About the Health Workforce Diversity Tracker
The Health Workforce Diversity Tracker provides a unique view into how the racial/ethnic diversity of the workforce in 10 key health professions varies across states. Despite recent focus on this issue, little information is available on how representation in the health professions differs across the country. This tool is intended to help people working in health education and policy understand which professions have the greatest gaps in their region.
The “New Graduates” tab provides data on the representation of Black, Hispanic, and White populations among people who graduated with health profession degrees from 2017 through 2019, an indication of the likely diversity of the future workforce. This data is from The Integrated Post-Secondary Educational Data System (IPEDS) from the National Center for Education Statistics.
The “Current Workforce” view provides data on the representation of Black and Hispanic populations among those working as health professionals today. This data is based on Mullan Institute’s analysis of 2010-2019 data from the American Community Survey, obtained from IPUMS USA (University of Minnesota).
The map displays how the Diversity Index, which is a measure of the diversity of the health profession compared to the diversity of the benchmark population, varies widely across state for all professions. For example, for Black registered nurses, the Diversity Index for the Current Workforce ranges from a low of 0.25 (Iowa), indicating severe underrepresentation, to 1.33 (New York), indicating moderate overrepresentation. Details on how the Diversity Index is calculated is available in the Methodological Appendix.
The “New Graduates” tab provides data on the representation of Black, Hispanic, and White populations among people who graduated with health profession degrees from 2017 through 2019, an indication of the likely diversity of the future workforce. This data is from The Integrated Post-Secondary Educational Data System (IPEDS) from the National Center for Education Statistics.
The “Current Workforce” view provides data on the representation of Black and Hispanic populations among those working as health professionals today. This data is based on Mullan Institute’s analysis of 2010-2019 data from the American Community Survey, obtained from IPUMS USA (University of Minnesota).
The map displays how the Diversity Index, which is a measure of the diversity of the health profession compared to the diversity of the benchmark population, varies widely across state for all professions. For example, for Black registered nurses, the Diversity Index for the Current Workforce ranges from a low of 0.25 (Iowa), indicating severe underrepresentation, to 1.33 (New York), indicating moderate overrepresentation. Details on how the Diversity Index is calculated is available in the Methodological Appendix.
workforce study of hematology physicians
The purpose of this study is to describe the trends impacting the current hematology physician workforce, with a particular focus on identifying those practicing benign hematology. Using surveys and focus groups, GW is:
Funder: The American Society of Hematologists
HWI Members: Clese Erikson, Leah Masselink
- Examining specialty choice and career influences that lead hematology/oncology fellows to pursue a career in hematology and how interest in a career in hematology changes over time.
- Assessing the current job market for new hematologists.
- Identifing key factors likely to impact future supply and demand for hematologists.
Funder: The American Society of Hematologists
HWI Members: Clese Erikson, Leah Masselink
social mission IN nursing education
The Mullan Institute is engaged in a multi-year study assessing the social mission in nursing education, aided by an Advisory Committee of leaders in the field of nursing education.
In phase two of this study, we are looking deeper into nursing education to identify programs and people who have played prominent roles in promoting social mission values. We will continue to draw on our National Advisory Committee for guidance on topics, people, and places and as participants in some data gathering and analysis.
The value of this exercise is the specification of nursing education programs that are models of social mission classroom and clinical learning. These insights will provide examples of how social mission concepts can be enhanced in planning and implementing nursing education. Case studies will bring evidence-based and example-specific authority to the discussion about social mission in nursing education today, providing nurse educators with valuable insight into the preparation their students to be active participants in the effort to build a culture of health. Learn more...
Funders: The Robert Wood Johnson Foundation
Institute Members: Patricia Pittman, Ashley Darcy-Mahoney, Edward Salsberg
In phase two of this study, we are looking deeper into nursing education to identify programs and people who have played prominent roles in promoting social mission values. We will continue to draw on our National Advisory Committee for guidance on topics, people, and places and as participants in some data gathering and analysis.
