Index

A

Academic advising

inequities in, 243-244, 264

and recruitment of URM students, 161

Academic performance

discrimination and, 66, 164

educational inequities and, 7, 67-68, 160, 242, 246

financial aid and, 93, 295

group differences on standardized tests, 7, 66-70

institutional climate and, 68-70, 147, 161, 170

predictive power of, 381

socioeconomic factors and, 66, 67-68

stereotype threat and, 68-70

support services and programming and, 14, 156, 164-165, 170, 174

Access to care

coalition building for, 209-210

communication problems, 26

community benefit standard and, 179-180, 184-185, 187, 188-189

diversity of health professionals and, 5, 26, 29-31, 234, 260, 305, 380

financial assistance for education, 113, 286, 297, 305, 307

innovative admissions programs and, 259-260

institutional partnerships and, 14, 15, 163, 170-171, 173-174

for low-income and Medicaid populations, 30, 32, 233, 305

for minority patients, 26, 28, 29-31, 49, 233, 234-235, 305

Accreditation.

See also individual accrediting bodies

and admissions policies and practices, 75-76, 129-130, 133-134, 204, 248, 326-328, 333, 338-339

community benefit standard and, 17, 197, 198, 199, 200, 208, 209

composition of standard-setting bodies, 12, 135, 140, 141, 321, 322-323

cooperation of other organizations in, 141, 330, 332, 339-340

coordination responsibilities, 127, 128

core competencies, 127, 129, 328-329, 332, 335-336, 337

cultural competencies, 11-12, 134, 140-141, 166, 206-207, 329-337, 375-376

defined, 11, 317-318, 321

dentistry, 131-133, 140, 252, 333, 335, 338

and faculty recruitment and retention, 334, 339



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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce Index A Academic advising inequities in, 243-244, 264 and recruitment of URM students, 161 Academic performance discrimination and, 66, 164 educational inequities and, 7, 67-68, 160, 242, 246 financial aid and, 93, 295 group differences on standardized tests, 7, 66-70 institutional climate and, 68-70, 147, 161, 170 predictive power of, 381 socioeconomic factors and, 66, 67-68 stereotype threat and, 68-70 support services and programming and, 14, 156, 164-165, 170, 174 Access to care coalition building for, 209-210 communication problems, 26 community benefit standard and, 179-180, 184-185, 187, 188-189 diversity of health professionals and, 5, 26, 29-31, 234, 260, 305, 380 financial assistance for education, 113, 286, 297, 305, 307 innovative admissions programs and, 259-260 institutional partnerships and, 14, 15, 163, 170-171, 173-174 for low-income and Medicaid populations, 30, 32, 233, 305 for minority patients, 26, 28, 29-31, 49, 233, 234-235, 305 Accreditation. See also individual accrediting bodies and admissions policies and practices, 75-76, 129-130, 133-134, 204, 248, 326-328, 333, 338-339 community benefit standard and, 17, 197, 198, 199, 200, 208, 209 composition of standard-setting bodies, 12, 135, 140, 141, 321, 322-323 cooperation of other organizations in, 141, 330, 332, 339-340 coordination responsibilities, 127, 128 core competencies, 127, 129, 328-329, 332, 335-336, 337 cultural competencies, 11-12, 134, 140-141, 166, 206-207, 329-337, 375-376 defined, 11, 317-318, 321 dentistry, 131-133, 140, 252, 333, 335, 338 and faculty recruitment and retention, 334, 339

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce and financial aid, 319, 340 goals of, 11, 127-128, 130, 131-132, 317-319, 335 institutional, 319 and institutional climate, 330-331, 370 and licensing, 332 medical education, see Liaison Committee on Medical Education monitoring and evaluation of outcomes, 12, 139-141, 319, 326, 332, 336-338, 339 nursing, 128-131, 334-336 and pedagogy, 368 peer review teams, 140 potential to enhance diversity, 127, 132-133, 138-141, 336-339 process, 139-140, 320, 322-323 professionalism and humanistic considerations, 75-76 program, 319 psychology, 11-12, 135-138, 139-140, 333-334, 335 race-conscious policies, 88 recommendations, 12-13, 19, 139, 140-141, 324, 330, 331-332, 336-339 and recruitment and retention of URMs, 12, 132-133, 137-138, 140, 141, 328, 338, 339 roles of accrediting bodies, 11, 138-141, 319, 320-323, 336 sanctions and reinforcement, 13, 140, 141, 332, 340 and social accountability, 11, 323-332, 338, 340 standardized tests and, 258 standard-setting process, 321, 322-323, 330 standards related to diversity, 11-12, 128-138, 236, 332-336 U.S. Department of Education role, 2, 11, 12-13, 127, 128, 129, 130, 131, 133, 138-141, 319-320, 322, 344 Accreditation Council for Graduate Medical Education (ACGME), 75, 134-135, 329 Admissions committees AAMC Expanded Minority Admissions Exercise, 79-80, 261 composition of, 8-9, 77-78, 82, 248-249, 255, 261 demographic characteristics, 77-78, 85 incentives for participation, 78, 85, 204 recommendations, 8-9, 19, 261 training, 8, 78-79, 82, 204, 248-249, 255, 257, 261 Admissions policies and practices “academic difficulty” considerations, 246 and access to care, 259-260 accreditation standards and, 75-76, 129-130, 133-134, 248, 326-328, 333 affirmative action litigation, 3, 4, 24, 25 n.3, 27, 29, 50, 71, 72-73, 76-77, 79, 81, 145, 239, 240-241, 258, 326-328, 345 applicant pool size and, 242-243 cultural competency considerations, 380 dentistry, 169-170, 251-253 Disadvantaged Status Evaluation Form, 267-268 “distance traveled” considerations, 82, 85, 247-248, 257, 260 eligibility in the local context, 71 evaluation forms, 260, 267-268, 270-272 impacts on diversity, 27, 70, 71-75, 239-242, 326-328 innovative strategies and best practices, 2, 75-83, 254-264, 326 institutional climate and, 83, 145, 146, 160-161, 169-171, 173-174, 249, 251, 256-257, 326, 345, 348 Interview Form, 270-272 MD File and Review Form, 269-270 mission-oriented review, 8, 76-77, 81, 82, 85, 244, 245, 257, 259-260, 263, 338 nursing, 56, 253-255 organizational behavior and, 366 percent plans, 7, 71-75, 84 process, 244-249 psychology, 61, 249-251 qualitative review of applicants, 7-8, 75-76, 79-80, 81, 82-83, 84-85, 170, 204, 245, 246-248, 259-261 race-conscious, 27, 70, 88, 327-328 race-neutral, 7, 27, 71-75, 81, 239-242, 256-257, 258-259, 260, 326-327 recommendations, 8-9, 19, 85, 255-264, 328 and recruitment and retention strategies, 83, 249, 250-251, 253, 254-256, 260, 261-262

