Disparities in health care are well documented and are most often experienced by Black, Latinx, and Indigenous communities, leading to less preventative health care and poorer health outcomes. The most recent example is COVID-19, which disproportionately affected these communities, resulting in higher morbidity and mortality rates. In addition, higher education institutions struggle to recruit and retain health care students from underrepresented racial and ethnic communities.
The problem is not likely to improve anytime soon, given the widespread health care provider shortages many communities face. Nurses, respiratory therapists, nurse practitioners, physician assistants, primary care physicians, physical therapists, occupational therapists, speech-language pathologists, pharmacists and mental health workers are all in short supply. In addition, the shortage of lower-wage health care workers such as home health aides, licensed practical nurses, medical assistants and operating room technicians contributes to the many unmet health care needs.
Health education is in dire need of changes if this situation is to be effectively addressed. Professional nursing is perhaps one of the most widely publicized and most talked-about industries affected by the COVID-19 pandemic. And many of the problems faced by these “health care heroes” that were illuminated during this time existed before the pandemic.
As a field, nursing, like other health professions, is at a crossroads. Nurses have been stretched far too thin well before the pandemic. The pandemic served to worsen the workforce landscape dramatically. Attrition through planned retirements was worsened as many nurses decided to retire early. Younger nurses left nursing altogether due to stress and burnout.
It also cannot be ignored that the U.S. is experiencing an ever-growing aging population, and according to the CDC, over half of Americans over 65 have two or more chronic health conditions. The end result is a need for more health care services. The current workforce is inadequate to address the need for additional health care services, including primary and secondary prevention, mental health services, diagnostic testing, surgical services, chronic care management and high acuity hospital-delivered care.
If higher education is to meet the health care needs of our communities, reduce health care disparities, and improve health outcomes for all Americans, nursing and the other health professions need to recruit and graduate students that mirror the patient population and reflect the diversity of our communities.
Nurses from diverse backgrounds are needed in the field to alleviate not only gaps in patient outcomes but also a large inequality among healthcare provider diversity. In 2021, the Bureau of Labor and Statistics reported that just 13.3% of all nurses in the United States were Black. Those of Asian and Hispanic backgrounds were also poorly represented, being just 8.6% and 8.8% of the nursing workforce, respectively.
While alarming, this presents an opportunity that benefits all. Studies have shown when a health care provider and patient are of the same race, patients are far more involved in their treatment, engaged in shared decision-making, have more extended office visits, and rate their providers as more participatory.
The obvious route forward is to actively recruit more students into the nursing field and all healthcare careers. While high school students should largely be the aim, we mustn’t exclude those who have already completed a degree program but who now seek a career change.
To that end, Carlow University offers both a four-year B.S. nursing degree and a second-degree Bachelor of Science in Nursing (BSN) degree program that’s accelerated. These students can complete the program in just 15 months. It’s a value-based education that deliberately addresses the inequities present in today’s health care landscape. Carlow, rooted in the “mercy mission,” is historically grounded in social justice and committed to admitting and graduating diverse students as part of its Catholic heritage.
“We embrace the viewpoints of cultures and promote cultural humility through classroom and clinical experiences,” said Ashley Cole, DPN, second-degree nursing program coordinator. “Acknowledging the importance of increasing the diversity of the nursing workforce and decreasing health disparities, we see that there are opportunities to recruit individuals from BIPOC communities to work towards the betterment of individuals, families, and our community.”
A greater emphasis must be placed on showing students that nursing and health care degree programs are excellent career options at a high school level, leading to well-paying and meaningful careers.
“We actively strive to start a student’s journey to higher education and a professional career while they’re still in high school,” said Mollie Cecere, MBA, vice president of enrollment management and corporate partnerships at Carlow. “Students can even earn college credits in high school, giving them a head start on their professional journey. A lot of this work is aimed at minority-serving high schools to help students see a more tangible career path.”
But higher education institutions can only do so much — financial barriers still loom large in the minds of young adults. Foundational support is vital to help recruit and retain students from minority backgrounds. A committed, good-faith effort must be made to help these students view nursing as a tangible path forward.
Our region’s business leaders, higher education institutions, and the communities that makeup Pittsburgh must step up and help to lead this charge. It seems like a hard sell today. But the more diversity there is in the health professions, the more that teens and young adults of the same background will be able to visualize a career in health care. Better health outcomes for patients from diverse communities, a more robust nursing and healthcare workforce, and less burnout are beneficial outcomes.