Journal of Genetic Counseling

, Volume 17, Issue 4, pp 301–313 | Cite as

Diversity in Genetic Counseling: Past, Present and Future

Professional Issues

Abstract

Despite decades of efforts to increase ethnic and racial diversity among genetic counselors, African Americans, Hispanics and American Indians, currently constituting almost one-third of Americans, remain only meagerly represented among genetic counselors at a level far under that seen in other health professions. This paper provides the first comprehensive effort to archive published and unpublished initiatives to increase ethnic and racial diversity in the profession. It also provides a review of national data and diversity initiatives in the health workforce in general. The paper reviews diversity initiatives in other health professions and suggests ways to improve recruitment and retention of underrepresented populations into genetic counseling. Increasing the diversity of the genetic counseling workforce stands not only to expand access to genetic services but also to improve the quality of genetic care provided to the American public.

Keywords

Genetic counseling Diversity Health disparities Recruitment Retention Minority Under represented minorities (URM) 

References

  1. Agrawal, J. R., Vlaicu, S., & Carrasquillo, O. (2005). Progress and pittfalls in underrepresented minority recruitment: Perspectives from the medical schools. Journal of the National Medical Association, 97(9), 1226–1231.PubMedGoogle Scholar
  2. All Nursing Schools. (2007). Nursing Programs for Minorities. Retrieved 6/27/07, from http://www.allnursingschools.com/faqs/diversityfaq.php.
  3. Association of American Medical Colleges. (2006a). Diversity in the physician workforce: facts and figures. Washington, DC.Google Scholar
  4. Association of American Medical Colleges. (2006b). New analysis reveals growing gap between undergrduates and medical school applicants. Press Release Retrieved 12/25/06, from http://www.aamc.org/newsroom/pressrel/2006/061116.htm.
  5. Barbee, E. L., & Gibson, S. E. (2001). Our dismal progress: The recruitment of non-whites into nursing. Journal of Nursing Education, 40(6), 243–244.PubMedGoogle Scholar
  6. Barnes, R. (2007, 6/29/07). Divided court limits use of race by school districts. The Washington Post. Retrieved 7/1/07, from http://www.washingtonpost.com/wp-dyn/content/article/2007/06/28/AR2007062800896_pf.html.
  7. Bell, J. (1998). The new genetics in clinical practice. British Medical Journal, 316, 618–620.PubMedGoogle Scholar
  8. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O., II (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302.PubMedGoogle Scholar
  9. Boldt, A. (1994). Professional Status Survey. Perspectives in Genetic Counseling.Google Scholar
  10. Brady, P. (2004). Med schools’ minority enrollment stays low. The Yale Daily News.Google Scholar
  11. Bumgarner, S. D., Means, B. H., & Ford, M. J. (2003). Building bridges: from high school to healthcare professional. Journal for Nurses in Staff Development, 19(1), 18–22, quiz 23–14.PubMedCrossRefGoogle Scholar
  12. Bureau of Labor Force Statistics. (2006). Employed and experienced unemployed persons by detailed occupation, sex, race, and Hispanic or Latino ethnicity, national average 2005. Retrieved 6/27/07, from http://www.bls.gov/cps/#overview.
  13. Cohen, J. (2005). Increasing diversity in the workforce is one solid way to Prevent Disparities in Healthcare. Retrieved 4/21/06, from http://www.medscape.com/viewarticle/514893.
