Executive Summary

California is experiencing compounding public health crises. The health professional shortage and the COVID-19 pandemic have left the state physically and financially distressed, without the health workforce needed to care for it. Decision-makers must take bold action to meet this need in a manner that is equitable and honors California’s rich diversity. Programs that assist youth of color in accessing health careers can play a major role.

Together with the Alameda County Health Pathway Partnership, The Greenlining Institute researched the effectiveness of health career pathway programs as a means of building a larger, more diverse health workforce. Alumni of Alameda County Health Pathway Partnership program, nearly all youth of color, were recruited to share their experiences navigating towards a career in health. From January to May of 2020, researchers used a focus group and a series of online surveys to capture participants’ stories. Through this research, Greenlining was able to identify major supportive factors and barriers for young people of color. From this, we developed a series of targeted recommendations that we believe will fortify the health workforce and ultimately, mitigate harm to the physical and economic health of California residents.

Background

While Black, Latino and Native American communities are projected to make up 62 percent of California’s population by 2030, only five percent of the state’s practicing physicians are Black and just 5.9 percent are Latino. This makes it difficult for large portions of the state’s population to receive culturally competent care, and represents a significant economic obstacle to these communities, as the health workforce offers a variety of well-paying, family-sustaining careers.

Report Findings

Participation in an ACHPP career pathway program increased the desire and confidence of youth of color to pursue a career in health.

Primary supportive factors:

  1. Exposure to different health careers and professionals built the skills and confidence of pathway alumni.
  2. Social support and mentorship were essential for first-generation and low-income youth.
  3. Financial assistance minimized the financial burden of choosing pathway opportunities over holding a current job.

Primary challenges included:

  1. Finances: Expenses associated with pathway programs, college applications and tuition were cost prohibitive without significant financial assistance.
  2. Transportation: Participants often engaged in riskier, less expensive transportation methods to travel the great distances from school, work or home to career pathway opportunities.
  3. Barriers to Higher Education: Participants shared anxiety about getting into, paying for and navigating higher education without support systems and experienced mentors from their communities.

Experiences of Young Women

Young women who participated in the focus groups and surveys shared negative experiences specific to their gender relating to safety, gendered stereotypes within the profession, familial expectations and mentorship.

Policy Recommendations

We propose four areas of policy implementation to build a more diverse and robust health workforce. Interwoven into each of these recommendations is the need for race, ethnicity and gender-specific initiatives that are accessible to undocumented populations. California needs a disproportionate and explicit investment in communities of color, as broader attempts to expand the health workforce have not provided sufficient resources to enable youth of color to enter the field in large numbers. Recognizing the financial scarcity brought on by the COVID-19 pandemic, we believe that these investments are a needed, equitable and efficient means of improving both health and economic outcomes in California.

  1. Pass Proposition 16. By repealing California’s 1996 ban on affirmative action, Prop. 16 would facilitate the sort of targeted programs California needs to diversify its health workforce.
  2. Increase financial support to individuals pursuing careers in health. At present, cost presents a nearly insurmountable obstacle for many youth of color.
  3. Increase funding for pipeline programs. A number of excellent programs exist, but they need to be scaled up and replicated.
  4. Expand higher education programs. California does not presently train enough health professionals to meet the state’s needs. Programs should be expanded, with targeted efforts to enroll underrepresented groups.