The Effects of Affirmative Action on Healthcare Diversity

On June 29th, 2023, the Supreme Court rejected affirmative action in U.S. colleges, marking the end of granting special consideration to minority students and women in college admissions¹. This rejection also banned race-based consideration in medical school admissions. In the long run, this will significantly impact the diversity in the healthcare field. This article will discuss the effects of affirmative action in medical schools, healthcare providers, and the consequences for minorities.

What is Affirmative Action?

On September 24th, 1965, President Lyndon B. Johnson signed Executive Order 11246, which prohibited discrimination in employment based on color, religion, race, or national origin². Soon after, the Office of Federal Contract Compliance Programs (OFCCP), which works under the Department of Labor, wrote an affirmative action plan establishing equal employment opportunities for minorities and women³. This order also applied to colleges and medical schools, allowing thousands of students from minority communities to be able to go to top schools and have the opportunity to become healthcare providers⁴.

However, on June 29th, 2023, the Supreme Court overturned this action stating that race can no longer be a basis for granting admissions⁵. Chief Justice John G. Roberts Jr. wrote that it violated the Equal Protection Clause, failing to show measurable reasons to justify the use of race⁶.

What Does This Mean for Medical Schools?

This ruling can have serious consequences. The Association of American Medical Colleges (AAMC), representing over 500 hospitals and medical schools, argued that diversity can “literally save lives”⁷. They added that having a diverse education can help healthcare providers care for a variety of patients from any background⁷. A study conducted in April of 2023 found that a 10 percent increase of Black primary doctors in a county can increase Black life expectancy by 30 days⁸.

Norma Poll-Hunter, the senior director of workforce at the AAMC, explained that a lack of diversity can reduce student, trainee, and physician confidence in treating patients from a different background than their own⁹.   

An analysis of six of the nine states that have already banned affirmative action found a 17% decrease in diversity after the ban was implemented⁷. This could mean that there will be an overall significant decrease in healthcare providers of color practicing medicine.

What Does This Mean for Patients?

Past events such as illegal testing of blood donated for diabetes research from the Havasupai Tribe, the Tuskegee Experiment– where Black men were injected with syphilis without consent— and forced sterilizations of Puerto Rican women all have facilitated minority patients’ mistrust of doctors of different ethnicities than their own¹⁰. As a result, patients from minority communities are more likely to trust and feel more comfortable and safe expressing their concerns and issues with healthcare providers of the same race or ethnicity⁷.

Furthermore, the ban on affirmative action will only increase the health inequity gap between white and minority communities. A more diverse group of healthcare providers can produce better health outcomes for groups that have been historically marginalized¹¹. Interestingly, a study done in Florida between 1992-2015 found that Black babies were twice as likely to die when cared for by a White physician compared to a Black physician⁹.

Currently, Black patients’ pains and conditions are under-treated in comparison to White patients¹². Healthcare workers are more likely to refer to Black patients as people who just want a “fix”¹³. Consequently, Black patients are neglected the proper care and treatment, only making their conditions worse. Not only are they neglected care, but individuals from minority races are less likely to visit the doctor, even when they have the services to go to¹⁴.  A less racially diverse healthcare system will only reduce the protection against these biases and hurt minority patients¹⁵.

Although diversity was increasing within the healthcare system before affirmative action¹⁶, current efforts to ensure that diversity keeps increasing are needed. The decrease in the diverse backgrounds of healthcare providers will not only increase the mortality rates of minority communities but will also push back the fight for racial equity and equality¹⁷. As America continues to become a more diverse country, individuals from minority communities must be granted the opportunities they deserve so that the voices of those who have been suppressed are heard and treated.