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce segregation and, 237-242 standardized test scores and grades and, 6-7, 8, 55, 56-75, 79, 81-82, 83, 84, 203-204, 236, 244, 245-246, 257-258, 259 Advanced Clinical Training and Service Program, 120 Advisory Committee on Student Financial Assistance, 91 Advisory Committee on Training in Primary Care Medicine and Dentistry, 300, 304 Affirmative action accreditation and, 129-130 admissions impacts, 3, 4, 24, 25 n.3, 27, 29, 50, 71, 72-73, 79, 145, 238-239, 240-241, 255, 256, 258, 326, 327-328, 345 anti-affirmative action initiatives, 50, 71, 239-240 Bakke decision, 239 benefits of, 255, 256 Brown v. Board of Education, 326 class-conscious, 258-259 employment effects, 364 Gratz decision, 240, 241, 326, 327-328 Grutter decision, 3, 4, 24, 25 n.3, 27, 29, 50, 79, 145, 199-200, 240-241, 326-327, 345 Hopwood decision, 4, 24, 71, 72-73, 76-77, 240, 258, 327 impact of bans, 80, 233, 237, 240, 241-242, 326-327 percent plans and, 71-75 as remedy for segregation, 238-239 African Americans. See also Underrepresented minorities academic performance issues, 66, 67, 68-70 access to care, 26 Armed Forces personnel, 290-291 clinician preferences, 31, 325 cross-racial interactions, 351-352 debt impacts, 102, 103-104 educational inequities, 7, 67-68, 242 faculty, 41-42, 46, 48, 50, 158 financial aid awards to, 93-94, 105-106 financial status of families, 89-90, 91 in graduate school, 48-49 in health professions workforce, 24, 30-31, 38, 42-43, 45-46, 48, 49, 163, 242, 253, 274-275, 339 medical breakthroughs by, 37 pedagogy, 158 recruitment strategies, 163 satisfaction with care, 32 school enrollment and graduation trends, 40, 45, 47, 51, 72-75, 83, 170, 171, 238, 253 standardized test performance, 63, 64, 65-66 U.S. population, 274, 305 Agency for Healthcare Research and Quality, 305 Aid Latino Community to Attain Nursing Career Employment (ALCANCE), 162 Alaska, 296 Alaska Natives. See Native Americans Alfano, Michael, 253 Alliances for Graduate Education and the Professoriate, 280-281, 293 American Association of Colleges of Nursing, 99, 254, 309, 335 American Board of Internal Medicine (ABIM), 75-76 American Board of Medical Specialties, 75, 329 American College Test, 58, 60 American Dental Association, Commission on Dental Accreditation Programs, 333 American Dental Education Association (ADEA), 112, 114, 251, 252-253 American Hospital Association, 190 American Indians. See Native Americans American Medical Association, 274, 321 American Medical College Application Service, 267-268 American Psychological Association, 275 Commission on Ethnic Minority Recruitment, Retention, and Training in Psychology, 250 Committee on Accreditation, 135-138, 139-140, 333-334 cross-cultural principles and guidelines, 167-169 fellowships, 111 Office of Ethnic Minority Affairs, 250

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce Office of Program Consultation and Accreditation, 135 recruitment and retention initiatives, 249-251 Suinn Minority Achievement Awards, 163, 250 Area Health Education Centers, 110, 276-277, 285, 295, 297, 300 Arizona State University, 361 Arkansas, financial aid programs, 294, 295 Armed Forces Health Professions Scholarship Program, 289 Asian Americans/Pacific Islanders access to care, 26 cross-racial interactions, 351-352 debt impacts, 102 faculty, 41-42, 48, 50 financial status of families, 89-90 in health professions workforce, 42-43, 46, 48, 274-275 initiative, 282 satisfaction with care, 32 school enrollment and graduation trends, 40, 51, 72-73, 74, 253 standardized test performance, 63, 64, 65-66, 70 U.S. population, 23 Association of Academic Health Centers, 309 Association of American Medical Colleges (AAMC), 3 n.1, 7, 27-28, 38, 78-79, 236, 238, 243, 244, 245, 261, 273 n.1, 275, 304, 309, 321, 323, 324, 327, 330-331, 336, 368, 369 Association of Canadian Medical Colleges, 321, 324 Association of Hispanic-Serving Health Professions Schools, 282 Association of Specialized and Professional Accreditors, 130, 320 Atkinson, Richard C., 233, 256 Atlanta University Center, 163 B Bakke, Allan, 239 Beason, Charlotte, 131 Binet, Alfred, 56 Bob Jones University, 181, 197 Brigham, Carl, 57 Bush, George H.W., 182 C California admissions policies, 71, 84, 241, 256-257, 261, 327 community benefit standard applied to nonprofit health care organizations, 183, 185, 187, 188, 189, 193 diversity in health professions, 30, 31, 244 financial aid programs, 294, 296 minority access to care, 26, 30, 234 minority population, 23, 235 Office of Statewide Health Planning and Development, 113, 187 Proposition 209 (Civil Rights Initiative), 4, 24, 240, 256-257 California Endowment, 11, 112-113, 252, 283, 309 California HealthCare Foundation, 309 California Wellness Foundation, 11, 112, 113-114 Canadian Medical Association, Council on Medical Education, 321 Carnegie Foundation, 321 Case Western Reserve Medical School, 368 Catholic Health Association of the United States, 190 Cecil G. Sheps Center for Health Services Research, 286 Center for California Health Workforce Studies, 283 Center for Medicare and Medicaid Services, 114, 291, 298, 302, 305, 307-308, 311 Centers for Disease Control and Prevention, 305 Centers of Excellence (COP) program, 108-109, 110, 276-277, 284, 300 Centers of Research Excellence in Science and Technology, 282-283, 293 Children’s Hospitals Graduate MedicalEducation Program, 278-279, 286-287 Civil Rights Act of 1964, 327 Civil Rights movement, 243 Clark-Atlanta University, 163 Clinical research benefits of diversity, 237 minority enrollment in, 35-36 Clinical Training grants, 280-281