The value of this exercise is the specification of nursing education programs that are models of social mission classroom and clinical learning. These insights will provide examples of how social mission concepts can be enhanced in planning and implementing nursing education. Case studies will bring evidence-based and example-specific authority to the discussion about social mission in nursing education today, providing nurse educators with valuable insight into the preparation their students to be active participants in the effort to build a culture of health. Learn more...
Funders: The Robert Wood Johnson Foundation
Institute Members: Patricia Pittman, Ashley Darcy-Mahoney, Edward Salsberg
Study of the Supply, Demand, and Use of Emergency Physicians
Background
Over the past 30+ years, the number of physicians training in accredited emergency medicine residency programs has steadily increased. In the past 10 years alone, the number of residents entering ACGME accredited emergency medicine programs increased from 1,568 (AY 2008-09) to 2,412 (AY 2017-18), an increase of 54%. After 30 years of growth in residency training positions, the overall supply of formally trained emergency medicine (EM) physicians has risen significantly. This has helped staff the nation’s emergency departments (EDs) as the population has grown and the use of the emergency department has risen.
With the sharp growth in both the supply of EM physicians and the numbers being trained annually, concerns are beginning to emerge regarding the possibility of a surplus of EM physicians in the future. In addition, the increasing supply of PAs and NPs, the development and expanded use of telemedicine, the implementation of programs designed to discourage hospital and ED use, and changes in financing and organization of services add to this concern.
The Mullan Institute was selected by the American College of Emergency Physicians (ACEP) to undertake a 2-year study of the factors driving the supply, demand and use of emergency medicine physicians and to assess whether the future supply will be in balance with the likely demand for emergency physicians.
Over the past 30+ years, the number of physicians training in accredited emergency medicine residency programs has steadily increased. In the past 10 years alone, the number of residents entering ACGME accredited emergency medicine programs increased from 1,568 (AY 2008-09) to 2,412 (AY 2017-18), an increase of 54%. After 30 years of growth in residency training positions, the overall supply of formally trained emergency medicine (EM) physicians has risen significantly. This has helped staff the nation’s emergency departments (EDs) as the population has grown and the use of the emergency department has risen.
With the sharp growth in both the supply of EM physicians and the numbers being trained annually, concerns are beginning to emerge regarding the possibility of a surplus of EM physicians in the future. In addition, the increasing supply of PAs and NPs, the development and expanded use of telemedicine, the implementation of programs designed to discourage hospital and ED use, and changes in financing and organization of services add to this concern.
The Mullan Institute was selected by the American College of Emergency Physicians (ACEP) to undertake a 2-year study of the factors driving the supply, demand and use of emergency medicine physicians and to assess whether the future supply will be in balance with the likely demand for emergency physicians.
Methodology
- A review of literature;
- A review of existing sources of data on supply, such as from the ACGME, NRMP, and AMA data, and data on demand/use, such as from HCUP and NHAMCS surveys;
- Analysis of Medicare Public Use Files for ED claims data;
- A Survey of physicians completing EM training in 2019; and
- Focus groups and interviews.
Deliverables
- Report on Survey of Physicians Completing Emergency Medicine Training in 2019;
- Report on Analysis of Medicare Public Use File; and
- A final report projecting supply and demand for EM physicians.
Funder: American College of Emergency Physicians
Institute Member: Edward Salsberg, Clese Erikson, Leo Quigley
Institute Member: Edward Salsberg, Clese Erikson, Leo Quigley
Study of the Social work workforce
Social workers play a significant role in providing social services to populations in need impacting on their health and well-being. As one of the largest professions in the health and social services sectors, social workers work in a wide range of settings from schools, to child welfare agencies to hospitals to mental health agencies. Yet despite the size of the profession and its contribution to society, our knowledge of the social work workforce is remarkably limited.
