Eliminating Racial and Ethnic Disparities in Health Care

Abstract

s of 1998, racial and ethnic minority groups made up 28% of the U.S. population. Current projections say that number will rise to 40% by 2030.' This growing diversity has strong implications for the provision of health care. Segregation, disparate treatment, and racism continue to contribute to the epidemiologic gap between minorities and whites. significant underrepresentation of minorities in the health professions and in the health care industry is one reason behind the disparity in the health status of whites and minority groups-blacks, Hispanics, Asian Americans, American Indians, Alaskan natives, and Pacific Islanders. nursing profession provides a prime example of this underrepresentation. 1996 National Sample Survey of Registered Nurses shows that approximately 246,363 RNs (an estimated 10% of the nursing workforce) came from minority backgrounds.' Nursing lacks the diversity needed to effectively provide services to a populace of increasing ethnic variety. According to Karen Scott Collins, assistant vice president at the Commonwealth Fund, a group that has done much research in this area, The United States as a nation has recognized and attempted to at least address racial, ethnic, and gender disparities in education, employment, and housing but has paid little attention to disparities in health care. No simple solutions will eliminate them. Issues such as routine access to preventive care, cultural competence in providing health care, and proportional representation of minorities in the health professions must also be addressed to eliminate inequities. Small steps are being taken to eliminate disparities in health status. In 1998 President Clinton announced a new plan, the Racial and Ethnic Health Disparities Initiative, which set a national goal of eliminating longstanding disparities in the health status of minorities by the year 2010. This is a first for the federal government. Nursing can support this effort by establishing affirmative action policies and initiatives to increase diversity in the profession and by incorporating cultural competence skills into the nursing curricula.