Ensuring diversity and inclusion in health care
As an African-American kid growing up without a father figure in subsidized housing in Pittsburg, Calif., Darin Latimore faced many hurdles in pursuing a career in medicine. But with the assistance of mentors and outreach programs designed to help students from disadvantaged backgrounds, Latimore became a physician.
Today, in his role of overseeing student diversity at the UC Davis School of Medicine, Latimore wants to boost the number of students from disadvantaged backgrounds, like himself, as well as help develop a health-care workforce that reflects California's diverse populations.
The mission emerges from a long-held institutional philosophy that excellence is possible only if a truly diverse workforce is in place.
UC Davis has emerged as a leader in diversity and inclusion. Its Principles of Community, created 20 years ago, have since been adopted throughout the UC system. The UC Davis campus community celebrated the 20th anniversary of the principles' creation by publicly reaffirming the university's commitment to "promoting freedom of expression, confronting acts of discrimination, appreciating our differences, and building a more inclusive campus community based on civility and respect."
This past summer, the health system received multiple "Best In Class" honors from the Institute for Diversity in Health Management for expanding diversity in the governance body and leadership team; strengthening diversity in the workforce; and delivering culturally and linguistically competent care.
"We must have a focused and deliberate strategy on diversity and excellence – not because it is the right thing to do or because we have a social responsibility, but because diversity is one of the most significant drivers of success in a competitive and challenging health-care environment."
— Shelton Duruisseau
In September, UC Davis Vice Chancellor for Human Health Sciences Claire Pomeroy appointed Shelton Duruisseau to the new position of associate vice chancellor, diversity and inclusion and chief external affairs officer at UC Davis Health System.
Within the new Office of Diversity and Community Engagement, and with the collaboration of designated faculty members such as Latimore and Sergio Aguilar-Gaxiola, director of the UC Davis Center for Reducing Health Disparities, Duruisseau is evaluating and integrating the health system's community engagement and cross-cultural programs.
"We haven't had an optimal way of measuring the effectiveness of our activities," Duruisseau says. "We need to ensure that our activities strengthen and support our mission of advancing health for all."
Aguilar-Gaxiola, an expert in health disparities, agrees.
"Our university has a strong stock in the health of our community. As a public institution, we have a responsibility to examine how our community benefits from an academic center like ours."
Duruisseau and his team are constructing the "framework" that will guide UC Davis Health System into the future in support of three primary goals: to promote and increase diversity among faculty, staff, residents, fellows and students in the School of Medicine and the Betty Irene Moore School of Nursing; to put into place the tools, mechanisms and strategies required to reduce health disparities; and to build on the diverse and inclusive culture already thriving at UC Davis.
"We must have a focused and deliberate strategy on diversity and excellence – not because it is the right thing to do or because we have a social responsibility," Duruisseau says, "but because diversity is one of the most significant drivers of success in a competitive and challenging health-care environment."
Literature suggests that when health-care recipients are treated by professionals whose cultural backgrounds reflect their own, the resulting interactions lead to better understanding and improved outcomes.
However, studies have long indicated that California's health-care workforce does not reflect the state's diversity. Latinos, for example, make up more than 37 percent of California's population, but account for just 5 percent of the state's physicians and registered nurses. Latinos also suffer disproportionately from asthma, HIV/AIDS and diabetes.
African-Americans, who are disproportionately affected by cancer, HIV/AIDS, diabetes, heart disease and stroke, are also underrepresented among California's health-care professionals.
"To deliver person- and family-centered care, future health-care professionals will require an unprecedented level of competency, understanding and sensitivity to the diverse populations they serve," says Heather Young, associate vice chancellor for nursing and founding dean of the Betty Irene Moore School of Nursing.
Young works closely with Latimore and with Mark Henderson, associate dean for admissions and outreach at the School of Medicine, to ensure diversity in their respective student bodies.
"Our guiding principle is to produce a workforce similar to the patient population that we serve," Henderson says.
Efforts are proving fruitful. The diversity of the medical school's admissions committees has been bolstered to more widely encompass gender, cultural and professional backgrounds and experiences. The current committee makeup is approximately 40 percent women and 20 percent from groups underrepresented in health care, both significant increases from previous years.
Focus also has been placed on the student experience after a student is admitted.
In the School of Medicine's class of 2014, the percentage of African-American students more than doubled over the past few years, to 11 percent – one of the highest percentages of all UC medical schools, Henderson adds.
The School of Nursing's curriculum is designed to prepare graduates to deliver culturally appropriate care, says Young. "Solid grounding in cultural studies, for example, will enhance nurses' abilities in working effectively with an increasingly diverse population."
Search committees are also being more keenly appraised. For example, including more women and underrepresented minorities on faculty search committees enhances the likelihood of recognizing the quality of female and underrepresented minority applicants, says Edward Callahan, associate dean for academic personnel. Faculty members also are actively soliciting colleagues around the country for recommendations of minority candidates who are ready for upper-level positions.
The recent inclusion of race, ethnicity and preferred language into the electronic health records (EHR) system will allow the health system to more effectively respond to its patient populations.
The next step will be to include information about sexual orientation and gender identity in the EHR. To begin to address the needs of lesbian, gay, bisexual and transgender (LGBT) populations, who experience significant health-care disparities, a task force is developing and launching educational experiences in LGBT health for all health-care professionals.
"We're exploring how sensitive information can be put into EHR in ways that respect the preferences of the individual, and are of value to the clinicians in providing care," Callahan says.
When people are better able to – and more comfortable with – accessing health services, UC Davis Health System goes far in accomplishing its mission to advance health for all, Duruisseau says.
"We are committed to providing the highest quality of care to everyone who comes to us, and by combining a diverse workforce with culturally competent care, we will continue to ensure a culture of excellence."