In recognition of the need for and importance of better data, in 2017 organizations representing the social work profession led by the Council on Social Work Education (CSWE) and the National Association of Social Workers (NASW), came together to form the National Workforce Initiative Steering Committee to initiate and guide this study of the social work workforce. Following a competitive process, the Mullan Institute was selected to conduct the study. The goals of the study include:
A major component of the study is a survey of a sample of graduates of social work degree programs. This survey was conducted in 2017, 2018 and 2019. The survey includes questions on demographic and educational background, jobs being entered by new social workers, their experience in the job market and their satisfaction with the profession. An annual report presents key findings from the survey. In addition, a series of briefs have been published including on variations by type of education, variations by race/ethnicity, demand for new social workers by a variety of factors and an analysis of social workers providing behavioral health and substance abuse services. Individual program level reports comparing respondents from an individual school to other new social workers was prepared for more than 25 social work programs.
A final report on the 2019 survey with recommendations for ongoing data collection on the social work workforce will be completed in the fall of 2019.
In recognition of the need for and importance of better data, in 2017 organizations representing the social work profession led by the Council on Social Work Education (CSWE) and the National Association of Social Workers (NASW), came together to form the National Workforce Initiative Steering Committee to initiate and guide this study of the social work workforce. Following a competitive process, the Mullan Institute was selected to conduct the study. The goals of the study include:
- informing the social work community about the supply, demand, distribution, and use of social workers
- developing a plan for ongoing data collection and analysis.
A major component of the study is a survey of a sample of graduates of social work degree programs. This survey was conducted in 2017, 2018 and 2019. The survey includes questions on demographic and educational background, jobs being entered by new social workers, their experience in the job market and their satisfaction with the profession. An annual report presents key findings from the survey. In addition, a series of briefs have been published including on variations by type of education, variations by race/ethnicity, demand for new social workers by a variety of factors and an analysis of social workers providing behavioral health and substance abuse services. Individual program level reports comparing respondents from an individual school to other new social workers was prepared for more than 25 social work programs.
A final report on the 2019 survey with recommendations for ongoing data collection on the social work workforce will be completed in the fall of 2019.
Funder: Council on Social Work Education
Institute Member: Edward Salsberg, Leo Quigley , Chelsea Richwine
Institute Member: Edward Salsberg, Leo Quigley , Chelsea Richwine
Nephrology Workforce Studies
Using a variety of data sources, including some original data collection, this project is assessing trends and factors influencing supply, demand, need, distribution and use of nephrologists. Among the factors being studied are the changing delivery and financing systems and population health needs. The goal of the project is to provide the specialty with information to promote a supply and distribution of nephrologists to assure access to high quality kidney care.
Funder: The American Society of Nephrology
Institute Member: Edward Salsberg
Funder: The American Society of Nephrology
Institute Member: Edward Salsberg
Council on Social Work Education
The purpose of this project is to assist the social work profession to better understand the size and scope of the workforce and to help improve the data infrastructure within the profession. A survey of 1,400 individuals graduating from social work programs was completed in 2017.
Funder: Council on Social Work Education
Institute Member: Edward Salsberg
Funder: Council on Social Work Education
Institute Member: Edward Salsberg
Additional Research
Caring For Our Own network
A greater appreciation of social determinants of health has led to increasing emphasis on advocacy and activism in health professional curricula around the world. However, the actual experiences of students who advocate on behalf of their peers, patients and communities are often not recognized as learning opportunities. In many cases, students have been targeted for speaking out, at a time that they are particularly vulnerable to unfair assessment and sabotaged professional advancement. The Caring For Our Own network is a transnational network nested within the Social Medicine Consortium that promotes democratic culture within health professional education and provides vulnerable student-advocates a means of extra-institutional support and solidarity.