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce Coffman, Janet, 283 Cohen, Jordan, 36, 275, 324, 327, 336 College Board, 95-96 Colleges and universities community benefit standard applied to, 196-198 historically black medical schools, 163, 282, 291, 292-293, 301 Colloton, John, 323 Colorado, financial aid programs, 294, 295 Columbia University, 169-170, 171 Commission on Collegiate Nursing Education, 130-131, 335 Commission on Dental Accreditation, 131-133, 140, 332 Committee on Accreditation of Canadian Medical Schools, 133, 321, 322 Commonwealth Fund, 325 Community benefit standard and access to care, 179-180, 184-185, 187, 188-189 and accreditation, 17, 197, 198, 199, 200, 208, 209 areas for improvement, 194 Bob Jones University v. United States, 181, 196 coalition building and, 208, 209 community health perspective, 191 evolution of policies and practices, 186-194 financial threshold approach, 16, 189 Healthy Community perspective, 191, 192 historical and legal background, 15-16, 178-186, 199 Legal/Historical perspective, 191 manual for planning and implementing programs, 190 Market-Failures perspective, 191 organizational practices, 193-194 payments in lieu of taxes, 184 private sector initiatives, 189-192 public policy options, 197-199 Public Trust Model, 190-191 recommendations, 2-3, 17-18, 20, 200 reporting requirement approach, 16, 186-189 state initiatives, 16, 186-189 strengths, 193 Utah County v. Intermountain Health Care decision and, 180, 182 and workforce diversity, 16-17, 194-197, 200 Community Care Network Demonstration, 190 Community Catalyst, 209 Community colleges, 56 Community health centers, 26 Community Voices Program, 209-210 Connecticut, 294, 296 Costs of education and access and completion, 9, 88, 90-96, 102 and career choice, 102-103 and career satisfaction, 103-104 defined, 89 dentistry, 96, 97, 102, 104, 303-304 impacts on URMs, 9, 102-104, 118, 122, 161, 283, 303-304 institutional climate and, 102, 146, 161, 164, 171, 348 and lifestyle, 104 medical education, 88, 96-98, 303-304 nontuition expenses, 101-102 nursing, 99-101 perceptions of burden, 102 planning for debt management, 104 psychology, 98-99, 100 tuition and student debt, 93, 96-101, 115, 303-304 undergraduate school, 90-96 Council for Higher Education Accreditation (CHEA), 127, 128, 129, 130, 320 Council on Graduate Medical Education (COGME), 115, 288, 302, 303-304, 311 Cultural audit, 153, 154 Cultural Competence Initiative, 282 Curriculum core competencies, 127, 129, 328-329, 332, 335-336, 337 cross-cultural, 34-35, 165-169, 174 cultural competencies, 11-12, 134, 140-141, 166, 206-207, 329-337, 375-376 CVS, 120 D Delivery of health care, attitudes of practitioners and, 373, 375

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce   Democracy outcomes diversity in training and, 6, 34, 35 institutional climate and, 147, 148, 172 Dental Health Professions Shortage Areas, 251 Dentists and dentistry access issues, 5, 26, 30-31 accreditation standards, 131-133, 140, 252, 333, 335, 338 admissions process, 169-170, 251-253 costs of education and debt loads, 96, 97, 102, 104, 303-304 faculty, 44, 46-48 financial assistance, 11, 115, 119-120, 121, 252-253, 297-298 improving institutional climate for, 154, 156-157, 169-171 participation trends of minorities, 24, 45-48 patient characteristics, 5 postbaccalaureate programs, 263 school enrollment and graduation trends, 44, 46, 47, 252 shortages, 119-120, 251 URM workforce, 45-46, 251, 274 Dirksen, Everett, 301 Disadvantaged, defined, 289 Disadvantaged Faculty Loan Repayment, 108-109 Disadvantaged Status Evaluation Form, 267-268 Discrimination. See also Segregation and academic performance, 66, 164 District of Columbia, 238 minority population, 23 Diversity in health professions. See also Institutional climate for diversity; Underrepresented minorities and access to care for minority patients, 5, 26, 29-31, 234, 260, 305, 380 accreditation and, 11-12, 17, 127, 132-133, 138-141, 197, 198, 199, 200, 336-339 admissions policies and, 27, 70, 71-75, 239-242, 326-328 advising inequities and, 243-244, 264 behavioral climate and, 13, 146, 172, 349, 351-352 benefits of, 23-24 n.1, 29-37, 51, 144, 147-152, 275, 345-346 campus-related initiatives, 13, 145, 148, 171-172 challenges to, 3-4, 234-237 and choice and satisfaction with care, 5, 31-32, 325 community benefit standard and, 16-17, 194-197, 200 compositional, 143, 146-147, 148, 348-349, 350, 353-354, 363, 379-380, 381-382 consequences of, 353-354 defined, 144-147, 171, 310, 347-354 demographic imperative, 3, 234-235, 306-307, 325 GAO recommendations for increasing, 310 and health policy, 36-37 interactional, 13, 145, 148, 171, 353, 363 and learning, 29, 34-35, 147-152, 35-43 63 mission of medical schools and, 235-237, 330 organizational behaviors and, 364-366 pedagogy and, 145, 158, 171, 379-380 psychological climate and, 13, 350-351 and quality of care, 5, 23-24 n.1, 29, 31-33, 37, 325 and quality of training, 6, 29, 33-35 rationale for increasing, 26-27 and research leadership, 29, 36-37 and research on disparities, 35-36 segregation and, 13, 172, 237-242, 349 social contract, 325-332 socioeconomic and educational inequities and, 7, 160, 161, 233, 242, 243, 283 standards related to, 11-12, 128-138, 236, 332-336 strategies for increasing, 23-26 structural, 13, 144-145, 172 transforming effect of initiatives, 363-366 Diversity in the Health Professions Priority Area Grants, 113-114 Dole, Robert, 207 Donnelly, Brian, 181-182 Drew, Charles R., 37 Duke, Elizabeth M., 282

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce E Education Appropriations Act, 305 Education of URM health professionals. See also Accreditation; Admissions policies and practices; Costs of education; Financing of education and research cross-cultural training and cultural competencies, 6, 33-35, 165-169, 236, 307, 374, 375-376 dentistry, 46, 96, 97 enrollment and graduation trends of URMs, 24, 40-41, 43-45, 46, 47, 48-49, 50, 94, 95-96, 115-117, 118, 235, 240, 241, 282, 284 experiences in higher education and HPEI settings, 68-70 financial status of URM families and, 9, 67-68, 89-90, 91, 92 graduate, 24 medical school, 43-45, 96-98 nursing school, 40-41, 99-101 psychology, 48-49, 98-99 and quality of care, 307 strategies to encourage, 206-208 undergraduate, 24 Education Policy Center, 283 Educational Excellence for Hispanic Americans, 282 Equal Employment Opportunity Commission, 338 Exceptional Financial Need program, 304 Extramural Associates Research Development Award, 288 Extramural Loan Repayment for Individuals from Disadvantaged Backgrounds Conducting Clinical Research, 278-279, 288 F Faculty. See also Pedagogy academic rank of, 50 on admissions committees, 77-78, 82 cultural competence of, 330, 332, 334, 336 dentistry, 46-48 financial assistance for, 105, 106, 276-277, 284, 286, 287 geographic variation in diversity, 41 and learning environment, 155, 351, 361-362 nursing, 41-42 psychology, 48, 50, 157 recruitment, hiring, and retention, 14, 15, 143, 145, 157-160, 161, 171, 173, 174, 284, 286, 308, 330, 332, 334, 336, 339, 361-362 as role models, 121, 157 sensitivity training of, 14-15, 156, 157, 166, 174-175 student-centered orientation, 14, 156 student interaction with, 155 URM workforce, 41-42, 46-48, 121, 157-160, 241, 308 Faculty Loan Repayment Program, 276-277, 284-285 Federal Comprehensive Health Manpower Training Act of 1971, 238 Financial Aid for Disadvantaged Health Professions Students, 304 Financing of education and research. See also specific sources and academic performance, 93, 295 and access to care, 113, 286, 297, 305, 307 accreditation and, 319, 340 average awards, 96 budget deficit and, 304 clearinghouse on program options, 309, 311 College Board recommendations, 95-96 community benefit standard and, 198-199 coordination and collaboration needs, 11, 301-302, 303, 307, 309, 310, 311 data collection and analysis, 305-306, 309, 311 debt loads of students and new practitioners, 93, 303-304 defined, 89 demographic changes and, 306-307 for dental school, 11, 115, 119-120, 121, 252-253, 297-298 discretionary funds, 107-111, 118, 122, 273, 275-293, 300 and enrollment and retention of URMs, 50, 94, 95-96, 115-117, 118, 282, 284 evaluation of programs, 11, 115-117, 119, 283, 284-285, 299-300, 301, 304-306, 307-308, 309, 311

