UC Hosts Urban Universities for Health Collaborative Learning Session

CINCINNATI—Increasing the number of minorities trained for careers in nursing, medicine, pharmacy and allied health sciences in the Tristate is an important component in improving the health outcomes for marginalized residents in Greater Cincinnati.

That was among the key messages delivered at the Urban Universities for Health (UUH) learning collaborative meeting held Oct. 5-6, 2015, in UC’s Tangemen University Center.

UC is one of five universities nationally participating in UUH, a national academic learning collaborative focused on investigating approaches to health care workforce development that lead to improved health outcomes and reduce disparities in local communities. UC received a four-year $400,000 grant in 2012 from UUH to advance work in this area.

For UC, boosting diversity in the health care industry will mean enhanced efforts to recruit and retain minority students in the Colleges of Nursing, Medicine, Pharmacy and Allied Health Sciences.

"The University of Cincinnati will work in collaboration with community stakeholders to develop a health workforce that not only facilitates access to health care, but enhances the opportunity for optimal health by increasing the number of providers who reflect the demographics in our community,” says Karen Bankston, PhD, associate dean for clinical practice, partnership and community engagement in the College of Nursing.

In 2012, minority representation for the Academic Health Center was at 8 percent of all students, but the goal by 2019 is to boost that number in the College of Allied Health Sciences from 8 percent to 12 percent and in the College of Medicine from 9.4 percent to 12.5 percent. In the College of Nursing, the goal is to boost minority enrollment from 8.4 percent in 2012 to 12 percent in 2019, while in the James L. Winkle College of Pharmacy, officials hope to see numbers increase from 5.5 percent in 2012 to 11 percent by 2019.

Nursing Dean Greer Glazer, PhD, has cited a 2002 Institute of Medicine report titled "Unequal Treatment” which documented the direct link between a shortage of underrepresented health care providers and poorer health outcomes for diverse patients. She says studies have shown that patients prefer to see health care providers of similar race and ethnicity to themselves.

"We hope to produce students who are culturally competent to ensure our local health care workforce has the background, qualities and skills to serve residents in the Tristate and decrease health disparities,” says Glazer. "This work is critical to being able to diversity the health care workforce and great strides are being made on that front.”

Partnerships and Pipeline Programs ‘Serve as National Model’

In the Tristate, our health care system partners, are making a commitment to support and sustain diversity in the health work force to address health disparities by transparently reporting work force data, says Tammy Mentzel, project manager and regional associate for the Urban Universities Health Project at the College of Nursing. 

Some partners such as UC Health, have also committed to providing scholarships to the UC Academic Health Center to increase the number of underrepresented students entering health care professionals, starting with the matriculating class of 2016, says Mentzel.

"This partnership will serve as a national model for other communities starting down this road,” says Barbara Tobias, MD, Robert and Myfanwy Smith Professor in the Department of Family and Community Medicine at UC. "Hosting the national UUHealth meeting created an historic opportunity for our regional health care systems, our largest health care employers, to publicly commit to collectively supporting educational pipeline, scholarship and health care work force transparency initiatives.”

UC President Santa Ono, PhD, Glazer, Senior Vice President for Health Affairs and COM Dean William Ball, MD, former Ohio State Sen. Eric Kearney and Cincinnati first lady Dena Cranley addressed attendees during the meeting.

Attendees also learned that UC has several pipeline programs and diversity initiatives underway to further its goal of creating a diverse health care workforce in the Tristate. Some of those include:

