSA report showed that minorities make up 35 percent of the total population but only 17 percent of the nursing population.
UCSF has been trying to respond to the 2004 Sullivan Commission Report, titled Missing Persons: Minorities in the Health Professions, which recommended that health profession schools hire diversity program managers and develop plans to ensure institutional diversity, including providing educational support, commitment, role modeling and dedicated recruitment. Currently, Judy Martin-Holland serves as associate dean for Academic Programs and Diversity Initiatives at UCSF School of Nursing, a role in which she recruits minority students, seeks to integrate more diversity in the curriculum, and offers support programs for minority students. In addition, after years of medical student advocacy, Renee Navarro, vice chancellor Diversity and Outreach, created the School’s first Multicultural Resource Center. Though the center currently has no budget, its director, Mijiza Sanchez, hopes to advocate for the types of programs that the commission has recommended, such as the mentoring that Sanchez herself offers students.
It’s also important to remember that minorities often face barriers to financing their education and would benefit from scholarships, loan forgiveness and tuition reimbursement programs.
In addition, universities should link to minority professional organizations to promote enhanced admissions policies, cultural competency training and enhanced minority student recruitment. For example, as volunteer past president of the San Francisco Bay Area chapter of the National Association of Hispanic Nurses (NAHN), I am proactively connecting to the UCSF student group Voces Latinas Nursing Student Association (VLNSA) to do just that. VLNSA is open to students of all ethnicities who are interested in working with the Latino community; the ability to speak Spanish is not required. And organizations like NAHN typically offer reduced student membership and benefits such as mentoring, résumé revision, job postings, volunteer opportunities, networking and more for students, without requiring them to be from any particular racial or ethnic background.
That last point is important, because no matter how diverse your workforce, the goal is to create an environment that is inclusive and allows everyone to express themselves. As minorities, we cannot address our specific health issues alone; rather, this is a challenge for all health care providers. Given what we know about diversity and its importance to health care, we must partner to creatively address and embrace an ever more diverse future.
Crystal Loucel is a second-year master’s student at UCSF School of Nursing and past president of the San Francisco Bay Area chapter of the National Association of Hispanic Nurses. She has a master’s in public health, specializing in global health, from Loma Linda University; has served as an AmeriCorps and Peace Corps volunteer in Honduras; was one of eight RNs chosen in 2012 for a General Electric-National Medical Fellowship in primary care; and is a 2012 scholarship recipient from the Deloras Jones Kaiser Foundation. An earlier version of this piece appeared in the UCSF student newspaper, Synapse.
By Christina Orlovsky
Ask a young girl what she wants to be when she grows up, and top answers are often a teacher or a nurse, which are professions that have been associated with women throughout history. Ask a young boy the same question and neither answer is likely to be given.
Ask Christopher Lance Coleman, PhD, MS, MPH, FAAN, and he’ll tell you that inequity has to change.
Coleman, an associate professor of nursing and multicultural diversity at the University of Pennsylvania School of Nursing in Philadelphia and the author of Man Up! A Practical Guide for Men in Nursing, is a strong advocate for recruiting males into the nursing workforce and empowering them to pursue leadership roles. His new book serves as a roadmap for men seeking to break into the predominantly female nursing profession.
“I believe men need a guide, a blueprint to use to navigate through the complexity of specialty choice and a culture where, frankly, a gender disparity still exists,” Coleman explains. “This is an opportunity of a lifetime for men not only to change the face of nursing in the 21st century, but also to reshape the public image that nursing is a women’s profession.”
In fact, while the most recent numbers show that men are still a clear minority in the nursing field, an uptick is occurring. According to a 2012 U.S. Census Bureau study, “Men in Nursing Occupations,” which presents data from the 2011 American Community Survey, the percentage of male nurses has more than tripled since 1970, from 2.7 percent to 9.6 percent. Of the 3.5 million employed nurses in 2011, 3.2 million were female and 330,000 were male. It’s a change, but, if you ask Coleman, it’s not enough.