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce for faculty, 105, 106, 276-277, 284, 286, 287 federal aid, 2, 9, 91-92, 95-96, 101, 107-111, 122, 273, 275-294, 299-300 financial status of URM families and, 9, 89-90, 91, 92 goal-setting in programs, 119, 302-303 graduate school sources, 105-106 grants, 95, 105, 106 information-seeking by students, 94-95 innovative ways of using, 11, 95, 119-122, 173-174, 294-299, 311 intergovernmental transfers, 297-298 for international medical graduates, 302 lack of recognition of programs, 301-302 loan repayment programs, 95, 105, 106, 108-109 mandatory (nondiscretionary) funds, 114-115, 122, 273, 282-283, 293-294, 296-299, 300 merits-based assistance, 92, 93-94, 304 needs-based assistance, 9, 92, 112, 303, 304 for nursing, 101, 119, 255, 276-277, 296, 298 private sources, 2, 9-10, 12, 111-114, 252-253 public-private partnerships, 11, 119-123, 308-310, 311 race and gender influences on awards, 93-94 recommendations, 11, 12, 19, 117, 118, 121-122, 262-263 and recruitment and retention of URMs, 9, 171, 173-174, 298, 307, 308, 311 research grants, 262-263, 284 siloing of small programs, 118, 301 state and local aid, 2, 11-12, 92, 118, 120-122, 274, 282-283, 303, 309 threats to, 4, 118, 299-304 tobacco settlements used for, 298-299 tuition waivers, 106 for undergraduate URM students, 106-114 unmet needs, 9, 89, 92-93, 102, 204 unpredictability of funding, 118, 300 work study, 106 Fisk University, 163 Flexner Report of 1910, 237, 321, 367, 368 Flexner, Abraham, 321, 367 Florida admissions policies, 71, 327 financial aid programs, 285, 294, 296 Fogarty International Center, 289 Ford Foundation Pre-doctoral and Dissertation Fellowships for Minorities, 11, 112, 114, 158 Free Application for Federal Student Aid (FAFSA), 101 G Gándara, Patricia, 283 Georgia, 297 Geriatric Education Centers program, 286 Graduate Medical Education, 280-281, 289-290 Reform Incentive Pool, 11 Graduate Record Examination (GRE), 61, 63, 64-65, 69 Grumbach, Kevin, 283, 303 Grumer, Barbara, 129-130 H Harlem Hospital Medical Center, 170-171 Harvard University, 150 Hastings Center, 236 Hawaiians, native, 23, 242, 274, 275, 285 Health Care Financing Administration, 307. See also Center for Medicare and Medicaid Services Health Care Reform Act, 209 Health Careers Opportunities Program (HCOP), 107, 108-109, 115, 276-277, 284, 285, 300 Health Education and Training Centers, 110, 276-277, 285 Health maintenance organizations, 183-184 Health professions. See also individual occupations barriers to inclusion of URMs in, 28, 203-204 focus of this study, 28 participation trends of URMs, 1-2, 23-24, 38-49, 238, 274-275 shortages in, 38-39, 234-235 Health Professions Education Foundation, 112, 113 Health Professions Education Fund, 113

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce Health Professions Education Summit, 329 Health professions educational institutions (HPEIs). See also Colleges and universities; Education of URM health professionals; Institutional climate for diversity; Medical school; specific institutions community benefit standard applied to, 194-198 and enrollment and retention of URMs, 50, 94, 95-96, 115-117, 118, 282, 284 historically black schools, 163, 282, 291, 292-293, 301, 349 leadership needs, 144, 152, 153, 156-157, 256-257, 328, 350 mission and mission statement, 8, 14, 76-77, 81, 82, 85, 159, 173, 174, 203, 244, 245, 257, 259-260, 263, 330, 346 Ombuds Office, 15, 165 predominantly white, 349 research-intensive, 158 tax-exempt status, 194-198 Health Professions Loan Repayment Program, 280-281 Health Professions Scholarship Program, 108-109, 280-281, 290 Health Research and Educational Trust, 190 Health Resources and Services Administration (HRSA), 2, 251 Bureau of Health Professionals, 107-110, 115, 116 discretionary funds for financial aid, 9, 107-110, 116, 199, 275-279, 282-287, 300, 301, 302 Division of Health Careers Diversity and Development, 110 evaluation of URM workforce initiatives, 11, 305 Office of Minority Health, 282 Healthy Cities, 192 Healthy People 2000 and 2010, 234, 307 Henderson, Tim, 294, 295, 296, 297 Hennessey, John, 256 Henry J. Kaiser Family Foundation, 309 Higher Education Act, 128, 319 Hispanics/Latinos. See also Underrepresented minorities access to care, 26 clinician preferences, 31, 325 cross-racial interactions, 351-352 debt impacts, 102, 103-104 educational inequities, 7, 67-68, 242 as faculty, 44, 46, 48, 50, 158 financial aid awards to, 93-94, 105-106 financial status of families, 89-90, 91 in graduate school, 48-49 in health professions workforce, 23-24, 30, 38, 42-43, 45-46, 48, 49, 162, 253, 274-275 pedagogy, 158 satisfaction with care, 32 school enrollment and graduation trends, 40, 45, 47, 51, 72-75, 83, 170, 171, 238 standardized test performance, 63, 64, 65-66 U.S. population, 23, 305 Historically Black Colleges and Universities initiative, 282 Hospital Community Benefit Standards program, 189 Hospitals. See Nonprofit hospitals and health care organizations Houston Associates, 115 Howard University School of Medicine, 43, 238 I Idaho, 183, 186, 296 Illinois, 294, 296 Indian Health Service (IHS), 108-109, 111, 285 Indiana, 183 Initiative for Minority Student Development, 287 Innovations in Health Professions Education Grant Fund, 297 Institute for Primary Care and Workforce Analysis, 294-295 Institute of Medicine, 309, 325, 329, 334, 339 Institutional and policy-level strategies, 51-52. See also Accreditation; Affirmative action; Intervention strategies barriers to URM participation, 4, 49-50, 203-204 coalition building, 18, 208-210 community benefit and, 197-199

