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To illustrate, not only is the infant mortality rate among blacks 2.4 times higher than that for whites, but also the black-white ratio in infant mortality has risen from 1.6 in 1950 to 2.4 at present. Blacks have higher death rates than whites for nine of the 15 leading causes of mortality in the U.S.: heart disease, cancer, stroke, accidents, diabetes, flu, pneumonia, kidney disease, septicemia, and homicide. Similarly, Hispanics have higher rates of hypertension and obesity than non-Hispanic whites. The rate of acquired immunodeficiency syndrome (AIDS) is seven times higher in Hispanic women than their white counterparts and is 3.3. times greater in Hispanic men than white men (Department of Health and Human Services, 2000). In 1997, about one of every three Hispanic persons was without health insurance coverage. In the National Survey of America’s Families (Urban Institute, 1997), Hispanics were the most likely of all ethnic groups to report being in poor health. A key strategy proposed by experts to reduce health disparities is to increase the representation of minority groups in nursing and the health professions. There is evidence that underrepresented minority health professionals, as compared to their non-minority counterparts, have a greater tendency to return to their respective communities to practice, thus contributing to the improvement of health in those communities. This strategy will also be effective in delivering culturally competent care for the growing population of ethnically and culturally diverse groups in the U.S. and in Florida. The ethnic and cultural diversity of the Florida population has grown more sharply in the last decade, with the proportion of non-Hispanic people decreasing from 73 percent a decade ago to 65 percent currently. The 2000 Census figures reveal that Hispanics now compose 16.8 percent and blacks comprise 14.6 percent of the state population. And yet, among registered nurses in Florida, only 3 percent are Hispanic and 9.2 percent are black. In a survey conducted by the Florida Nurses Association Task Force on Cultural Diversity (Grossman, 1998), we found that of nursing students registered in Florida’s programs, only 5 percent were Hispanic and 11 percent black. In other health care fields in the state, the same trend can be found in the proportion of minorities: Divina Grossman, Ph.D., RN, is director of the School of Nursing at Florida International University. in medicine, 3.9 percent Hispanic and 5.5 percent black; in pharmacy, 3.4 percent Hispanic and 6.2 percent black; and in dentistry, 2.4 percent Hispanic and 1.5 percent black.
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A recent report by the Institute of Medicine of the National Academy of Sciences (2002) titled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare” points to the compelling need for a diverse workforce in nursing and health care. This document, a compilation of research prepared by a national panel of experts, presents extensive evidence that people from racial and ethnic minority groups receive a lower quality of health care than their nonminority counterparts, even after controlling for income and socioeconomic status.
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