Funder: N/A
Institute Member: Lalit Narayan
Funder: N/A
Institute Member: Lalit Narayan
EVALUATION OF BALTIMORE ALLIANCE FOR CAREERS IN HEALTHCARE (BACH) COACHING PROGRAM
BACH offers free employment coaching to entry level health workers earning less than $14 per hour working for seven Baltimore area hospitals. The researchers will compare outcomes such as job turnover, promotions, and further education for those who enroll in the coaching program compared to a matched sample of eligible employees who elected not to receive coaching services. The project will also include developing a model that shows how employee characteristics affect the probability of receiving coaching.
Funder: The Baltimore Workforce Funders Collaborative; PI: Burt Barnow
Funder: The Baltimore Workforce Funders Collaborative; PI: Burt Barnow
GW-DC Health Professions Pipeline Program
This initiative targets D.C.-area students interested in health care, health equity, and careers in the health sciences for mentorship and educational development led by the Mullan Institute team and the SMHS Office of Diversity and Inclusion.
Funder: Atlantic Philanthropies
HWI Members: Sonal Batra, Fitzhugh Mullan, Julie Orban
Funder: Atlantic Philanthropies
HWI Members: Sonal Batra, Fitzhugh Mullan, Julie Orban
Impact of Health Care Delivery System Innovations and Reform
Researchers will will examine policy-relevant health care delivery system innovations and reforms and their impacts on practitioners and the patients for whom they care. Analyses include an examination of the supervision of advanced practice clinicians (e.g., nurse practitioners, physician assistants) in office-based settings in the United States, a comparison of primary care physicians in certified patient-centered medical home (PCMH) practices to those in non-PCMH practices, and a comparison of the tasks performed by various primary care practitioners (physicians, physician assistants, and nurse practitioners) using data from the National Ambulatory Medical Care Survey (NAMCS).
Funder: National Center for Health Statistics
Institute Member: Ellen Kurtzman
Funder: National Center for Health Statistics
Institute Member: Ellen Kurtzman
language diversity and language barriers in Indian medical education
Medical education in India is in English but medical trainees and physicians interact with patients in over 122 languages. Little is known about language diversity among medical students, language barriers to academic success and patient care and strategies employed to overcome them. This pilot survey aims to create an snapshot of the language ecology at a single institution in Bangalore, India as a prelude to multi-site surveys of the Indian health professional training system.
Funder: N/A
Institute Members: Seble Frehywot, Lalit Narayan
Funder: N/A
Institute Members: Seble Frehywot, Lalit Narayan
National Partnership for the Safety Net: Convening Stakeholders to Inform, Implement, and Influence Health Policy
Researchers will conduct case studies of value-based payment collaborations between safety net hospitals and community health centers.
Funder: Kaiser Permanente
Institute Member: Leah Masselink
Funder: Kaiser Permanente
Institute Member: Leah Masselink
The Clinical Conversation Project
The Clinical Conversation Project uses design thinking to develop, implement and evaluate solutions to better prepare medical students to work with multi-lingual clinical populations. In the first phase, we are focusing on the creation of clinical phrasebooks and a pre-clinical language skills course for students at St. John's Medical College, Bangalore.
Funder: N/A
HWI Member: Lalit Narayan
Funder: N/A
HWI Member: Lalit Narayan
UK Faculty of Physician Associates Annual Census
The FPA Annual Census is a longitudinal cohort study of the all the Physician Associates (same as "Physician Assistants" in the US) in the United Kingdom. Since 2011, each PA and PA student has been surveyed annually regarding academic and clinical background, specialty of practice, scope of practice, job satisfaction and other factors influencing PA practice in the UK. The design of this cohort study allows each individual to be tracked over the years through a unique ID, which allows us to see individual-level changes in scope of practice over time.
Funder: N/A
Institute Member: Tamara Ritsema
Funder: N/A
Institute Member: Tamara Ritsema
Healthcare is a major economic force worldwide, and nations increasingly compete for the best and the brightest regardless of the country of education. In this country, the health care industry comprises one sixth of the U.S. economy and employs more workers than any other sector. As we emerge from a major economic recession, health care jobs have continued to grow at a faster pace than jobs in other industries.
