Terrance R. Eubanks, II, Tennessee State University
HBCUs and Healthcare-Related Degree Production
Historically Black Colleges and Universities (HBCUs) are paramount when it comes to educating African American students in the United States. Currently, there are 107 institutions that carry this historical designation which enrolls about 14 percent of all African American student nationwide. HBCUs were founded to meet the educational needs of African American students that were previously excluded from attending predominantly white institutions (PWIs). To this day, HBCUs are the lead degree givers of African Americans. They outpace PWI’s when it comes to retaining and graduating African American students, and a lesson can be taught to larger institutions on how they retain an underrepresented population on their campuses (Noonan, Lindong, & Jaitley, 2013).
HBCUs have been leaders in producing and leading African American students toward health professions. Out of the top ten undergraduate feeder institutions applying to medical school, three HBCUs—Spelman, Howard, and Xavier (LA)—are top producers of medical school aspirants. Many more HBCUs have joint B.S-M.D. programs that students can enroll in if eligible after their junior year. HBCUs have been known to have more nurturing environments that allow many students to matriculate without the worry of racial bias and discrimination by their peers. Advisors must recognize HBCUs as a catalyst for change and bastion of future health professionals that need to be cultivated and mentored (Thompson-Rogers, Davis, Davis-Maye, & Turner, 2018).
Minority Underrepresentation in the Health Care Workforce
Some may question the importance of HBCUs in the overall scheme of higher education, but the need is clear. Minorities fill a dire need when it comes to the shortage of health professionals in all areas of the profession. Currently, minorities make up 25% of the American population but only make up 10% of all healthcare personnel (Ralston, 2003). In 1996, there was a ratio of one dentist to every 1,700 people, but only one African American dentist for every 6,000 people. Currently, in the physical therapy field, only 2.7% of African American applicants are accepted by PTCAS (Physical Therapist Centralized Application Service) to move on to the candidacy stage of going to physical therapy school. Only 7% of all athletic trainers, 4.5% of nurses, and 4.7% of pharmacists were African American as of 2003 (Ralston, 2003). The occupational therapy field is overwhelmingly female and Caucasian. The only field in which African Americans outpaced national percentages was the area of public health. However, the total percentage in this area is low compared to the national population percentage of 12 percent of the total population (Tucker & Winsor, 2013).
It is estimated that by 2040, the majority of the American population will not be Caucasian, but Caucasians still make up an overwhelming majority of workers in the area of healthcare. On that note, there is a need for African Americans to become successful in the pursuit of a career in healthcare when historically people of color have been underrepresented in all primary health professions.
Major Choice, Persistence, and African American Students
When it comes to solving the minority representation chasm in the healthcare field, there is an important correlation between major choice and racial groups. For example, Caucasian students are more likely to choose majors in the area of science, technology, engineering, and math. On the other hand, African American students are more likely to major in social sciences, business, or declare an undecided major. When it comes to majoring in healthcare-related majors, more Caucasian students persist to graduation, while African American students do not persist in as high of numbers. As many students consider financial implications of their major, they may be deterred from considering a career that requires an additional 2–4 years of schooling after receiving a baccalaureate degree and instead pursue a career with an immediate salary (St. John, Hu, Simmons, Carter, & Weber, 2004).
It is to be noted that the requirements to attain a career in healthcare may be more widely taken into consideration with Caucasian students than their counterparts of color. The Social Reproduction Theory can explain this gap in the diversity of healthcare workers; it suggests that students with high cultural competence have clear ideas about what it takes to remain and graduate from college. These same students know what career fields will maintain their social capital post-graduation. In urban schools, the exposure that students have to high achieving and high-quality postsecondary schools is very limited. Also, it is notable that African American students have a significantly lower percentage of A or B averages than their white counterparts. As an effect, more of these students have averages in the C or below range, a range that would disqualify them from even being considered for admission to professional healthcare-related programs. This gap in achieving an appropriate grade point average (GPA) could be that many students of color are not aware of the rigorous standards that many post-baccalaureate programs require before choosing a major.
The Color Gap: How HBCUs Can Bridge Access for Underrepresented Students
The nurturing environment that HBCUs have is conducive for the achievement of African American students. On top of that, there are several things that advisors at these institutions can do to affect diversity in the health care field.
