Study Warns of Less Health Care for Minorities
Anti-affirmative action measures would deplete the number of California’s African American and Latino primary care physicians, many of whom already are overburdened with minority patient loads, researchers at UC San Francisco say in a study published today.
“Dismantling affirmative action programs, as is currently proposed, may threaten health care for both poor people and members of minority groups,” concludes the study, which is being published today in the New England Journal of Medicine.
The study is sure to provide fodder to opponents of the anti-affirmative action initiative that has qualified for the November ballot. Initiative sponsors withheld comment, saying they wanted to wait until they read the study.
It is “impossible to predict” what effect a scaling back of affirmative action programs would have, the study said, but researchers have credited such programs with significantly increasing the number of historically underrepresented minority physicians.
The study reports that 52% of the patients seen in African American practices are black. By contrast, only 9% of the patients are black in non-African American practices, the researchers said.
Among Latino physicians, 54% of the patients are Latino, but only 20% of the patients are Latino in non-Latino practices.
Researchers, using U.S. census data of primary care physician records provided by the American Medical Assn., also reported that black doctors practiced in areas where the percentage of black residents was nearly five times as high as in areas where other physicians practiced. Latino physicians practiced in areas where the percentage of Latino patients was twice as high as other areas.
Communities with high proportions of black and Latino residents were four times as likely as other communities to have a shortage of physicians, the study said.
The study also found that African American physicians care for significantly more Medi-Cal patients than other physicians and that Latino doctors care for more uninsured patients.
“We found that black and Hispanic doctors are playing an enormously important role in providing care to these underserved communities,” said Dr. Miriam Komaromy, an assistant professor of medicine at UC San Francisco and chief author of the study. “If we limit or decrease the number of black and Hispanic doctors in the work force, then we are likely to worsen the health care and the health of the neediest populations in the state.”
Efforts are underway on state and national political fronts to undo affirmative action programs.
In California, the UC Board of Regents has voted to disband affirmative action programs, but implementation of the new policy has been delayed until next year.
In March, the anti-affirmative action initiative qualified for the November ballot, and the campaign to pass it is highly organized.
The efforts to dismantle affirmative action programs come at a time when extraordinary efforts are being made to train and license physicians from underrepresented minority groups.
African Americans made up 12% of the U.S. population in 1990 but only 4% of the physicians, according to the UC San Francisco study. Latinos represented 9% of the population and 5% of the doctors.
Though those percentages are low, they represent a significant improvement since the late 1960s and early 1970s, when affirmative action programs began.
The Assn. of American Medical Colleges is sponsoring a special project to increase from 1,600 to 3,000 the number of underrepresented minority students entering U.S. medical schools by 2000.
Programs are underway in Los Angeles to get African American and Latino and Latina students interested in medical careers as early as grammar school. The Charles R. Drew School of Medicine in Los Angeles, which opened in 1969 and now is one of four black-run medical schools, sponsors a medical magnet high school and grammar school programs designed to encourage students to think about careers in medicine.