• UC Summer Bridge Program is a residential intensive program which brings incoming freshman to campus for seven weeks to study sessions covering biology, physics, pre-calculus, calculus, chemistry and English. It’s designed to boost the number of underrepresented students exploring science, technology, engineering and math and medicine (STEMM) disciplines in the Colleges of Engineering and Applied Science, Allied Health Sciences and the McMicken College of Arts & Sciences. 
• UC recently started a summer bridge program with Hughes STEM High School in Cincinnati that will also include year round support to students at Hughes. UC President Santa Ono announced the initiative during the White House Summit on College Attainment. Leadership 2.0 is a workforce diversity initiative that supports underrepresented students applying to the College of Nursing’s traditional BSN program. 
• Leadership 2.0 is a highly competitive, two-year program that provides holistic support through a student’s sophomore year. The U.S. Department of Health and Human Services’ Health Resources and Services Administration provided a $1 million three-year grant in 2012 to support this effort. The College of Nursing also has a partnership with Cincinnati State Technical and Community College known as Cincinnati Pathways to offer a seamless transition from RN programs to BSN programs at UC. 
• The College of Nursing was recently also awarded a $2.5 million grant from the Office of Minority Health in the U.S. Department of Health and Human Services to boost diversity in health care through the Pathways for Emerging Healthcare Leaders Program.
• The James L. Winkle College of Pharmacy has hired a chief diversity officer tasked with developing inclusive practices for not only students, but also for the patients the students serve. The chief diversity officer will work to diversify their students and faculty.  The chief diversity officer will recruit students of color at college diversity fairs, colleges, and high schools. In collaboration with UC, the College of Pharmacy is developing a pipeline program with Hughes STEM High School. 
• The College of Allied Health Sciences has developed a pre-allied health sciences program open to freshmen that is tailored to provide academic coaching sessions and tutoring for students along with faculty mentoring. The college also offers a college-level medical terminology class to seniors at Hughes STEM High School to offer students a "jump start” to their college careers and to encourage their matriculation at the University of Cincinnati. CAHS Faculty and students offer power lunches at Hughes STEM to provide early introduction into the allied health sciences disciplines.
• The College of Medicine’s Office of Diversity and Inclusion visits several recruitment fairs during the year including those sponsored by the Association of American Medical Colleges (AAMC) and the Student National Medical Association to attract students of color. 
• Various scholarships including the Peter and Sandy Stern Diversity Scholarship, the Marilyn Hughes Gaston Scholarship and the Lucy Oxley Scholarship, named after the first black woman to graduate from the College of Medicine, are offered to underrepresented minority students entering medical school at UC to improve diversity in the medical field.
• The Med Mentors program in the College of Medicine recruits first- and second-year medical students to provide multiple years of mentorship for elementary students in Cincinnati Public Schools. Among the program’s goals is to encourage students to think early about careers in health care. The UC chapter of the Student National Medical Association also mentors school age children, many from communities of color, in hopes to encouraging their interest in the health care professions.

Role Models Needed, Disparities Continue

"One of the largest hurdles facing many minority students is the lack of exposure many have to role models in careers in health sciences. They also lack the preparation to be successful in sciences courses in college,” says Mia Mallory, MD, associate dean in the Office of Diversity and Inclusion in the College of Medicine. "This is especially the case for young black males.”

Mallory cites a recent study from the AAMC which shows that despite an overall increase in the number of black male college graduates during the past three decades the number of black males applying to medical school has dropped to 1,337 in 2014 from 1,410 in 1978.  

The AAMC study noted that a similar trend is observed among black students graduating from medical school. In 1978, there were 542 black males graduating from medical school while in 2014 the number had dropped to 515.

"Anthropologists tell us that there is no biological basis for race. However, we still have health disparities based on race,” says Nicole Avant, Pharm D, chief diversity officer at the James L. Winkle College of Pharmacy.

These differences are seen across a wide range of health conditions partly due to discrimination in access to quality health care, employment, finance, housing and education, explains Avant. 

Data demonstrates that these health disparities can be mitigated with a diverse health workforce. People of color account for around half of Cincinnati’s population, but their representation among our student body, faculty and staff in the College of Pharmacy is much smaller and really must be improved if we want to assist in improving health outcomes, says Avant.

Sean Rugless, president and CEO of the Greater Cincinnati and Northern Kentucky African American Chamber of Commerce, offered a keynote address at the UUH meeting in which he asked for a sense of urgency in closing racial disparities that have actually grown wider in some areas between white and African-American residents during the past 50 years.

That comes despite some real gains across the nation and in Cincinnati, which has enjoyed a revitalization in recent years.

In the workforce, black unemployment nationally according to the Economic Policy Institute (EPI) has remained twice that of whites during the past 50 years, while the wealth disparity has grown even wider during the Great Recession, says Rugless. The Urban Institute reported that from 1983 to 2010, average family wealth for whites was about six times that of blacks and Hispanics and that the rift worsened in the Great Recession.

Rugless cited an EPI study that says schools are more segregated than in 1980 and the Pew Research Center, which found that incarceration rates for black men are now six times higher than those of white men, slightly larger than the gap in 1960. He said health care is another area where African Americans consistently lag behind the general population.

Cradle Cincinnati has reported that the Hamilton County infant mortality rate ranks among the worst 10 percent in the nation. For African-Americans, the likelihood of losing a child is 2.7 times more than white or Hispanic households, reports Cradle Cincinnati.

Rugless says health care is an area that needs addressing because it is also an economic engine that provides jobs to the region. In 2012, the economic impact of health care in our area was $17.5 billion, according to a report from the Greater Cincinnati Health Council.

"While we have huge amounts of success and a significant amount of momentum we still have a lot of work to do,” says Rugless. "We have to talk about the fierce urgency of now.”