  14. Cohen, J. J., Gabriel, B. A., & Terrell, C. (2002). The case for diversity in the health care workforce. Health Affairs (Millwood), 21(5), 90–102.CrossRefGoogle Scholar
  15. Cohen, J., & Steinecke, A. (2006). Building a diverse physician workforce. Journal of the American Medical Association, 296(9), 1135–1137.PubMedCrossRefGoogle Scholar
  16. Cooksey, J. A., Forte, G., Benkendorf, J., & Blitzer, M. G. (2005). The state of the medical geneticist workforce: findings of the 2003 survey of American Board of Medical Genetics certified geneticists. Genetics in Medicine, 7(6), 439–443.PubMedCrossRefGoogle Scholar
  17. Cooksey, J. A., Forte, G., Flanagan, P. A., Benkendorf, J., & Blitzer, M. G. (2006). The medical genetics workforce: an analysis of clinical geneticist subgroups. Genetics in Medicine, 8(10), 603–614.PubMedCrossRefGoogle Scholar
  18. Cordes, B., & Miller, G. (2005). Inequality of education in the United States. Retrieved 6/29/07, from http://cte.rockhurst.edu/FileUploads/Cordes.pdf.
  19. Dennery, P. A. (2006, Jul). Training and retaining of underrepresented minority physician scientists—an African-American perspective: NICHD AAP workshop on research in neonatal and perinatal medicine. Journal of Perinatology, 26(Suppl 2), from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16801969.
  20. Dolgin, J. L. (2000). Personhood, discrimination and the new genetics. Brooklyn Law Review, 66, 755–822.PubMedGoogle Scholar
  21. Doyle, D. L. (1996). Professional Status Survey results. Perspectives in Genetic Counseling, 18, 1–8.Google Scholar
  22. Duffy, F., West, J., Wilk, J., Narrow, W., Hales, D., & Thompson, J. (2004). Mental health practitioners and trainees. Rockville, MD: US Department of Health and Human Services.Google Scholar
  23. Educational Broadcasting Corporation. (2004). Slavery and the making of America: The slave experience: Education, arts and culture. Retrieved 6/29/07, from http://www.pbs.org/wnet/slavery/experience/education/history2.html.
  24. Farmer, J. (2000). Professional Status Survey. Perspectives in Genetic Counseling, 22(4), S1–S12.Google Scholar
  25. Fine, B., Baker, D., & Fiddler, M. (1996). ABGC Consensus Development Consortium. Journal of Genetic Counseling, 5(3), 113–121.CrossRefGoogle Scholar
  26. Fletcher, A., Williams, P. R., Beacham, T., Elliott, R. W., Northington, L., Calvin, R., et al. (2003). Recruitment, retention and matriculation of ethnic minority nursing students: a University of Mississippi School of Nursing approach. Journal of Cultural Diversity, 10(4), 128–133.PubMedGoogle Scholar
  27. Friedman, A. L. (2007). Enhancing the diversity of the pediatrician workforce. Pediatrics, 119(4), 833–837.PubMedCrossRefGoogle Scholar
  28. Gardner, J. (2005a). A successful minority retention Project. Journal of Nursing Education, 44(12), 566–568.PubMedGoogle Scholar
  29. Gardner, J. (2005b). Barriers influencing the success of racial and ethnic minority students in nursing programs. Journal of Transcultural Nursing, 16(2), 155–162.PubMedCrossRefGoogle Scholar
  30. Gilchrist, K. L., & Rector, C. (2007). Can you keep them? Strategies to attract and retain nursing students from diverse populations: best practices in nursing education. Journal of Transcultural Nursing, 18(3), 277–285.PubMedCrossRefGoogle Scholar
  31. Gonzalez, L. S., Kearns, E. H., Lafferty, S., Lampignano, J., & Pappas, V. M. (2000). The middle school mentoring program in allied health: a proposed model. Journal of Allied Health, 29(2), 114–119.PubMedGoogle Scholar
  32. Grumbach, K., & Chen, E. (2006). Effectiveness of University of California postbaccalaureate premedical programs in increasing medical school matriculation for minority and disadvantaged students. Journal of the American Medical Association, 296(9), 1079–1085.PubMedCrossRefGoogle Scholar