“The startling thing is how underrepresented men still are in areas of leadership,” he says. “While the numbers of RNs has increased, when you look at the profession as a whole--heads of nursing, academia--we are still so far underrepresented. This is significant for males going through school looking for role models and seeing predominantly female leaders. I want men to know this is a viable profession and there are tremendous opportunities out there.”
Coleman believes the greatest opportunities for change are in younger men, who even at the high school level should do their research and start the conversation with their parents about the opportunities that exist for them in nursing. Ethnic minority groups, he adds, are particularly critical.
“Many ethnic minority groups, even today in 2013, still think of nursing as only a woman’s profession,” he says. “That racial disparity needs to be taken away.”
Coleman hopes that his book also opens up a dialogue among current male registered nurses. Empowering male RNs to continue to climb the ladder to leadership roles where they can influence change and serve as a new face of the nursing profession, he says, can encourage them to become the mentors male RNs need to help them succeed.
Another conversation that needs to occur in order to influence a culture shift is one between female nurses who may stereotype their male counterparts as only necessary for heavy lifting or things they “can’t” do.
“That’s a stereotype that hurts women and hurts the profession,” Coleman explains. “We don’t want nursing to be seen as a profession of the weak, we want it to be seen as a profession of the strong, because nurses are strong. We all need to do a better job of marketing ourselves--stop stereotyping and typecasting males and do more education in the hospital setting about gender diversity.”
Many men, after all, possess all the qualities required to be good nurses.
“Passion; someone with a tremendous amount of integrity; leadership skills; with a natural curiosity about the world; someone who is unafraid to take on issues that perhaps have challenged them in the past; someone who could treat someone at the end of the day how they want to be treated; and someone who cares to change the world we live in--those characteristics are essential and they transcend gender,” Coleman concludes. “Those are things I’d like to see in anyone who is interested in entering our noble profession.”
© 2013. AMN Healthcare, Inc. All Rights Reserved.
When it comes to nursing education, African Americans tend to aim for more advanced degrees, yet their percentage among all U.S. nurses is far lower than it is in the general U.S. population. Phyllis Sharps, PhD, RN, FAAN, intends to find out what is behind that disconnect as a key step toward correcting it.
Sharps, associate dean for Community and Global Programs, director of the Center for Global Nursing, and the principal investigator for a $20,000 grant from the National Black Nurses Association (NBNA), will use the funding to conduct a national survey to identify the drivers and barriers to success among African-American nursing students and nurses. Through research funded by the new grant, “Enhancing the Diversity of the Nursing Profession: Assessing the Mentoring Needs of African American Nursing Students,” Sharps hopes to determine what mentoring needs are essential to keeping African-American nursing students on track in their education and their career paths.
While African-Americans are underrepresented in the profession (5.5 percent of U.S. nurses vs. 13.1 percent of the U.S. population), the 2008 National Sample Survey of Registered Nurses (NSSRN) shows that African Americans as well as other minority groups in nursing are more likely to pursue baccalaureate and higher degrees—52.5 percent pursue degrees beyond the associate level, while only 48.4 percent of their white counterparts seek equal degrees.
“As nurses, we all know what we needed while attending nursing school,” says Reverend Dr. Deidre Walton, NBNA President. “We need to have a better understanding of what this generation of nursing students needs in this new technological and innovative world of nursing.”
Source: John Hopkins University
Promoting diversity in nursing is one of the goals of the Campaign for Action because it is essential that the nursing population evolves to reflect America's changing population. Arilma St. Clair, MSN, RN, of the Washington, D.C., Action Coalition, says diversity has to be part of every aspect of nursing—whether in the classroom, in a hospital, or in the community.
Source: Champion Nursing
By Jane Gutierrez
When you think of a nurse, what’s the first image that comes to mind? Chances are, you think of a woman — and for good reason. The vast majority of professional nurses in the U.S. are white women. In fact, only about six percent of nurses are male and, Considering males make up approximately half of the population and minorities are 30 percent, there’s a major disparity in the profession.