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce data and research needs, 18, 205-206 defined, 25 education of stakeholders, 18, 206-208 leadership needs, 256-257 rationale for examining, 23-24, 26-27 recommendations, 18, 20, 210, 256-257 state referenda, 4, 24 supportive mechanisms, 205-210 Institutional climate for diversity and academic performance, 68-70, 147, 161, 170 accreditation and, 330-331, 370 admissions policies and, 83, 145, 146, 160-161, 169-171, 173-174, 249, 251, 256-257, 326, 345, 348 affiliations with community health care facilities, 14, 15, 163, 170-171, 173-174, 175 attitudes and, 145, 146, 148, 157, 350, 354, 373 behavioral, 13, 146, 172, 349, 351-352 campus-related initiatives, 13, 145, 148, 171-172 and clinical practice, 381-382 compositional diversity and, 143, 146-147, 148, 348-349, 350, 353-354, 363, 379-380, 381-382 cross-cultural curriculum, 34-35, 165-169, 174 cross-racial interactions, 13, 351-352, 353 cultural audit of, 153, 154 curricular and cocurricular activities, 34-35, 155-156, 165-169, 174 defining, 13, 144-147, 171, 347-354 and democracy outcomes, 147, 148, 172 in dentistry, 169-171 design principles for improving, 13-14, 152-156, 172-173 external influences, 145-146, 348 faculty recruitment, hiring, and retention strategies and, 14, 15, 143, 145, 157-160, 161, 171, 173, 174, 361-362 financial aid policies and, 102, 146, 161, 164, 171, 348 holistic approach to change, 13-14, 144, 152, 172-173, 346-347 leadership and, 144, 152, 153, 156-157, 204, 350 and learning outcomes, 6, 34-35, 147-152, 158, 172, 262-263, 354-363, 368-369, 370-371, 374-375, 378-379 long-term perspective, 144 mediation mechanisms, 15, 165, 175 in medical education, 366-382 mission statement and, 14, 159, 173, 174, 346 monitoring and evaluation of intervention strategies, 13-14, 144, 152, 153, 167, 171, 175, 370-371 organizational impediments, 364-366 orientation for students, 14, 164, 174 pedagogy and, 143, 145, 155, 158, 164, 171, 352, 359-361, 367-368, 371-376 peer group influences, 351, 352, 355, 360, 363 psychological, 13, 145, 146, 172, 348, 349, 350-351 recommendations, 2, 15, 19, 174-175 resource allocation and, 144, 152 segregation and, 13, 145, 146, 151-152, 155, 156, 172, 237-242, 348-349, 351 sensitivity training of staff, 14-15, 156 student development, 155-156, 377-379 student recruitment, 14, 83, 143, 145, 160-161, 162-163, 169-171, 173-174, 249, 262 student retention, 14-15, 161-165, 169-171, 173-174 support services and programming, 14, 156, 164-165, 170, 174 Institutional culture, 146, 347-348 Institutional isomorphism, 365 International medical graduates, 302 Intervention strategies. See also Affirmative action; Institutional and policy-level strategies academic advising, 243-244, 264 in admissions policies and practices, 2, 75-83, 254-264 community-based learning experiences, 119-120 data collection and analysis, 305-306 early matriculation programs, 262-263 financial aid, 11, 95, 119-123, 294-299, 308-310, 311 institutional climate improvements, 13-14, 144, 152-171, 175, 370-371 monitoring and evaluation of, 13-14, 144, 152, 153, 167, 171, 175, 370-371

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce pipeline enhancement programs, 25, 27, 110, 118, 119, 161, 250, 252, 263, 299 postbaccalaureate programs, 263 Iowa, 294, 296 J Joint Commission on Accreditation of Healthcare Organizations, 382 K Kids into Health Careers, 110 Krueger, Alan B., 328 L Latinos. See Hispanics/Latinos Learning active formats, 158, 352, 357-358, 360, 361, 368, 378, 379 apprenticeship format, 367-368 assessment of, 373 automatic thinking and, 357 case-based and didactic, 372 collaborative and cooperative environments, 155, 158 complex social structures and, 358 contextual issues in environments for, 357-359 development concepts, 354-357 diversity in training and outcomes in, 6, 29, 34-35 faculty diversity and, 155, 351, 361-362 formats for, 158, 372-373, 378-379 experiential/field studies techniques, 158 external assessments of, 370-371 institutional climate for diversity and, 6, 34-35, 147-152, 158, 172, 262-263, 354-363, 368-369, 370-371, 374-375, 378-379 Kegan’s orders of consciousness, 356-357, 377-378, 381 negative reinforcements to, 374-375, 381 in nontraditional settings, 366-367 pedagogy and, 158, 350, 352, 359-361, 367-368, 378-379 Piagetian perspective, 355, 377, 379-380 problem-based, 368-369 segregation and, 151-152 self-authorship/self-directed, 377-378 theory and research, 147-152, 354-359 transformative, 358-359, 378-379 women’s epistemological model of, 356 Liaison Committee on Medical Education, 75, 133-135, 236-237 commitment to achieving diversity, 134-135, 336-339 composition of, 321, 322-323 development of standards, 322-323 historical perspectives, 320-321, 368 present role of, 322-323, 370 standards related to diversity, 133-134, 140, 336-339 Licensing, 61, 166, 245-246, 258, 332, 368 Loan Repayment Program for Health Disparities Research, 278-279, 288 Loans for Disadvantaged Students, 108-109 Louis Stokes Alliances for Minority Participation, 280-281, 292-293 Louisiana, 240, 241, 327 M Mahoney, Maureen, 255 Martin Luther King, Jr./Charles R. Drew Medical Center, 326 Maryland, 183 Massachusetts, 183-184, 187, 209, 302 Mathematica Policy Research, Inc., 286 McMaster University, 368 Medicaid Graduate Medical Education, 122, 273, 282-283, 294, 295, 296-299, 303 Medical College Admissions Test (MCAT), 57, 60-61, 63, 65-66, 79, 236, 245-246, 257-258 Medical College of Georgia, 297 Medical school accreditation standards, 133-135, 370 admissions committee appointment and training, 249-250 admissions policies and process, 70-71, 244-249 assessments of learning, 370-371 attitudes, 148, 373 choosing students, 245-248 clinical training, 381-382

