Underrepresented in Healthcare

Defining who is considered an underrepresented minority (URM), the frequent obstacles they face, and how we can combat these issues in order to create more inclusive and diverse healthcare systems.

The demand for qualified healthcare professionals is high, but the supply of doctoral-level healthcare workers to fill these positions is at risk if underrepresented groups are not engaged in these fields. There are many barriers that underrepresented minorities (or URMs) face that prevent them from enrolling as pre-health students and even more barriers that affect graduation rates. As a result, the healthcare workforce is not representative of the American population. With this being said, progress must continue to be made to combat growing health disparities in our communities.

Who is Considered an Underrepresented Minority?

The term minority is defined as the group that is the smaller part of a larger whole. A racial/ethnic minority is a person whose race or ethnicity is the non-dominant race within the group. In the United States, racial/ethnic minorities are generally considered to include Hispanic/Latinos, Black/African Americans, Asians, Native Americans/Alaskans, Hawaiian/Pacific Islanders, and those of two or more races when one or more of the races is from the preceding list.

The definition of underrepresented minority (URM) is a little different. An underrepresented minority can be defined as an individual whose percentage of the population in a given group is lower than their percentage of the population in the country. For example, underrepresented in dentistry means those racial and ethnic populations that are underrepresented in the dental profession relative to their numbers in the general population. With that being said, underrepresented minorities in healthcare are generally considered to include: Hispanic/Latinos, Black/African Americans, Native Americans/Alaskans, Native Hawaiian/Pacific Islanders, and those of two or more races when one or more of the races is from the preceding list. International students generally fall into a separate category of their own. Note that this does not include Asians, who are overrepresented in healthcare in comparison to their percentage in the overall US population.

The Underrepresented Experience

The fact that underrepresented minorities face a significant amount of obstacles in comparison to their majority counterparts is undeniable. To put it bluntly, URM students face all the same challenges while pursuing healthcare professions as they do in other areas of life. Throughout America’s history, disadvantaged minorities have experienced metric underachievement due to racially charged bigotry and prejudice, affecting their levels of success and attainment. While it is impossible to list every obstacle here, there are three major topics I would like to touch on that hinder minority students from personal and professional success: discrimination, financial barriers, and lack of support.

Discrimination

As an underrepresented minority, discrimination is encountered frequently and has a significant direct and indirect impact on academic performance and social development. Racial and ethnic minority students are more likely to experience alienation, marginalization, and loneliness. Additionally, URMs often believe that their ethnic majority colleagues misunderstand affirmative action programs, scholarships, and admissions policies. As a result, URMs feel as though their colleagues show a lack of confidence in their abilities, causing tension and insecurities. School climate can also provide an atmosphere that does not promote diversity or allow students to report issues. Without an outlet to express growing concerns, students are continuously disadvantaged in terms of academic achievement levels and overall psychological adjustments.

Financial Barriers

If you have gone through the process of applying to dental, medical, or other graduate level health professional school, you know the admissions process alone is very expensive. It often deters some of the brightest students from applying. Financial concerns have been reported to pose additional challenges to URMs’ academic and professional pursuits. As a result of long-standing systematic racism, minorities face higher levels of poverty and low-income rates. With this being said, many URM health professional students provide monetary support to their own families while they are still students. This pressure to financially support their families heightens awareness of personal sacrifice during training. It can also interfere with time dedicated to class, studying, and school engagements. These students have expressed that the lack of financial support and reliance on student loans resulted in more difficulty for them in comparison to many of their majority student colleagues, who they felt received more finances from family resources. Often times, perceptions such as these undermine minority student satisfaction with academic and professional experiences.

Lack of Support

Interactions with insensitive colleagues and educators frequently signify a lack of support for URM students and their career pursuits. It is often expressed by students that their colleagues don’t share an interest in diversity/inclusion or show ignorance towards issues that frequently affect underserved minority populations. As a result, minority students have often had to band together to support their causes that would otherwise go overlooked by their counterparts.

In terms of institutions, some don’t have spaces created for the promotion of diversity and equity. This has often left minority students feeling as though undue attention is paid to underrepresented-focused gatherings. Students have even experienced situations where they have been ignored by faculty and demonstrated a lack of support in the classroom or clinical rounds. All in all, instances like this can make it very difficult for underrepresented students to remain encouraged on their healthcare journey.

How to Increase Diversity

The term “diversity” has become a commonly used word in the English language, with an increased focus on it in recent years. Diversity means to me what it probably means to the majority of people: It is the knowledge of different ethnic, racial, religious and spiritual, cultural, age, gender, sexual orientation, physical and mental abilities, and class backgrounds of people. It is also seeing how all these people can make an effort to actively collaborate as a community in any professional, educational, or living situation. Differences do not equate to deficiencies. Rather, these differences are what allow for shared growth and learning opportunities. In this day and age, it is not only desirable but imperative that greater efforts be made towards achieving diversity, especially in today’s rapidly changing environment.

It is no secret that the health professions lack diversity when it comes to African American/Black, Hispanic/Latino, and Native American students, and health professional schools understand the need to increase the enrollment of underrepresented minorities. However, to allow this to happen, certain steps must be set in place to ensure URM students are supported and welcome.

1. Acknowledgment, Acceptance, and Celebration of Multiculturalism

We must put an end to the “colorblind” narrative. This has been a consistent response to racism, as it is commonplace for those in the majority to say they see “people, not color”. However, while this is often said with good intentions, it only perpetuates the continued racism minorities face. Minorities want you to see their color, their culture, and their experiences. When you view everyone through a colorblind, white lens, you deny the reality that non-white people face. We must work to acknowledge, accept, and celebrate multiculturalism by diversifying faculty, staff, and the student body; by emphasizing the value of diversity within missions and curricula; and by valuing interdependence and intersectionality in the classroom and the community.

2. Responding to Threats to Inclusivity

While we said to be living in a “post-racial America”, students and institutions of higher education still deal with issues of harassment, bullying, and discrimination. However, it is how the colleges and universities respond to such actions that show minority students they are valued members of the college community. Colleges must create a system where they respond rapidly and firmly to behaviors that might demonstrate to underrepresented groups that they are not accepted, valued, or safe within their college community.

3. Remind Students They Are Not Alone

Minority students entering health professional school often find themselves having a harder time adjusting in comparison to their ethnic majority classmates. At many institutions, URMs find themselves being one out of five minority students in a class of 80. From here, students may find themselves being the only African American, Hispanic, or Native American student in the entire class. This creates a feeling of isolation. These students sometimes feel as though there is no one they can reach out to who empathizes with their position or who understands the challenges they currently and potentially face. Therefore, making sure systems are set in place so that minority students know they are not alone and have faculty and administrative support is key to creating a sense of belonging.

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Student Doctor Network offers an “Underrepresented in Healthcare” forum for discussion of topics unique to URM students and providers.