That disparity is reflected in equal measure in nursing schools, both in the student population and faculty. Experts argue improving the diversity in nursing education will improve health care by creating a more culturally sensitive healthcare workforce with improved communication abilities, reduced biases and stereotypes and fewer inequities, as well as increasing the diversity of the nurse education faculty.
At a time when the healthcare system is faced with a nursing shortage caused at least partially by a shortage of nurse educators, some argue males and minorities represent an untapped resource for recruiting new educators. They believe that by creating new opportunities to attract traditionally underrepresented populations to the field, we can both solve the shortage and make a measurable improvement to our healthcare delivery system.
Why Diversity Is an Issue
While minorities have made great strides in other traditionally white-dominated fields and women have done the same in traditionally male fields, nursing is one area where diversity initiatives seem to have been ineffective.
In the case of men, much of the resistance to nursing as a profession comes from a cultural perception of nursing being a “female” profession. Men report while they enjoy the care giving aspects of the job, it’s difficult when others ask questions or make comments deriding their career choice. For example, male nurses report being asked why they didn’t choose to become doctors, with the implication that they did not earn adequate grades or were too lazy to become doctors. In addition, men report feeling left out of the profession, with most training and professional development materials referring to nurses as “she” and a female-centric approach to teaching and training.
In the case of minorities, including African-Americans and Latinos, studies attribute the disparity in the nursing profession largely to lower overall academic achievement in those groups. Given that admission to nursing school generally requires at least a moderate level of academic achievement — and earning a
degree in nursing education requires at least a bachelor’s degree and some experience — it’s no surprise that groups that aren’t as academically advanced are lacking in the nursing profession.
Fixing the Problem
Because improving diversity in the nursing profession is a key to solving the nurse shortage — and by extension, the nurse educator shortage — the healthcare field is looking for new ways to recruit, mentor and retain minority nurses, male nurses and educators.
One step is to recruit potential professionals earlier — in some cases, as early as high school. Throughout the country, in the field in exchange for high school credit, with the goal of encouraging them to maintain their academic performance and attend nursing school.
However, academic performance is only part of the equation. The cost of education is another barrier to many potential students, regardless of sex or ethnicity. The cost for a four-year BSN program can be over $100,000 in some cases, while a two-year program generally runs between $5,000 and $20,000. Factoring in the master’s and doctoral degrees required to become nurse educators, and the cost only goes up.
In response, many schools, as well as states and the federal government, have instituted financial assistance programs designed specifically for minorities and males. The Federal Nursing Workforce Diversity program allows minority students to borrow money for school, and have some or all of their loans repaid if they agree to work in specific, undeserved areas. For those who want to become nurse educators, the government’s Nurse Faculty Loan Program offers partial or full repayment of student loans for agreeing to teach for at least two years after graduation.
With the nursing shortage only expected to grow, thanks to increased access to healthcare, reaching out to minorities and males only makes sense. Not only will it solve a serious problem, it will ensure quality, effective health care for future generations.
About the Author: Jane Gutierrez is a nurse educator and a member of her employer’s diversity initiative committee. She visits with local high schools to encourage students to consider careers in health care
By Mable Smith, PhD, JD, MSN, BSN, RN
A diverse nursing student body builds the foundation for a diverse workforce that can become effective in the provision of culturally competent care to patients. Our student body at Roseman University of Health Sciences is reflective of the diversity seen in the population that consists of Caucasians, African Americans, Hispanics, Asians, Native Hawaiian and other Pacific Islanders, to name a few. This diversity is reflected in the health care system among workers and patients. Students bring a wealth of information that is shared with each other and with faculty.
For example, in a class discussion on nutrition, students from various cultures shared how and what types of foods are used to treat certain illnesses. There were discussions on how food should be presented, such as hot versus cold, raw versus cooked. Some students shared the significance of family presence during meals even for hospitalized patients. These discussions quickly incorporated religious practices and certain etiquettes to promote “religious correctness” when interacting with various cultural and religious groups. Students also provided insight into generational differences and changes with emphasis on the fact that many in the younger generation have not adopted the strict traditions of their parents and grandparents.
