AFFIRMATIVE ACTION: NEW POLICIES MAY IMPACT UNDERSERVED
The recent movement to roll back affirmative action policiesThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
in American universities threatens the health of low-income and
minority people because they are served disproportionately by
minority and female physicians, according to a study published
today in INQUIRY, the journal of the Blue Cross and Blue Shield
Association. The study follows the U.S. Supreme Court's recent
refusal to hear an appeal of a Texas ruling that prevents public
universities from taking race into account when making admissions
decisions. In addition, the University of California has
implemented a policy that limits affirmative action in student
selection, including medical school admission. "The impact of
ethnic and racial diversity extends far beyond the campuses of
those schools that embrace it," according to the research team,
which was led by Joel Cantor of the United Hospital Fund of New
York. "Limiting or ending affirmative action programs will hurt
poor and minority people who are already underserved by this
country's health system," the researchers said.
STUDYING SERVICE: The Robert Wood Johnson Foundation-funded
study, "Physician Service to the Underserved: Implications for
Affirmative Action in Medical Education," was based on data from
the 1987 and 1991 Robert Wood Johnson Foundation Surveys of Young
Physicians. The surveys examined the practice patterns of
physicians under the age of 45. The study found that minority
patients receive the highest level of service from young
physicians of the same race or ethnicity, regardless of the
physician's sex. Approximately half the patients of black and
Hispanic physicians were minorities, compared to one-quarter for
white physicians. The study also found that young black and
Hispanic women physicians provide the greatest amount of care for
low-income and Medicaid patients (RWJF release, 7/29).
MONEY MATTERS: The economic background of physicians also
plays a role in the patient population they serve, but it is not
as important as race. The study found that physicians from
"disadvantaged backgrounds" served more underserved patients than
those from wealthier backgrounds. Medicaid recipients accounted
for 24.6% of black doctors' income, compared to 18.1% for
physicians whose parents didn't complete high school and 20.1%
for "doctors who said they were raised in lower-class families."
According to Cantor, the data "support race-based affirmative
action as opposed to programs organized around economic
disadvantage" (Madden, USA TODAY, 7/29).
UNINTENDED IMPACT: The authors conclude that moves to limit
affirmative action policies in medical schools "may undermine
access to care for underserved populations" (Cantor, et al,
INQUIRY, Summer 1996 issue). "Policymakers need to recognize
that affirmative action in medical schools is also an effective
tool for helping people in vulnerable groups get access to timely
and appropriate care. Let's not make the problem worse" (RWJF
release, 7/29).