Despite the importance of the healthcare workforce, both in the U.S. and abroad, there is a significant governance gap in the development and management of this sector. Health workforce planning and policymaking have a notoriously weak evidence base, and local, state, and national policies remain uncoordinated. Moreover, the phenomenon of professional self-regulation and the power that professional associations yield in the policy sphere further exacerbate the challenge of assessing and addressing the social effectiveness of our health care education, organization, and financing policies.
Despite the importance of the healthcare workforce, both in the U.S. and abroad, there is a significant governance gap in the development and management of this sector. Health workforce planning and policymaking have a notoriously weak evidence base, and local, state, and national policies remain uncoordinated. Moreover, the phenomenon of professional self-regulation and the power that professional associations yield in the policy sphere further exacerbate the challenge of assessing and addressing the social effectiveness of our health care education, organization, and financing policies.
Our goal is to advance health workforce equity by having a health workforce that addresses social justice by:
- Ensuring specialty distribution;
- Ensuring geographic distribution, including rural, urban, and underserved;
- Providing service in decentralized settings, including homes and communities;
- Being prepared to practice in interdisciplinary teams that focus on the whole person, family, and communities;
- Coordinating care and aligning resources; and
- Being diverse and inclusive
The Mullan Institute hosts nationally renowned speakers that help shape and influence national health workforce policy discussions. Speaker presentations provide important networking opportunities between students and faculty within the School of Public Health, with faculty from in other GW schools, and with leaders from other academic centers and foundations. View Archived Presentations
NEPHROLOGY WORKFORCE STUDIES
Using a variety of data sources, including some original data collection, this project is assessing trends and factors influencing supply, demand, need, distribution and use of nephrologists. Among the factors being studied are the changing delivery and financing systems and population health needs. The goal of the project is to provide the specialty with information to promote a supply and distribution of nephrologists to assure access to high quality kidney care.
Funder: The American Society of Nephrology
Institute Member: Edward Salsberg
Using a variety of data sources, including some original data collection, this project is assessing trends and factors influencing supply, demand, need, distribution and use of nephrologists. Among the factors being studied are the changing delivery and financing systems and population health needs. The goal of the project is to provide the specialty with information to promote a supply and distribution of nephrologists to assure access to high quality kidney care.
Funder: The American Society of Nephrology
Institute Member: Edward Salsberg
The Social Mission Faculty Fellowship is a new and unique opportunity offered through the Health Policy & Social Mission Collaboration between Kaiser Permanente and the George Washington University. It aims to provide emerging physician-leaders with skills and mentorship to produce an action research project, as well as to provide opportunities to develop leadership skills and to engage in a network of learning.
The Residency Elective in Health Policy (REHP) is a unique opportunity offered through Kaiser Permanente. The goals of the REHP are to orient residents and fellows to the fast changing world of health policy, increase their knowledge of key health policy issues facing their community and the nation, and prepare them to be effective physician-leaders in systems-based practice.
EVALUATION AND INITIAL ASSESSMENT OF THE HRSA TEACHING HEALTH CENTERS GRADUATE MEDICAL EDUCATION PROGRAM
This project's goal is to better understand the model of community-based residency training and the costs of GME training in teaching health centers, and to initiate a longitudinal evaluation of teaching health centers’ contributions to the primary care workforce, particularly in underserved communities. GW will:
Funder: Health Resources and Services Administration (HRSA)
Institute Member: Fitzhugh Mullan
- Build a landscape of teaching health centers’ characteristics, costs associated with training, and curricula through site visits and a systematic review of materials.
- Develop an estimate of costs of GME training in teaching health centers, including direct and indirect costs.
- Survey residents and establish a longitudinal evaluation of the teaching health centers’ production of primary care workforce including practice settings, communities served, geographic distribution of graduates, and the unique contributions of the teaching health center training experience.
Funder: Health Resources and Services Administration (HRSA)
Institute Member: Fitzhugh Mullan