Several students picked up on the stereotyping of religious and cultural classifications. Two students of the same racial group, but from different parts of the U.S., highlighted the differences in their beliefs, values, health practices, diets and even religion. Both are African American students, with one raised Catholic and the other Baptist.
Students in the College of Nursing are assigned to groups and remain with their group through the program of study. They learn to work with a racially and culturally group of people, address issues, confront problems, and share in successes. They rely on each other during clinical rotations to address the diverse needs of patients. More importantly, this foundation in education provides the tools for them to effectively interact with members of the interprofessional health care team.
The diversity in the College is the strength of the program. Learning from each other promotes collaboration, encourages innovation, and leads to respect.
Nursing is both an art and a science. While the science is fairly uniform, the art is often learned from experiences and interacting with others. These students graduate with a strong knowledge base, but most importantly with a mutual respect and appreciation of individual differences. Educational policies should promote, not hinder, diversity.
Source: Robert Wood Johnson Foundation
By Neal St. Anthony
Registered nurse Rachele Simmons walked away from a $100,000 career two years ago.
She still isn’t generating enough cash to pay herself a salary from the St. Paul business she started in 2011. But if passion and commitment matter, Simmons already is wealthy from her mission to train and place more minorities in health care jobs.
And as business continues to grow at fledgling Foundations Health Career Academy, Simmons should generate positive cash flow by the end of this year.
“Rachele is phenomenal,” said Tom Thompson, administrator at St. Paul’s Galtier Health Center. “She’s positive and she knows what she is doing. We’ve hired some of her graduates and never had any problem. Her people are very good. And we have a diverse clientele in our facility. So we need staff who speak different languages and who are from different backgrounds and races.”
Simmons is the founder, teacher, marketer and chief bottle washer at Foundations Health, a state-certified private school that has graduated 160 students through its four-week, certified nursing assistant/home health aide program. For many graduates, the course offers a first step into the growing health care industry into jobs that can pay as much as $20 per hour plus benefits.
Simmons, 44, has been a hospital nurse and last worked as a manager at Walgreens, training managers and others to use retail-medical equipment. And she always worked a shift or two a week as a hospital nurse to build a rainy-day fund.
Over the years, Simmons got used to being the only black nurse on the floor or in managerial meetings at Walgreens.
She also knew that health care is a growth area, particularly lower-cost primary care that can be delivered relatively inexpensively outside the hospital and help keep patients in their homes.
She also thought she could be an inspiration to young people of color.
“I just wanted to give something back,” said Simmons, who decided, as her sons reached adulthood, she could handle some business risk. “I had been involved in nursing for 25 years. I was always the nurse called to see the ‘diverse’ patients, often black. It meant so much to them.
“This is what I was called to do. Maybe we can start something that … will get more people of color in nursing, in science, in medicine. We need more black nurses and Hmong nurses and more diversity in health facilities.” She’s even had a couple of white medical students take the class because they wanted to learn the grass roots and work in diverse clinics.
Foundations Health, housed in the Hmong Professional Building a mile west of the State Capitol on University Avenue, is a first business step for Simmons.
Simmons is no stranger to drive and hard work. Divorced when her sons were toddlers, Simmons said her ex-husband never paid child support, forcing her for a short time onto public assistance. The St. Paul Highland Park High School graduate completed two-year nursing school in St. Paul and worked days while completing her registered-nurse degree at Minneapolis Community and Technical College, often bringing her boys to play in the commons while she attended class.
“She was a successful nurse and thrifty with her money,” said Isabel Chanslor, a business trainer with nonprofit Neighborhood Development Center, which for 20 years has provided training to several thousand would-be urban entrepreneurs, including Simmons. “She did not want to take a loan.’’
Last month, NDC recognized Simmons for her commitment to community as a finalist in the organization’s annual entrepreneurial awards.