Set expectations early. Show the student the qualifications for their school type of choice in the first advising appointment. More often than not, students may come to college knowing what they want to do, but the requirements are unclear. Underrepresented populations may lack access to high achieving professionals, so the advisor must lay the groundwork early when it comes to GPA requirements, courses needed, and other factors that graduate schools look for in admissions. Many HBCUs receive grants and have partnerships in place so students can receive assistance with entrance test exams and prep courses.
Gather interests and encourage research on their career ambition. Sometimes, students are interested in the area of healthcare but do not know exactly where they would fit in. It is important to help students plan for a curriculum that is consistent with their abilities and interests (Miller & Cohen, 2005). In an initial appointment, take the time to garner their interests and see where exactly they see themselves in the field. Many students do not realize that healthcare services are rendered in places outside of a hospital or clinic. These places include schools, institutions of higher education, insurance companies, government agencies, etc. In person care may not be up to a student’s alley, but working in the background influencing decisions may be their niche. After having such a meeting, it is imperative that the student performs their own research to see where they would see themselves and follow up with the advisor so that they can be advised and steered appropriately.
Encourage connection with academic departments. At many schools, advising may be centralized for first and maybe second-year students. With this, academic department personnel are important in backing up the foundation for future healthcare professionals. Students can be guided toward internships, scholarships, and many more opportunities that professional advisors may not be able to facilitate. In the STEM area, many companies collaborate with HBCUs to have a funnel of qualified African American applicants in fields where they are underrepresented. Many HBCUs have professional schools located on their campuses that allow the student to visit and talk to current students about their journey and what it takes to get to their ultimate career. This is important in recruiting and grooming.
Be honest in expectations and offer alternatives. There will always be students who aspire to work in healthcare but not necessarily make the needed grades and get discouraged. Advisors who work with pre-admission majors must talk with students when their grades do not match up with their ambition. HBCUs have a higher percentage of first-generation, lower-income students than their PWI counterparts. Therefore, retention strategies have to be rich with support services and nurturing. Some students may need tough love while others may need empathy. To be honest, both are needed. As advisors, we must be there to diagnose the issue and see what happened to impede a student’s success. Instead of only being the bearer of bad news, advisors should have some other scenarios in place for students who may not be able to enroll in a competitive entry program. This may include them using the summer to repeat courses in which they have had poor performance, changing their major to a similar degree with less rigor, or taking care of prerequisites after receiving a baccalaureate degree and then attending professional school. Encouragement and nurturing go a long way with students at HBCUs, but they go further when the student is given the tools they need to serve in an area where they are underrepresented.
Terrance R. Eubanks, II, M.Ed
Professional Advisor, Advisement Center
Student Success Center
Tennessee State University
Miller, M. A., & Murray, C. (2005). Academically underprepared students. Retrieved from https://www.nacada.ksu.edu/Resources/Clearinghouse/View-Articles/Academically-underprepared-students.aspx
Noonan, A., Lindong, I., & Jaitley, V. (2003). The role of Historically Black Colleges and Universities in training the health care workforce. American Journal of Public Health, 103(3), 412–415. https://doi.org/10.2105/AJPH.2012.300726. Retrieved from https://ajph.aphapublications.org/doi/10.2105/AJPH.2012.300726#citart1
Ralston, P. (2003). Diversifying the health professions: A model program. American Journal of Health Behavior, 27(3), 235–245.
St. John, E., Hu, S., Simmons, A., Carter, D. F., & Weber, J. (2004, May). What difference does a major make? The influence of college major field on persistence by African American and White students. Research in Higher Education, 45(3), 209–232. https://doi.org/10.1023/B:RIHE.0000019587.46953.9d
Thompson-Rogers, K., Davis, D., Davis-Maye, D., & Turner, C. (2018, Summer). Historically Black Colleges and Universities’ mentorship of health profession students: A content analysis exploring the North Carolina Health Careers Access Program. IAFOR Journal of Education, 6(2), 17–32. Retrieved from https://files.eric.ed.gov/fulltext/EJ1181056.pdf
Tucker, C., & Winsor, D. (2013). Where extrinsic meets intrinsic motivation: An investigation of Black student persistence in pre-health careers. Negro Educational Review, 64(1–4), 37–57.
Cite this article using APA style as: Eubanks II, T. R. (2019, September). The anatomy of it all: The role of HBCUs in producing healthcare professionals. Academic Advising Today, 42(3). Retrieved from [insert url here]