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce composition of student body, 379-381 costs of, 88, 96-98, 303-304 cross-cultural training and cultural competencies, 34, 286 current status of, 375-376 curriculum, 236, 374-375, 376 enrollment and graduation trends, 43-45, 161 faculty, 42-44 financial assistance, 96, 98, 295 goals and objectives, 369 grades and MCAT scores and, 70, 245-246 hidden/unintended curriculum, 374-375, 376, 381 institutional climate for diversity, 366-382 knowledge and skills, 371-372 learning formats, 372-373 mission and mission statement, 235-237, 245, 330 negative reinforcements to learning, 374-375, 381 “othering” perspective of students, 376 participation trends of minorities, 24, 42-45 pedagogy, 367-368, 371-376 preparatory programs, 27, 263 preparing clinicians, scientists, and leaders, 235-237 problem-based learning, 368-369 public health mission, 235 public support and investment in, 235 recruitment efforts, 83, 249, 307 structure of education in, 367-369 student development, 377-379 Medical School Objectives Projects I-IV, 236, 369 Medicare Graduate Medical Education program, 114-115, 118, 198-199, 282-283, 293-294, 298, 301, 302-303, 307, 308-309, 311 Medicare/Medicaid Act of 1965, 180 MedPAC, 308-309, 311 Meharry Medical College, 43, 238 Mellon Foundation Fellowships, 158 Mental health and diversity, 37 services, 26, 30, 31 Mentored Minority Career Enhancement Award, 280-281, 292, 301 Mentored Minority Research Enhancement Coordinating Center, 280-281, 292, 301 Mentored Minority Supplemental Award, 280-281, 292, 301 Mexican Americans, 31, 45, 238, 242, 339, 351-352 Michigan, 185, 297 Minnesota, 297, 298-299 Minorities. See also Underrepresented minorities access to care, 26, 28, 29-31, 49, 233, 234-235, 305 adherence to treatment plans, 33 in clinical trials, 35-36 defined, 23 demographic changes, 1, 23, 73, 235, 305, 306-307 educational inequities, 7, 67-68, 160, 242, 246 focus of this study, 27-28 health status and disparities, 30, 35-36, 49, 234, 237, 307 preferences and satisfaction with care, 31-32, 33 quality of care, 32-33, 307 representation in health professions, 23-24 utilization of health services, 30, 33 Minority Access to Research Careers, 278-279, 287 Minority Biomedical Research Support, 278-279, 287 Minority Faculty Fellowship Program, 108-109, 110 Minority Fellowship Program, 108-109, 111 Minority Health Knowledge Management Initiative, 282 Minority Management Development Program, 282 Minority Medical Education Program, 27, 242 Minority Participation in Medical Education Grant Program, 11, 120-121 Minority Training Programs Tracking System, 282 Mississippi, 240, 241, 327 Montana, 296 Morehouse College, 43, 163

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce Morris Brown College, 163 Mount Sinai School of Medicine, 103 Muñoz, Claudia, 283 N National Advisory Council on Nurse Education and Practice, 253, 335 National Agenda for the Nursing Workforce, 335 National Association of Hispanic Nurses, 162 National Board of Medical Examiners, 61, 75 National Center for Complementary and Alternative Medicine, 289 National Center for Health Workforce Analysis, 117, 294, 295-296, 305-306, 311 National Center for Research Resources, 289 National Center on Minority Health and Health Disparities, 288 National Comparative Survey of Health Care, 325 National Conference of State Legislatures, 294 National Health Service Corps (NHSC), 108-109, 110, 118, 278-279, 285-286, 304 National Institute of Drug Abuse, 111 National Institute of General Medical Sciences, 287 National Institute on Aging, 111 National Institutes of Health discretionary funding for students, 199, 278-279, 287-289, 301 evaluation of URM workforce initiatives, 305 grant programs for minority researchers, 36, 111 leadership diversity, 36-37 Office of Behavioral and Social Science Research, 289 National Institutes of Mental Health, 108-109, 111 National League for Nursing, 99, 100 Accrediting Commission, 128-130, 334 National Library of Medicine, 288-289 National Medical Fellowships, Inc., 10, 111-112, 304 National Postsecondary Student Aid Studies, 93, 102, 105-106 National Register of Health Service Providers, 29 National Research Council, 58 Ford Foundation Pre-doctoral and Dissertation Fellowships for Minorities, 112, 114 National Resident Matching Program, 302 National Sample Survey of Registered Nurses, 38 National Science Foundation, discretionary funding for students, 163, 280-284, 292-293, 301 National Student Loan Survey, 102 Native Americans. See also Underrepresented minorities clinician preferences and satisfaction with care, 31 educational inequities, 7 faculty, 41-42, 46, 48, 50, 158 financial status of families, 90 in graduate school, 49 in health professions workforce, 42-43, 46, 48, 49, 162, 242, 253, 274-275, 339 pedagogy, 158 school enrollment and graduation trends, 40, 45, 47, 51, 83, 238 New Hampshire, 184, 185, 187-188 New Mexico minority population, 23 New York state, 235 community service plans for nonprofit hospitals, 16, 182, 183 financial aid program, 11-12, 120-121, 297, 299, 302, 303 Physician Diversity Project, 209 New York University, 189, 253 Nickens, Herbert, 325 Nonprofit hospitals and health care organizations areas for improvement, 194 charitable obligations of, 181-182 community benefit standard applied to, 186-189, 195-196 evaluation of charitable behavior of, 192 organizational practices, 193-194 recognition and support of, 189-190 roles and obligations of, 191-192 strengths of, 193