“She’s a gutsy lady,’’ Chanslor said. “She’s high energy, sharp, rides her little motor scooter everywhere. She has a good business plan and she’s a really good instructor and very focused and dedicated, according to her students.”
Simmons has invested $50,000 in space and equipment. She uses word-of-mouth and social media to attract students. The 80-hour course costs about $950.
“My students are mostly young, single, with kids, without kids, battered, not battered, on welfare, not on welfare … most of them are working poor,” Simmons said. “If they want to work hard and truly better their life, we’ll take them.”
Na Yang graduated from Foundations Health in 2011, but can’t work as a nursing assistant because of an injury. So, she joined the office as a part-time office manager.
Simmons said Yang works more hours than she’s paid because of her commitment to the cause and the need to stay on top of the paperwork.
“You couldn’t find a better instructor,” Yang said of Simmons.
“She’s knowledgeable and passionate. She couldn’t do this without her passion.”
Source: Star Tribune
Diana Kamyk discusses the opportunities and challenges of her position as head of the U.S. diversity and inclusion program for Bayer Corp.
Diana Kamyk has dedicated her career to creating a diverse and inclusive work environment. As the head of the U.S. diversity and inclusion program for Bayer Corp., she makes it her mission to foster and facilitate a spirit of understanding within the workplace. The company has been recognized multiple times by Working Mother as a top company for working mothers while under Kamyk’s leadership. She oversees the diversity program at Bayer, of which the Women’s Leadership Initiative is a part. The Initiative aims to increase the number of female employees in managerial positions within the company. In addition, Kamyk helped found Bayer's Diversity Advisory Council, which facilitates and promotes diversity through various conferences and workshops.
How does Bayer's diverse workforce drive and promote innovation?
Through our U.S. Bayer Diversity Advisory Council, we incorporate diversity and inclusion initiatives — such as the Diversity Conference, Women’s Leadership networks and mentoring/coaching programs — into our business strategies and daily operations as a means to foster professional growth and to help build upon our culture. These efforts collectively help support the company’s belief that the more diverse the workforce, the more creative and innovative the results.
What are the goals of Bayer's various diverse employee networks?
Each network has between 50 and 450 members. Some develop new initiatives for their work locations, others get involved in job-related issues in science or the pharmaceutical industry. Their priorities range from doing voluntary work in schools, to promoting women in leadership positions, to offering a safe and inclusive workplace for homosexual, bisexual and transgender employees.
How does Bayer facilitate a work-life balance for moms?
The ProMoms professional network is a forum that allows working moms to learn from and provide support to each other. It creates awareness and understanding among all Bayer employees of the diverse roles of working moms and the contributions they offer to the workplace.
Bayer HealthCare in Berkeley, Calif., opened a new child care center in 2012 with space for 150 children, ages newborn through kindergarten. The child care center serves both children at Bayer and within the West Berkeley community. Bayer recognizes the importance of early childhood development. Therefore, providing an environment where a child can learn and develop to his or her full potential is critical in the maturation process and something that Bayer highly values.
What's the biggest challenge you face in your diversity role, and how do you overcome it?
With operations touching all corners of the globe, working with employees from varying cultures presents a wide range of challenges. Beliefs and priorities as they relate to diversity vary from country to country, so there is certainly a learning curve that we have to take into account as we work to implement unique programs — ones that are impactful and meaningful to employees — that support the foundation of diversity and inclusion across the globe.
Educating myself about each unique culture and understanding our specific employees, basically learning what works and what doesn’t work, has been invaluable for the creation of such plans. For anyone working at a global company, being able to think outside of your own borders and to understand other cultures is imperative to success.
Source: Diversity Executive
If you live a neighbourhood which is ethnically diverse, you're more likely to be healthier and less likely to experience racial discrimination, a new study has found.
Researchers at the University of Manchester say diversity is associated with higher social cohesion and a greater tolerance of each other's differences.
They also found that someone from an ethnic minority is less likely to report racial discrimination in an ethnically diverse neighbourhood.
