One aspect of the Affordable Care Act that has flown under the radar is its potential to increase employment in the health care sector for everyone, including people of color. Currently, health care employees comprise 12 percent of the labor force, making this sector the largest employer in the economy. The Affordable Care Act will only increase this share, not just because the newly insured will boost the demand for health care, but also because many who already have insurance will likely seek more preventive care than they did before.
As a result of the Affordable Care Act and demographic trends, employment in nearly all health care jobs is expected to grow drastically between now and 2020. Ensuring that people of color are able to take part in this job growth is vital both for the families and communities that benefit from this economic opportunity directly, and for the patients of color who will benefit from having more culturally competent providers.
Health care is one of the fastest growing and most recession-proof fields in the US economy. The two most numerous types of health care employees—registered nurses and home health aides—are expected to see their ranks swell 26 and 70 percent, respectively, by the end of the decade.
This is great for the economy as a whole, and given that one fourth of registered nurses and one half of home health aides are people of color, it is encouraging for minority communities as well. However, many of these employees, particularly home health aides, often receive low pay.
Therefore, it is vital that communities of color benefit from the growth in other types of health care employment as well. Physicians and pharmacists, for example, will also see increased demand for their services, and currently people of color are disproportionately less likely to hold these positions than whites. It is crucial that people of color receive a chance to attain these more technical, higher-paying positions that require post-secondary education (college and/or training programs).
In their paper “Affordable Care Act of 2010: Creating Job Opportunities for Racially and Ethnically Diverse Populations,” Drs. Bianca Frogner and Joanne Spetz note several ways to meet this goal. First, both high schools and colleges (especially community colleges) should educate students about employment in the health care industry and provide classes to prepare them for relevant post-secondary education. Some school systems, such as Boston Public Schools, have already established these types of programs, calling them “Health Care Career Academies.” Additionally, health care employers may wish to establish on-the-job training programs, which would increase the skill level of their workers and qualify them for higher level positions.
Finally, health care employers or federal, state, and local agencies could provide tuition support to those who are training for or looking to advance their careers in health care. Employers, educators, and agencies should also work to address non-financial barriers to post-secondary education, such as difficulty accessing transportation or childcare.
The second reason to encourage diversity in the health care workforce is to build cultural competence, which is defined as the ability of systems to provide care to patients with diverse beliefs, behaviors, and values.
There are many aspects to cultural competence. At its most basic, it includes ensuring that medical professionals speak the same language as their patients, or at least that interpreters are available in situations where this is not possible. However, culturally competent care also addresses more subtle aspects of patient care. Studies have shown, for example, that African Americans are more likely to feel that they have a say in their visits when their physician is also African-American, which leads to increased patient satisfaction. Patient satisfaction, in turn, is linked to better health outcomes for certain conditions. Therefore, cultural competence can be an important ingredient in reducing health disparities. A more diverse health care workforce is likely to be a more culturally competent one that will be better equipped to care for our increasingly diverse nation.
The Department of Health and Human Services has recently moved to address these issues, awarding $22.1 million in grants to offer low-interest student loans to students training to become nurse faculty. It also has awarded $5.2 million to improve nursing diversity, by expanding educational opportunities to those who come from disadvantaged backgrounds, including racial and ethnic minorities. This is a crucial acknowledgment of what is at stake, and hopefully, one of many forthcoming steps to encourage a diverse health care workforce.