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce tax-exempt status, 15-16, 178-185, 190-191, 195-196 workforce diversity, 195-196 Nurses and nursing accreditation standards, 128-131, 334-336 admissions process, 56, 253-255 baccalaureate, 56 costs of education, 99-101 faculty, 41-42 financial assistance, 101, 119, 255, 276-277, 296, 298 participation trends of minorities, 24, 26, 38-42, 253, 274-275 recruitment of URMs, 160, 162, 163 school enrollment and graduation trends, 40-42, 254 shortages, 38-39, 119, 160, 163, 253, 298 variability of programs, 254 workforce, 38-39, 253, 335 Nursing Education Loan Repayment Program, 276-277, 285 Nursing Workforce Diversity Program, 108-109, 110, 276-277, 285 O O’Connor, Sandra Day, 240-241, 345 Office of Management and Budget, 38 Oklahoma, 296 Oregon, 31 Orthodontic Education Company, 11, 119-120 P Pedagogy accreditation standards and, 368 active teaching methods, 158, 352, 357-358, 360, 361 collaborative and cooperative environments, 155, 158, 359-360 communication skills approach, 371-372, 378 and compositional diversity, 145, 158, 171, 379-380 cultural competency approach, 371, 378-379 Giroux’s antiracist approach, 378-37 9 and institutional climate for diversity, 143, 145, 155, 158, 164, 171, 352, 359-361, 367-368, 371-376 knowledge/skills method, 372 and learning outcomes, 158, 350, 352, 359-361, 367-368, 378-379 peer teaching, 360, 363, 379 student-centered, 350, 352, 359, 361-362, 379 traditional, in medical schools, 367-368 Peer groups, influence on institutional climate, 351, 352, 355, 360, 363 Pell grants, 95-96, 102 Pennsylvania, 183, 184, 188 Perry, William, 355 Pew Charitable Trusts, 129, 309 Pew Health Commission Competencies, 334-335 Pharmacy and pharmacists, 120 Physician Diversity Project, 209 Physician Payment Review Commission, 308-309 Physicians, URM. See also Medical school access issues, 5, 29, 30, 189, 248-249 career choices and satisfaction, 103-104 debt loads, 102-103, 303-304 essential characteristics, 7, 236, 247 expectations of, 235-236 participatory decision-making style, 32, 33 patient characteristics, 5, 235, 248-249 patient preferences and satisfaction with, 5, 31-32, 325 quality of care, 33 recruitment of, 308 resident salaries, 104 VA, 291 workforce, 42-43, 238, 274, 291 Pipeline enhancement programs, 25, 27, 110, 118, 119, 161, 250, 252, 263, 299 Ponce School of Medicine, 43 Powell, Lewis Franklin, Jr., 239 Primary Care Medicine and Dentistry Grant Program, 286 Princeton University, 239, 328 Project 3000 by 2000 Health Professions Partnership Initiative, 238-239, 304 Prospective Payment Assessment Commission, 308-309

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce Psychology/psychologists access issues, 5, 29-30 accreditation standards, 135-138, 333-334, 335 admissions process, 61, 249-251 costs of education, 98-99, 100 cross-cultural training, 167-169 earnings, 98 faculty, 48, 50, 157, 249, 250 financial assistance, 298 institutional climate, 157 participation trends of minorities, 24, 48-49, 275 patient characteristics, 5 recruitment programs, 163, 250 school enrollment and graduation trends, 48-49, 51, 249-250 standardized tests, 61, 64 workforce, 48 Public Health Institute, 190 Public Health Service Act evaluation set-aside, 305 Titles VII and VIII, 9, 11, 107-110, 115, 118, 275, 300, 335 Public–private partnerships, 11, 119-123, 205, 308-310, 311 Puerto Ricans, mainland, 45, 159, 238, 339 Puerto Rico, medical school faculty, 43 Q Quality of care diversity and, 5, 23-24 n.1, 29, 31-33, 37, 325 nursing shortages and, 38-39 patient satisfaction with racially concordant clinicians, 5, 31-32 R Racial and ethnic groups. See also Minorities; Underrepresented minorities; specific groups educational inequities, 7, 67, 160, 161, 233, 242, 283 OMB categories, 38 Rainey, Michael, 334, 339 Recommendations accreditation, 12-13, 19, 139, 140-141, 324, 330, 331-332, 336-339 admissions committees, 8-9, 261 admissions policies, 8-9, 19, 85, 255-264, 328 coalition building, 18, 20, 209 community benefit standard, 2-3, 17-18, 20, 200 data collection and research, 18, 20, 206 education of stakeholders, 18, 20, 208 financing options, 11, 12, 19, 117, 118, 121-122, 262-263 institutional and policy-level strategies, 18, 20, 210, 256-257 institutional climate for diversity, 2, 15, 19, 174-175 Recruitment and retention of URMs academic advising and, 161 accreditation policies and, 12, 132-133, 137-138, 140, 141, 328, 338, 339 admissions policies, 83, 249, 250-251, 253, 254-256, 260, 261-262 educational inequities and, 160, 161 faculty, 157-160, 161, 171, 173, 284, 286, 308, 330, 332, 334, 336, 339 financial incentives, 9, 171, 173-174, 298, 307, 308, 311 institutional climate for diversity and, 14-15, 83, 143, 145, 160-165, 169-171, 173-174, 249, 262 institutional partnerships, 14, 15, 163, 170-171, 173-174 in nursing, 162 orientation, 14, 164, 174 recommendations, 14-15, 174-175 students, 14-15, 83, 143, 145, 160-165, 169-171, 173-174, 249, 262 support services and programming, 14, 156, 164-165, 170, 174 Regional Centers for Health Workforce Studies, 294 Registered Nurse Education Loan Repayment Program, 113 Registered Nurse Education Scholarship Program, 113 Research. See also Clinical research accreditation outcomes, 12, 139-141, 319, 326, 332, 336-338, 339 data collection and analysis, 18, 205-206, 305-306, 309, 311

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce demonstrations on URM relationships to Medicare and Medicaid programs, 307-308, 311 on financing innovations, 11, 115-117, 119, 283, 284-285, 299-300, 301, 304-306, 307-308, 309, 311 grant programs for minority researchers, 36 on health disparities of minorities, 35-36 on institutional and policy-level strategies, 205-206 leadership diversity, 29, 36-37 outcomes of institutional climate for diversity, 13-14, 144, 152, 153, 167, 171, 175, 370-371 Research Initiative for Scientific Enhancement (RISE), 287 Research Supplements for Underrepresented Minorities, 278-279, 288-289 Reserve Officer Training Corps (ROTC) program, 290 Rhode Island, 185 Robert F. Wagner Graduate School of Public Services, 189 Robert Wood Johnson Foundation, 11, 27, 242, 252-253, 309, 324 Rogers, Paul, 207 Rosenoff, Emily, 283 Roybal, Edward, 181-182 S Scholarship of Excellence program, 120 Scholarships for Disadvantaged Students, 108-109, 276-277, 284 Scholarships for Health Professions Students, 111 Scholastic Aptitude Test (SAT), 57, 58, 60, 62, 63-64, 244, 257 School-Based Scholarships for the Disadvantaged, 304 Schroeder, Steven, 324 Segregation and admissions policies, 237-242, 328 affirmative action as a remedy, 238-239 Bakke decision, 239 and educational inequities, 7, 67-68, 72, 328 historical ramifications, 13, 172, 237-242, 349 and institutional climate for diversity, 13, 145, 146, 151-152, 155, 156, 172, 237-242, 348-349, 351 Senior Executive Service, 310 Sensitivity training, 14-15, 156, 157, 166, 174-175 Sepulveda, Enrique, 283 Social Accountability Budget, 190 Social contract core competencies as part of, 328-329 cultural competencies as part of, 329-332 defined, 324 diversity as part of, 325-332 health professions’ and medical education’s responsibility within, 323-324 Social Security Amendments of 1983, 302 South Dakota, 296-297 Spelman College, 163 Spencer Foundation Fellowships, 158 St. Louis University, 163 Stafford Loans, 102, 104 Standardized tests. See also specific tests and accreditation, 258 admissions policies and practices, 6-7, 8, 55, 56-75, 79, 81-82, 83, 84, 236, 244, 245-246, 257-258, 259 appropriate use of, 7, 58, 61-62 attributes measured by, 59 background, 56-58 benefits, 58 consequences of reliance on, 70-75 “cut-off” range, 62, 259 elimination of, 258 experiences in higher education institutions and HPEIs and, 68-70 and grade point average, 60, 63 group differences in performance, 7, 63-70 misinterpretations and misuses, 58-60, 84 precision and fairness of, 7, 59 pre-college influences on preparation for, 67-68 predictive power, 6-7, 60-62, 84, 246, 257-258, 381 preparation programs, 263 racist and eugenicist ideology and, 56 ranking of academic institutions with, 59-60