And that a neighbourhood's high level of deprivation - rather than diversity - is linked with poor physical and mental health, low social cohesion and race discrimination.
The findings, based on analysis of census and survey data, will be presented tomorrow at a conference attended by the study researchers, policy makers and community organisations
Professor James Nazroo, director of the university's Centre on Dynamics of Ethnicity,said: "Our research and this conference is all about setting the record straight on those diverse neighbourhoods which are so widely stigmatised.
"So often we read in our newspapers and hear from our politicians that immigration and ethnic diversity adversely affect a neighbourhood, but careful research shows this to be wrong.
"In fact, the level of deprivation, not diversity, is the key factor that determines these quality of life factors for people in neighbourhoods.
"So our research demonstrates the disadvantages of living in deprived areas but the positives of living in ethnically diverse areas.
"It's deprivation which affects those Caribbean, Black African, Pakistani, and Bangladeshi people who are disproportionately represented in these neighbourhoods, as well as those white people who live alongside them."
Also according to the researchers, one in five (20%) people identified with an ethnic group other than White British in 2011 compared with 13% in 2001.
The ethnic minority populations of England and Wales lived in more mixed areas in 2011 and this mixing has accelerated over the past 10 years, says the study.
Traditional clusters of ethnic minority groups have grown but the rate of minority population growth is greatest outside these clusters with ethnic diversity spreading throughout the country.
Fellow researcher Dr Nissa Finney said: "Despite the clustering of ethnic minority people in some areas, the vast majority of ethnic minority people have a strong sense of belonging to Britain, feel part of Britain and feel that Britishness is compatible with other cultural or religious identities."
While colleague Dr Laia Becares said: "Increased diversity is beneficial for all ethnic groups so we say the policy agenda should develop strategies for inclusiveness rather than marginalising minority identities, religions and cultures.
"Policies aimed at reducing the stigmatisation of diverse neighbourhoods and promoting positive representations can only be a good thing."
The conference, entitled 'Diverse Neighbourhoods: Policy messages from The University of Manchester', will take place at Manchester Town Hall.
Source: UK Huffington Post
New learning institute builds on past success to diversify the dental profession
By Janet Edwards
At the age of 13, Esther Lopez, DDS, knew intimately her mother’s battle with cancer because she served as the primary translator between the patient, a native of Ecuador, and her doctors. Even at such a young age, Lopez vowed the excruciating experience would influence her life’s work. She didn’t know the term “public health” then, but that’s where she would later find fulfillment, through dentistry. In part, Lopez credits the now defunct, but still influential, Dental Pipeline program for helping her achieve that dream. A new project, the Dental Pipeline National Learning Institute, builds on the program that brought Lopez into dentistry.
Esther Lopez is a dentist in Oak Park, Ill. Through both private practice and volunteer public health efforts, she works with low-income and minority populations, groups that typically find dental services inaccessible, complex, and unwelcoming. In large part, Lopez credits a now-defunct minority recruitment program, the Dental Pipeline, for the opportunity to do such work, a longtime ambition that often seemed out of reach.
Lopez is one of a small number of minority dentists in the country—only 9 percent of practicing dentists are African American, Hispanic, or American Indian. While these underrepresented groups comprise nearly 30 percent of the general population, they account for just 13 percent of first-year dental students. Dental schools and their community partners seek to close that gap through a new program that adopts lessons learned from the Dental Pipeline.
Dental Pipeline National Learning Institute
The original Dental Pipeline launched with funding from The Robert Wood Johnson Foundation (RWJF) and The California Endowment. In all, 23 (out of 62) U.S. dental schools were involved in the decade-long program, which ended in 2011. Widely credited with transforming dental education, the Dental Pipeline resulted in better access to care for underserved populations, along with more student exposure to community-based services and higher enrollment among minority students.
A new program launched in fall 2012, the Dental Pipeline National Learning Institute (NLI), is intended to build on that success. Project partners are the American Dental Education Association and the University of the Pacific Arthur A. Dugoni School of Dentistry, in San Francisco, Calif. Support comes from an initial 18-month, $650,000 grant funded by RWJF.
