Figures from the 2000 census show that African Americans, American Indians, Asians and Latinos already account for more than half of California's population. Despite this rapidly changing demography, minorities are woefully underrepresented in the physician, oral health and nursing workforces. At the same time, ethnic minorities carry the brunt of health disparities and suffer from higher incidences of chronic conditions such as asthma, diabetes, heart disease, and HIV/AIDS than their White counterparts.

Research demonstrates that the supply and composition of the health work force are key ingredients in maintaining and improving the health status of individual patients from diverse communities. A study in the American Journal of Public Health demonstrated that minority physicians are "significantly more likely than other physicians to care for medically underserved populations." Another study published in the New England Journal of Medicine found that African-American and Latino health professionals were significantly more likely to care for patients with family incomes below the poverty level. Moreover, a diverse health workforce has been associated with improved cultural competency, patient trust and compliance to treatments. The California Endowment believes that a diverse health work force can also serve as a means to address the work force shortages currently facing the health professions in the state.

The Workforce Diversity Program aims to increase the diversity and improve the distribution of California's health work force by supporting approaches that expand the number of underrepresented minorities in the medical, oral health and nursing professions who practice in underserved areas.

The Endowment's Response

The California Endowment's Workforce Diversity Program launched the following programs to help ensure that the nursing, medical, and oral health professions reflect California's diverse communities:

• Central Valley Nursing Work Force Diversity Initiative: This $10 million pilot program is designed to address the attitudinal, financial, educational and systemic barriers that prevent regionally underrepresented minorities, including men and women from rural communities, from successfully entering the nursing profession. The program also intends to trigger regional infrastructure development and capacity to address nursing workforce diversity and shortage issues over the long term. Six strategies support the goals of the Initiative, including: 1) the development of a policy and advocacy voice to address nursing issues; 2) the provision of scholarships and fellowships; 3) a communications and marketing campaign to attract underrepresented minorities to the nursing profession; 4) capacity building for nursing education programs; 5) technical assistance in cultural competency for Initiative grantees; and 6) a cluster evaluation to measure the impact of the program's various efforts. While each strategy is administered by a different grantee, their combined efforts hold tremendous potential to transform the nursing field.

• Welcome Back Initiative: The purpose of this statewide Initiative is to build a bridge between the pool of internationally trained health workers living in California and the need for linguistically and culturally competent health services in underserved communities. To accomplish this goal, the Welcome Back Initiative provides program participants with counseling, education and support in obtaining the appropriate professional credentials and licenses required to work in the U.S. health care system. Their offices are located in the San Francisco and San Diego areas and have served almost 4,000 people from 110 different countries.

• The California Endowment Scholars in Health Policy at Harvard University: This one-year, full-time program is designed to create a network of health professional leaders who are capable of advancing the multicultural health interests of California's public, nonprofit and academic sectors. Three scholarships are awarded each year to top underrepresented minority physicians, dentists and mental health professionals who receive advanced training in leadership and cultural competence. The program leads to a Master's degree in Public Health or Public Administration from Harvard University.

• California Dental Pipeline Program: This 4 1/2 year $6.3 million Initiative was designed to address the oral health needs of California's underserved communities. Four dental schools in California (Loma Linda, University of the Pacific, UCLA and USC) received up to $1.3 million in funding to: 1) recruit and retain an increased number of underrepresented minority students; 2) reform the dental school curricula to integrate community-based practice experience and courses in cultural competence, public health and social and behavioral sciences; 3) change a portion of dental school clinical programs to patient-centered and community-based sources of care for disadvantaged populations; and 4) create a state and national policy agenda that will increase the number of underrepresented minorities in the dental work force. The California Dental Pipeline Program is a partnership with The Robert Wood Johnson Foundation's $19 million initiative entitled, Pipeline Profession and Practice: Community-Based Dental Education. A collateral grant of $1 million from the W.K. Kellogg Foundation will award each school, including UCSF, an additional $100,000 for financial aid to underrepresented minority and low-income students.

Read our workforce diversity reports and publications