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce “stereotype threat” and, 7, 68-70, 82, 243, 246, 248, 261 “successful intelligence” theory and, 62 underperformance/overprediction, 62-63, 248 validation for diverse applicants, 62-63 Stanford University, 69, 77, 80, 82-83, 256 Early Matriculation Programs, 262-263 State University of New York at Albany, 294 States. See also individual states community benefit policies, 16, 186-189 financial aid, 2, 11-12, 92, 118, 120-122, 274, 282-283, 303, 309 Steele, Claude, 68-69 Stereotype threat, 68-70 Sternberg, Robert, 62 Stevens, David, 134 Strategies for Improving the Diversity of the Health Professions, 283 Student Assistance Programs, 110 Substance Abuse and Mental Health Services Administration, 108-109, 111, 305 “Successful intelligence” theory, 62 Sullivan Commission on Diversity in the Healthcare Workforce, 207 Sullivan, Louis, 207 Support of Continuous Research Excellence (SCORE), 287 T Tax Reform Act of 1986, 181 Tennessee, 163, 238, 296, 297, 298 Texas college admissions policies, 71, 72-73, 80, 240, 241, 258, 327 community benefit standard applied to nonprofit health care organizations, 183, 186, 188 diversity of health professionals, 30, 235 financial aid programs, 294, 295, 296 Health Professions Resource Center, 258 Texas A&M University, 72-73, 76-77, 80, 81-82 Partnerships for Primary Care, 258 Thorndike, E.L., 56 Tienda, Marta, 72-73 Tobacco settlements, 298-299 Tokenism, 350, 359 Training of health professionals, cross-cultural, 6, 33-35, 165-169 Tribal Colleges and Universities initiatives, 282, 291 Tuskegee syphilis experiments, 35 U Undergraduate Scholarship Program, 278-279, 289 Underrepresented minorities (URMs) access to care, 28, 49 on accrediting bodies, 12, 135, 140, 141, 321, 322-323 on admissions committees, 77-78 advising inequities, 243-244, 264 barriers to inclusion in health professions, 28, 243-244 college enrollment and graduation trends, 24, 40-41, 43-45, 46, 47, 48-49, 50, 94, 95-96, 115-117, 118, 235, 240, 241, 282, 284 costs of education, 9, 102-104, 118, 122, 161, 283, 303-304 defined, 3 n.1, 6, 24 n.2, 27-28, 38, 242-243, 252, 273 n.1 eligibility for enrichment programs, 161, 242 financial assistance for college, 106-114 financial status of families, 9, 67-68, 89-90, 91, 92 participation trends in health professions, 1-2, 37-49, 238 primary and secondary education, 3-4, 24, 27, 84 recruitment and retention, 250-251, 255, 298 stereotype threat, 68-70, 82, 243, 246, 248 “tracking,” 67, 117 Uniformed Services Health Professions Revitalization Act of 1972, 289 Uniformed Services University of the Health Sciences, 289 Universidad Central del Caribe School of Medicine, 43 University of California admissions policies, 71, 73-75, 84, 233, 238, 239-240, 256-257 at Berkeley, 74 at Davis, 238, 239, 283

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce at Irvine, 259-260 at Los Angeles, 74, 326 Medical Student Diversity Task Force, 233, 244 at San Francisco, 150, 283, 294 University of Colorado, 11, 101, 119-120, 121 University of Denver, 361 University of Illinois at Chicago, 294, 326 University of Maryland, 361 University of Massachusetts at Amherst, 361 University of Michigan affirmative action lawsuits, 3, 24-25, 29, 145, 147-148, 240-241, 255, 326-328, 345, 379-380 diversity and learning outcomes, 151-152 faculty recruitment strategies, 157 multicultural audit, 154 Program on Intergroup Relations, 360, 361 University of Minnesota, 374 University of Nebraska Medical Center, 162 University of New Mexico, 325-326 University of North Carolina at Chapel Hill, 286 University of Puerto Rico School of Medicine, 43 University of Texas, 72-73, 157, 240, 294 University of Washington, 294 U.S. Army, Alpha and Beta tests, 57 U.S. Bureau of the Census, 300, 305 U.S. Department of Defense, discretionary funds for financial aid, 274, 280-281, 289-291, 301-302, 307 U.S. Department of Education, accreditation role, 2, 11, 12-13, 127-128, 129, 130, 131, 133, 138-141, 319-320, 322, 344 U.S. Department of Health and Human Services definition of underrepresented minority, 242-243, 273 n.1 discretionary funds for financial aid, 274, 255, 275-289, 299-300 evaluation of effectiveness of initiatives, 299-300, 304-305 nondiscretionary funds for financial aid, 114, 274 Office of Assistant Secretary for Planning and Evaluation, 299, 305 Office of Inspector General, 284-285 Office of Public Health and Science, 305 Office of Research, Development, and Information, 305 Office of the Secretary, 305 Race and Health initiative, 234 U.S. Department of Homeland Security, 304 U.S. Department of Veterans Affairs, 274, 280-281, 291-292, 301-302, 305, 307 U.S. General Accounting Office, 116-117, 300, 310 U.S. Medical Licensing Exam, 61, 245-246, 258, 370 U.S. News & World Report, college rankings, 59 U.S. Office of Management and Budget, 300 U.S. Surgeon General, 37, 234, 251 Utah, 294, 296, 297, 298 tax status of health care organizations, 16, 180, 182-183, 184, 186, 188 V Vanderbilt University, 101, 163 Voluntary Hospitals of America, 190 W Warm Spring Reservation (Oregon), 31 Washington Business Group on Health, 207-208 Washington state college admissions policies, 241, 327 financial aid programs, 294, 296 Initiative 200, 4, 24, 240 Washington State University, 162 West Virginia, 183, 294, 296 White House Hispanic Agenda for Action Initiative, 282 Williams, Daniel Hale, 37 Wisconsin, 294, 296 W.K. Kellogg Foundation, 4, 11, 25, 112, 114, 189, 207, 209, 309 World Health Organization, 192, 324 World War I, 57 World War II, 57

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In The Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Workforce Y Yale University, PACE Center, 62 Z Zlotlow, Susan, 135, 137