Eleven schools were tapped as NLI participants. Each institution receives $12,000 to cover the cost of building a recruitment project or community-based education component. The program includes a three-day training course covering best practices, advocacy and leadership, and various mentoring opportunities.
Paul Glassman, DDS, professor and director of Community Oral Health at University of the Pacific, is project director. The primary goal is to expose other dental schools to methodologies developed as part of the Dental Pipeline “so they wouldn’t be reinventing the wheel,” he says.
Evidence of the Dental Pipeline’s success is found in the numbers, Glassman says. “Schools involved in the Pipeline managed to dramatically increase—double, triple, even quadruple—the number of underrepresented minority students entering their schools. [Enrollments of] other dental schools not involved in the program stayed static,” he says.
The NLI is a one-year program. Participants are dental school faculty members who collaborate with a partner from a local organization, such as a minority-focused college or community health center. “We want some significant community partner involved because we’re really trying to emphasize the fact that in this very complex world that we live in, dental schools really can’t break through these barriers by themselves. The way to make progress in our current world is through partnerships and establishing networks,” Glassman says.
Like its predecessor, the NLI is also designed to develop future leaders in the push to provide more diverse dental care in community-based health settings, Glassman says. Barriers to health care for low-income and minority individuals, which result in less dental care and more dental disease, are well documented, he adds.
“Minority populations tend to have more dental disease than more affluent populations and majority populations. They tend to have more barriers to access to care, so they get care less regularly,” he says. Paying for dental care is a serious obstacle, along with language and cultural challenges. “They feel uncomfortable going into a dental office because they feel someone isn’t going to understand them,” he says.
“We’re expecting people who go through this program to become future leaders in this area, so within their own school and their community, and maybe even regionally, they’re going to be someone steeped in this whole idea of the dental profession doing a better job of improving the health of underserved populations and keep the momentum going,” he says.
The Minority Enrollment Challenge
While the Dental Pipeline made positive inroads toward recruiting minority dental students, the NLI is designed to keep the momentum going, says Kim D’Abreu, senior vice president for access, diversity, and inclusion for the ADEA.
The effort continues to face several high priority challenges. A large pool of minority students who could succeed in dental school remains untapped, D’Abreu says, including 12,500 students of color who graduate with majors in the biological sciences each year. “A 2003 focus group study published in the Journal of Dental Education found that early and frequent exposure to dentistry and dentists in practice is essential for minority students to consider the profession. Dental schools need additional tools and strategies to attract a talented group of underrepresented minority students,” she says.
The process by which dental schools evaluate student candidates is undergoing review, Glassman says.
“Traditionally, admission is based on grade point average, extracurricular activities, and other sorts of measures that aren’t necessarily the measures that students from minorities have excelled in … because they were working while they were in school and facing other social challenges in their lives,” he says. While it makes it harder for them to get through the admission process, it doesn’t necessarily mean they are less qualified or passionate about a career in dentistry, he says. Schools are now adopting a whole file review approach, one less focused on the numbers, Glassman says.
The whole file review, which takes into consideration a host of cognitive and non-cognitive variables, has already proven to be effective and is just one of other successful admissions strategies shared with NLI institutional participants, D’Abreu says.
Engaging Students in Community Health
Along with recruitment of minority students, another goal of the Dental Pipeline was to get students to spend more of their clinical time in community health settings, a mission that continues under the NLI program.
“(In the Dental Pipeline) we increased the number of days from three to four to up to 50 days for senior dental students as part of the education program,” Glassman says. “The hope is that in doing so, these students become more comfortable with community sites, they understand more about that kind of delivery mechanism, become more comfortable with diverse populations, and are better able to serve those populations in the future.”
