Study finds nursing isn't diverse enough

A new study published in the journal Health Affairs (vol. 20, no. 3) warns that the nursing profession seriously lags when it comes to reflecting some racial and ethnic populations. A University of California review of registered nursing trends shows that gaps in educational attainment account for much of the nursing profession's lack of diversity, gaps that need to be addressed. The authors examined nursing and general educational attainment in California and reviewed 1996 demographic data from the National Sample Survey of Registered Nurses, evaluated the educational level attained by Californians according to racial and ethnic group, and examined degrees awarded to college students in the state.

"We have a pool of nurses that doesn't reflect the nation's population," said study co-author Janet Coffman, associate director of the Center for California Health Workforce Studies at UC San Francisco. "Nursing has historically drawn primarily on white women to fill its ranks. The field has to attract people from a wider range of backgrounds to alleviate the shortage and serve the public effectively," she says.

The authors found that both blacks and Latinos are underrepresented among registered nurses relative to the entire and working-age populations in California. Blacks account for 4% of RNs, compared with 7% of working-age adults. According to the study, the gap is most pronounced for Latinos, who account for 28% of working-age adults in California but only 5% of RNs. Although Latinos are better-represented among recent nursing school graduates, they remain the most underrepresented group in nursing.

Nursing education

Among women, Latinas have the lowest rates of high school graduation and college entry of any racial/ethnic group in California, and one of the lowest rates of college graduation. Of women receiving college degrees in California, 5.8% of black women and 3.4% of Latinas received a degree of nursing. White female college graduates were 56% more likely than Latina graduates to receive nursing degrees. In addition, Latina graduates were less likely than non-Latina white graduates to receive degrees in other health fields or science fields. In general, Latino college students are entering nursing at a lower rate than non-Latino whites and blacks, a trend that is contributing to the lower proportion of Latinos in nursing.

The authors conclude that improving the representation of blacks and Latinos in nursing will demand comprehensive and coordinated policies to improve their overall educational attainment.

"If we can get more minorities into college, then that should result in a higher number being educated as nurses," said Coffman. "The study makes clear that we not only need to get nurses into the field, but nurses that represent the patients they serve." PR