Diversifying the Health Care Workforce

Challenge

There is a shortage and maldistribution of clinical workforce. Over 90 percent of counties in the Carolinas have at least one partial designation as a Health Professional Shortage Area (HPSA). Additionally, the stress and demands of the profession, exacerbated by the COVID-19 pandemic, are contributing to the losses. A recent national survey revealed that one in five frontline workers left the field citing burnout as a contributing factor.

The current workforce does not adequately represent the diversity of the population served. In many of the higher income professions, the percentage of Black clinicians is half their representation in the general U.S. population. The representation of Hispanic clinicians is one third, and the lack of diversity in health professions training programs perpetuates the problem. The diversity of the health workforce carries implications for access, quality, health equity, and job opportunities in low-income communities.

There are dramatic health inequities associated with unmet social needs and an increasing recognition that an individual’s ZIP code can affect infant mortality and life expectancy. Our historical focus on developing clinical care capacity fails to recognize that a person’s behavior and social determinants of health significantly impact overall health. Our current workforce needs clinicians who can understand an individual’s social needs and connect them to resources.

Our Objective

We seek to ensure an adequate diverse workforce that can address critical shortage areas, maldistribution of staff and support new complementary personnel models. 

We also strive to increase the racial/​ethnic diversity in the healthcare workforce. Increasing staffing among underrepresented groups will support diversity of values, reflect the beliefs of the entire population and heighten cultural awareness in healthcare service delivery. Strengthening the nation’s workforce by improving cultural competency and increasing diversity is identified as important in the U.S. Department of Health and Human Services’ Disparities Action Plan. Education, training, and development of the workforce — including both professionals and lay community health workers — are essential in meeting the health and service needs of communities of color. 

We seek to advance new workforce models that address the social drivers of health. This workforce should be diverse and culturally competent, supporting vulnerable populations with interpretation and translation services, culturally appropriate education, health and social services coordination, and advocacy for individual and community health needs. Evidence demonstrates the clinical and economic return on investment when such new workforce models are part of the health delivery system.

What We Fund

Health Care supports efforts to increase the diversity of students entering academic institutions. Current efforts include diversifying the pipeline of students entering the medical profession, as well as programs and system changes that increase access and wrap clinical and social support around minority and rural students. This may include increasing clinical time and exposure, developing residencies in federally qualified clinics and rural hospitals, access to rural rotations, creating pipeline programs within community colleges, and mentoring by minority professionals. 

Health Care seeks to address workforce shortages among critical licensed medical professionals. We are interested in reducing burnout and enhancing resiliency, particularly in light of the toll COVID has taken on frontline professionals. Health Care seeks to advance models that use the workforce in innovative ways to address maldistribution, such as leveraging family medicine physicians for labor and delivery. 

We assist health systems in employing and integrating alternative personnel to move upstream into communities and address the social drivers of health. Individuals with lived experience are often trusted and have a particularly strong understanding of the community served. New types of staff, such as Community Health Workers, serve as a liaison between health and social services and the community to facilitate access to services and improve service delivery and cultural competence. The Endowment supports health systems in integrating community health workers onto the clinical team, as well as other types of community-based workforce addressing social needs, such as community paramedics and doulas, with an emphasis on individuals with lived experiences.