  33. Grumbach, K., Coffman, J., Granada, P., Munoz, C., & Rosenoff, E. (2003). Strategies for improving the diversity of the health professions. San Francisco, CA, USA: The California Endowment.Google Scholar
  34. Institute of Medicine (2001). The right thing to do the smart thing to do. Washington, DC.Google Scholar
  35. IOM (2002). Unequal treatment: Confronting ethnic and racial disparities in health care. Washington, DC, USA: The National Academic Press.Google Scholar
  36. IOM (2004). In the nation’s compelling interest: Ensuring diversity in the health-care workforce. Washington, DC, USA: Institute of Medicine.Google Scholar
  37. Komaromy, M., Grumbach, K., Drake, M., Vranizan, K., Lurie, N., Keane, D., et al. (1996). The role of black and Hispanic physicians in providing health care for underserved populations. New England Journal of Medicine, 334(20), 1305–1310.PubMedCrossRefGoogle Scholar
  38. Kosanovich, K. (2006). Employed and experienced unemployed persons by detailed occupations, sex, race, and Hispanic or Latino ethnicity, annual average 2005 (Source: Current Population Survey). In I. Mittman (Ed.), Bureau of Labor Force Statistics (BLFS).Google Scholar
  39. Lea, D. H., Williams, J. K., Cooksey, J. A., Flanagan, P. A., Forte, G., & Blitzer, M. G. (2006). U.S. genetics nurses in advanced practice. Journal of Nursing Scholarship, 38(3), 213–218.PubMedCrossRefGoogle Scholar
  40. Lee, M., & Coulehan, J. L. (2006). Medical students’ perceptions of racial diversity and gender equality. Medical Education, 40(7), 691–696.PubMedCrossRefGoogle Scholar
  41. Lega, M., McCarthy Veach, P., Ward, E. & Leroy, B. (2005). Who are the next generation of genetic counselors? A survey of students. Journal of Genetic Counseling, 14(5), 395–407.PubMedCrossRefGoogle Scholar
  42. Lin-Fu, J., Lloyed-Puryear, M., Khoury, M., Burke, M., & Thomson, E. (2000). Access to genetic services in the United States: A challenge to genetics in public health. In Genetics and Public Health in the 21st Century, (pp. 273–289). New York: Oxford University Press.Google Scholar
  43. Marcelin, G. E., Goldman, L., Spivey, W. L., Eichel, J. D., Kaufman, F., & Fleischman, A. R. (2004). The Junior Fellows Program: motivating urban youth toward careers in health, science, and medicine. Journal of Urban Health, 81(3), 516–523.PubMedGoogle Scholar
  44. Maton, K. I., & Hrabowski, F. A., III (2004). Increasing the number of African American PhDs in the sciences and engineering: a strengths-based approach. American Psychologist, 59(6), 547–556.PubMedCrossRefGoogle Scholar
  45. Matsui, J., Liu, R., & Kane, C. M. (2003). Evaluating a science diversity program at UC Berkeley: more questions than answers. Cell Biology Education 2(2), 117–121.PubMedCrossRefGoogle Scholar
  46. McNeal, G. J., & Walker, D. (2006). Enhancing Success in Advanced Practice Nursing: a grant-funded project. Journal of Cultural Diversity, 13(1), 10–19.PubMedGoogle Scholar
  47. Mittman, I. (1997). Building bridges: Counselors promoting diversity. Perspectives in Genetic Counseling, 19(1), 6.Google Scholar
  48. Moreno, J., Smith, D. G., Clayton-Pedersen, A. R., Parker, S., & Teraguchi, D. H. (2006). The revolving door for underrepersented minority faculty in higher education.Google Scholar
  49. Moy, E., & Bartman, B. A. (1995). Physician race and care of minority and medically indigent patients. Jama, 273(19), 1515–1520.PubMedCrossRefGoogle Scholar
