A Need for Diversity in the Oral Health Workforce

 

MitchellThe racial and ethnic composition of the health professions workforce, including the dental workforce, fails miserably to reflect the increasing diversity of the U.S. population. Census data from 2010 indicate that African Americans, Hispanics, and American Indians respectively constitute 12.6, 16.3, and 0.9 percent of the U.S. population, totaling approximately 30 percent of the overall population. However, they represent only 5 percent of dentists and 9 percent of dental school faculty members. A look at the racial and ethnic composition of the nation’s dental schools indicates that this disparity will continue to persist in the near future.

In fall 2013, African American, Hispanic, and American Indian dental students constituted 4.6, 8.1, and 0.2 percent of all students, respectively. Together, they made up 13.3 percent of all first-year pre-doctoral dental school classes nationally.

The discrepancy between racial and ethnic minorities’ representation in the general population and their representation in the oral health workforce is a challenging issue in its own right. In addition, it contributes to the documented substandard healthcare received by impoverished populations and racial and
ethnic minorities.

Conservative estimates indicate that more than 25 million individuals reside in areas with a shortage of health professionals and have limited access to quality healthcare. Members of racial and ethnic minority groups represent a disproportionate number of these 25 million individuals and therefore are unduly affected by the emotional, financial, and physical consequences of poor oral health.

A report published by the Institute of Medicine titled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” illustrates that patients of color — who bear the brunt of poor oral health — receive a lower quality of care and are less likely to receive routine care than their white counterparts. One factor contributing to the quality of care received by these patients is the patient-provider relationship.

Because of fewer underrepresented minorities in the workforce and inadequate training of health professionals on cross-cultural issues, patients who receive the poorest care are the least likely to find a provider who is willing and able to effectively address their needs.

Although research shows that health professionals who identify as a racial or ethnic minority are more likely to serve in areas of need, diversification is not solely a minority concern or responsibility. Increasing diversity in the classroom and the workforce will have a positive impact on the nation’s health as a whole and is thus a national imperative. While underrepresented minority faculty members and healthcare providers are obvious candidates to spearhead this mission, current disparities will not be properly addressed without the commitment of all professionals.

Over the past 40 years, steps have been made toward addressing diversity in health professions. Recommendations for further action at the policy, institutional, and provider levels include financial restructuring of healthcare systems, changes to admissions procedures for medical and dental schools, and continuing education on cross-cultural issues for current healthcare providers. With these recommendations in hand, we as oral health professionals need to work in concert with policymakers and other health professionals to increase minority representation in the healthcare workforce and reduce disparities in the quality of oral healthcare received by patients from racial and ethnic minorities, as well as economically disadvantaged patients.

As we look to the future — which will likely be marked by the lack of a distinct racial and ethnic minority group — we must all commit, individually and collectively, to diversifying the health professions in general and the oral healthcare workforce in particular.●

Dennis A. Mitchell, DDS, MPH, is senior associate provost for faculty diversity and inclusion at Columbia University and senior associate dean for student development at the university’s College of Dental Medicine (CDM). He also chairs the Provost’s Advisory Council for the Enhancement of Faculty Diversity. He leads the university’s efforts in attracting and retaining diverse faculty and is in charge of diversity programs targeted at underrepresented minority student enrollment and development.