A study conducted by the University of California, Los Angeles, has shown a serious underrepresentation of African Americans in the United States health sector, raising concerns about the pace of progress toward diversity and equity.
According to the study, the number of Black physicians in the United States has increased by only 4% over the past 120 years. By 2023, just 5.7% of all doctors in the country identified as Black or African American, far below the African American share of the US population, which is about 14%.
This situation was discussed by Dr. James Hildreth, President and CEO of Meharry Medical College in Tennessee, during the Social Determinants of Health Symposium organized by Modern Healthcare.
His institution, the oldest historically Black academic health science center in the United States, is one of only six Historically Black Colleges and Universities (HBCUs) operating medical schools.
Dr. Hildreth explained that while these schools have produced nearly half of all practicing Black doctors, the overall number of African American medical professionals remains low compared to other groups.
He noted that young African American students often lack mentors, financial support, and encouragement to pursue careers in medicine. His personal journey to becoming a doctor, he said, was different from that of most non-Black physicians but familiar to many other Black professionals.
A 2019 study from the University of Pennsylvania supported these findings, showing that while the number of Black and Hispanic doctors has risen slightly, the physician workforce still does not reflect America’s changing population.
Following the elimination of Affirmative Action, Dr. Hildreth said applications to Meharry Medical College and other Black medical schools have increased sharply. However, this has led to tougher competition.
While the national average acceptance rate for medical schools is around 6.3%, acceptance rates at Meharry Medical College, Morehouse College, and Howard University are significantly lower, 1.19%, 1.31%, and 1.09%, respectively.
Dr. Hildreth believes people from underrepresented communities are more likely to serve populations facing major health challenges. But he warned that the current competitive situation means many graduates may accept positions at higher-paying specialist institutions, reducing the number of Black doctors available to work in underserved areas.
In his presentation, Dr. Hildreth said diversity in the workforce has real benefits. According to him, when patients are treated by healthcare workers who share their cultural and racial backgrounds, it improves trust, communication, and health outcomes.
He explained that a diverse workforce can help reduce disparities in healthcare access and quality, and contribute to better care delivery.
His only direct quote during the event stated: “Do not underestimate the value of a diverse [medical] workforce… We must hire and deploy a workforce that is trained to implement a care plan for individuals and communities that address the social forces that impact and undermine their well-being.”
The problem of underrepresentation extends into clinical research. Michellene Davis, who leads the National Medical Fellowships, said there is a significant shortage of Black researchers and participants in clinical studies. T
his, she explained, creates uncertainty about how safe or effective certain treatments are for minority populations, who may be affected by different genetic, economic, or social factors.
Both Dr. Hildreth and Davis suggested that healthcare organizations should introduce job shadowing opportunities for students, to help them learn about careers in medicine. They also encouraged the creation of diversity-focused recruitment and retention programs, as well as formal training to help staff recognize and overcome biases.
Another barrier is financial. Many Black students face economic challenges that make it difficult to pursue medical training. After graduation, they often carry higher debt levels than their peers.
Dr. Hildreth stressed that schools must not only admit Black students, but also support them through graduation and help place them in jobs, especially in rural or underserved communities.
Meharry Medical College reports that about 75% of its graduates return to such communities to serve as doctors or dentists.
Howard University’s medical college has the highest number of Black faculty members in the country, which helps create role models for students.
A separate report from the OC Justice Initiative revealed that Black or African American surgeons make up just 1.8% of all surgeons in the United States.
Out of approximately 32,876 surgeons in the country, only about 592 are Black, reflecting another area where representation remains low.
Dr. Hildreth and other experts believe that improving representation in the health workforce must be seen as a priority for building stronger communities in the future.
By: Joshua Narh