Esther Lopez knows too well the importance of that exposure. Her father, a Cuban-born immigrant, abandoned the family of three children, including a brother and sister, following the death of her mother. But in the midst of her undergraduate work in biology at DePaul University—coursework Lopez had hoped would lead to medical school—her father returned, homeless and afflicted with health issues that eventually led to two strokes. He had no job and no insurance. Between studies, Lopez pleaded with pharmaceutical companies for free medicine, and again served as a translator with various health agencies and doctors.
“We were able to get some assistance,” Lopez says. “Things were going as well as they could have, considering the fact that we didn’t have health insurance. I really wanted to stay in school so I tried as best I could to find resources to help us along the way.”
By the time her father died in 2000, Lopez, exhausted, had given up on medical school, but she was more determined than ever to help resolve the challenges facing low-income and minority individuals seeking medical care. She completed her bachelor’s degree, and then enrolled in the master’s program in public health at the University of Illinois at Chicago (UIC). With her coursework finished, Lopez continues to work on her thesis.
While attending UIC, she joined a research project involving people with periodontal disease and diabetes.
“We were trying to determine what needs existed for people that had diabetes, and if they even knew there was a corollary between that and periodontal disease, specifically in the Latino community. I got engaged, really excited, and decided dentistry intrigued me,” Lopez says.
With the help of the Dental Pipeline, she enrolled in UIC’s College of Dentistry. “Dental school is really,
really expensive. The fact that we have programs like the Dental Pipeline for people like me is just amazing,” she says. Lopez received some tuition reimbursement from the program and worked as a research assistant in exchange for remaining tuition waivers.
While in dental school, she joined a group of fellow students in establishing the first student-run dental clinic in the United States.
Located on the north side of Chicago, the clinic still operates in Goldie’s Place, which serves as a place for homeless adults to get back on their feet. In 1997, a single dentist began providing services. In 2008, Lopez and others created the student component.
“Goldie’s Place helps dental students become part of the change, which is what I really wanted to do,” says Lopez, who served for a time as clinic director after graduating
from dental school.
As a student, she often spoke with colleagues about the challenges of health care in low-income communities. “A lot of times someone who comes from privilege has blinders to different barriers that exist. I think it’s more impactful when you’re hearing from a colleague about things that make it hard for you to succeed,” she says.
No matter a person’s race, ethnicity, or income level, dental needs will always be the same: a cavity is always a cavity, an extraction is an extraction, Lopez says. “But the way they perceive disease is always different,” she says, a concept that young dental students initially struggle with at Goldie’s Place. “It’s hard for them to understand, but it’s true. When you come from an underprivileged background, it’s not that you’re neglecting yourself; it’s just that it’s more important to feed your child. Or pay your rent.”
Communicating correct information in a way that is easy for clients to understand is imperative, Lopez says. “It’s important to service them understanding their cultural needs.”
Today, many of her classmates continue to work with grassroots organizations. One student has written a manual on how to establish a student-run dental clinic based on the Goldie’s Place model. “They’re addressing dental health issues not one person at a time, but communities at a time,” Lopez says. Other community-based health organizations in Chicago are beginning to incorporate the model for student clinicians, she says.
“I’m proud of the fact that … I was able to do something like participate in the Goldie’s Place dental clinic. There are so many great things going on there. Every time I hear of some success on their part it makes me happy. If it weren’t for the Dental Pipeline I wouldn’t have been able to do that. It’s meant a lot, not just for me, but for community members that really needed it.”
Lopez continues to volunteer at Goldie’s Place, and as part of a Chicago Community Oral Health Forum project to assess the dental health needs of adults and children. The Dental Pipeline gave Lopez the opportunity to both share her hard-won knowledge in the realm of public health and to establish a meaningful career addressing the issues, she says.
“I’m really excited that programs like this exist because they give students like me a chance to fulfill their dreams,” Lopez says. “It really does make me feel a sense of responsibility, because there was an organization that backed me, to really give back to the community in a significant way.”
Source: Insight Into Diversity
Is something similar to the Dental Pipeline National Learning Institute happening in your area to increase the number of minorities that go in to the Nursing profession as well as offer Nursing access to undeserved populations? Comment below!