  50. NSGC (1991). NSGC position statement on access to care. Retrieved 8/31/07, from http://www.nsgc.org/about/position.cfm#Access.
  51. NSGC (1992). Genetic counselors and their clients. Retrieved 8/31/07, from http://www.nsgc.org/about/codeEthics.cfm#sec_2.
  52. NSGC (2003). NSGC Strategic Plan 2004–2006. Retrieved 2/17/07, from http://www.nsgc.org/about/strategicPlan.cfm.
  53. Oh, T., & Lewis, L. J. (2005). Consideration of genetic counseling as a career: Implications for diversifying the genetic counseling field. Journal of Genetic Counseling, 14(1), 71–81.PubMedCrossRefGoogle Scholar
  54. Parrott, S., & Del Vecchio, M. (2007). Professional Status Survey 2006: National Society of Genetic Counselors, Inc.Google Scholar
  55. Parrot, S., & Manely, S. (2004). National Society of Genetic Counselors, Inc. Professional Status Survey 2004: NSGC.Google Scholar
  56. Price, E. G., Gozu, A., Kern, D. E., Powe, N. R., Wand, G. S., Golden, S., et al. (2005). The role of cultural diversity climate in recruitment, promotion, and retention of faculty in academic medicine. Journal of General Internal Medicine, 20(7), 565–571.PubMedCrossRefGoogle Scholar
  57. Raymond, W. E., & Lue, R. A. (2006). Shared challenges: Shared solutions. TheScientist: Magazineof the Life Sciences Retrieved 11/30/2006, from http://www.the-scientist,com/2006/11/01/s38/1.
  58. Saha, S., Taggart, S. H., Komaromy, M., & Bindman, A. B. (2000). Do patients choose physicians of their own race? Health Affairs (Millwood), 19(4), 76–83.CrossRefGoogle Scholar
  59. Schnieder, H. (1998). Professional Status Survey. Perspectives in Genetic Counseling, 20(3), S1–S8.Google Scholar
  60. Schoonveld, K. C., Veach, P. M., & Leroy, B. S. (2007). What is it like to be in the minority? ethnic and gender diversity in the genetic counseling profession. Journal of Genetic Counseling, 16(1), 53–69.PubMedCrossRefGoogle Scholar
  61. Smith, S. C., Warren, N. S., & Misra, L. (1993). Minority recruitment into the genetic counseling profession. Journal of Genetic Counseling, 2(3), 171–181.CrossRefGoogle Scholar
  62. Stewart, S. R., Pool, J. B., & Winn, J. (2002). Factors in recruitment and employment of allied health students: preliminary findings. Journal of Allied Health, 31(2), 111–116.PubMedGoogle Scholar
  63. Sullivan, L. W. (2004). Missing persons: Minorities in the health professions. Retrieved 3/11/08, from http://www.aacn.nche.edu/Media/pdf/SullivanReport.pdf.
  64. Terrel, C., & Beaudreau, B. (2003). 3000 by 2000 and beyond: Next steps for promoting diversity in the health professions. Journal of Dental Education, 67(9), 1048–1052.Google Scholar
  65. Thomson, W. A., Miller, L. M., Shargey, B. O., Smith, Q. W., & Denk, J. P. (1991). A follow-up study of allied health educational and career interests of graduates of a high school for health professions. Journal of Allied Health, 20(4), 233–244.PubMedGoogle Scholar
  66. Uhlmann, W. (1992). Professional Status Survey. Perspectives in Genetic Counseling, 14(2), 7–10.Google Scholar
  67. Uhlmann, W. (2000). Task force appointed. Perspectives in Genetic Counseling, 22(1), 2.Google Scholar

Copyright information

© National Society of Genetic Counselors, Inc. 2008

Authors and Affiliations

  1. 1.Department of Epidemiology and Preventive MedicineUniversity of MarylandBaltimoreUSA
  2. 2.Department of Otolaryngology-Head & Neck SurgeryUniversity of MichiganAnn ArborUSA
  3. 3.Wayne State University School of MedicineDetroitUSA
  4. 4.Maryland Department of Health and Mental HygieneOffice of Minority Health and Health DisparitiesBaltimoreUSA

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