Affirmative action bans reduce diversity in physician workforce, impact health equity

Abstract: https://www.acpjournals.org/doi/10.7326/M21-4312

URL goes live when the embargo lifts

A study of U.S. medical school enrollment data found that state bans of affirmative action policies significantly impact the percentage of underrepresented minority students enrolled in medical schools, which has important implications for the diversity of the physician workforce. The authors suggest that efforts to improve medical equity for patients should consider medical school admission policies an important target. The findings are published in Annals of Internal Medicine.

Increased diversity in the U.S. physician workforce can improve the health of patients from historically underserved communities. However, the percentage of practicing physicians who identify as being from these groups is low relative to their proportion in the U.S. population. Contributing factors may include state-level bans on the use of affirmative action policies. Few studies have evaluated the impact of these bans on public medical schools, and none have examined their longer-term effects and take into account more recent bans.

Researchers from the University of California, Los Angeles, the University of Pittsburgh, Columbia University, and Harvard University used publicly available data on state affirmative action bans to examine the association between such bans and the percentage of enrollment from underrepresented racial and ethnic groups at 21 public medical schools between 1985 and 2019. The schools were compared to public medical schools in states without affirmative action bans. The authors tracked the reported proportions of four mutually exclusive racial and ethnic groups that are underrepresented in medicine: Black, Hispanic, American Indian or Alaska Native, and Native Hawaiian or other Pacific Islander. They found that affirmative action bans were associated with a 5.5 percentage point decrease in enrollment of underrepresented students relative to control schools. Because underrepresented students accounted for approximately 14.8 percent of medical students in ban schools in the year before ban implementation, the 5.5 percentage point reduction implies an approximately 37% relative reduction in underrepresented students. According to the authors, these findings are important for understanding the overall lag in diverse representation of the medical student body and physician workforce. They also suggest that despite national efforts to improve enrollment diversity, state-level policy related to admissions is a critical factor.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with the lead author, Dan P. Ly, MD, PhD, MPP, please email Enrique Rivero at ERivero@mednet.ucla.edu. To speak with the author from the University of Pittsburgh, Utibe R. Essien, MD, MPH, please contact Sarah Katz at katzsb@upmc.edu.

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