Building an Ethnically and Racially Balanced Physician Assistant Workforce

Objectives: The increasing ethnic diversity of the U.S. population has significant implications for the health workforce and for the provision of health services. A diverse health workforce is important in assuring the delivery of linguistically appropriate and culturally competent health care and helping to reduce health disparities. The objectives of this study are to explore ethnic composition of the physician assistant (PA) workforce and identify the most underrepresented populations in PA supply.

Methods: Among the total care providers in the U.S. are 77 thousand PAs. We examined PA to population ratio, as a measure of health service level, in each major ethnic population with data from the national PA database and the U.S. Census.

Results: Hispanic population account for 12.6% of the U.S. population in 2000, 15.5% in 2010 and is projected to 17.8% in 2020. However, Hispanic PAs account only for 4.5% in the PA population in 2000, 5.2% in 2010 and stay flat in the years followed, which leaves an increasing gap between PAs supplied and population served within the Hispanics. Further, percentages of the non-Hispanic blacks are 11.6% in 2000, 11.8% in 2010 and is projected to 11.2% for 2020 in total population. PAs who are non-Hispanic black account for only 5.7% of total PAs in 2000, 6.1% in 2010 and remain at this level for next 10 years. Finally, population shares of non-Hispanic white are decreasing from 69.4% in 2000, to 65.1% in 2010 and finally to 61.3% for 2020 as projected. Meanwhile, the level of PAs in non-Hispanic whites remain above 82% in PA population.

Conclusions: Increasing the number of care providers from ethnic populations is an integral part of the solution to improving access to care. In this study, we identified two priority populations who are underrepresented in PA profession. In Hispanics both PA supply and PA growth are low when compared to their population. The next vulnerable population is non-Hispanic blacks, for whom PA supply level is low while PA growth is proportional to their population. To reduce diversity shortage in PA profession from policy perspective, we need to strategically increase representation of minorities in PA education so that more Hispanic and non-Hispanic black students can enter and be trained. More generally speaking, we need to develop a more diverse health care workforce including education addressing population diversity and the health needs from minority, low-income, and rural populations.