Programs designed to enhance opportunities for young people and adults from historically underrepresented groups in professions such as teaching, engineering, evaluation, medicine, and nursing play a major role in our nation’s response to workforce diversity (see, for example, Collins & Hopson, 2014; Fenwick, 2001; Greer, Clark, & Bankston, 2015; Nivet & Berlin, 2014). This article discusses why such programs are necessary and what it takes to institutionalize workforce diversity without compromising the focus on equity—ensuring that everyone is treated fairly before and after they enter the profession regardless of their race, ethnicity, gender, and other demographic characteristic—and quality—holding everyone, regardless of their background, to the highest level of competency and professional standards.

Why is the diversification of these professions and many others so critical?

  • Diversity is key to innovation and contributes to the bottom line. A diverse staff or group of professionals is more innovative because it builds on and combines the unique intelligence, perspectives, experiences, and strengths of different people (Herring, 2009; Konrad, 2003; Page, 2007). Several studies have shown that—with the right organizational context—diversity is correlated to profits (Herring, 2009).
  • Diversity in sectors where people from certain groups have been historically underrepresented is necessary to uphold a pluralistic society. Children and youth of color or with disabilities; lesbian, gay, bisexual, and transgender (LGBT) children and youth; and girls need to see and have role models who look like them or share their experiences. Positive role models are equally important for children and youth not from such groups in order to dispel stereotypes and to benefit from what the role models from diverse backgrounds have to offer (Fenwick, 2001). Diversity in settings such as schools, hospitals, recreational centers, and other social and service settings also could increase knowledge and understanding of different cultural groups, improve the ability to interact across cultures, and contribute to culturally competent services).
  • Diversity is a means for reducing racial and ethnic disparities in education, health, and other outcomes. It has been argued and demonstrated that having teachers, physicians, and healthcare providers who share the same demographic attributes as the people they serve lead to positive outcomes. These individuals are more likely to want to work in resource-poor communities; have the inherent ability to understand the experiences, attitudes, and perspectives of the people they serve; and integrate cultural-relevant material into their work (Hilliard, 1988; HRSA, 2006).

What does it take to institutionalize workforce diversity?

Diversification of our nation’s workforce is more urgent now than ever, given global changes that have contributed to the arrival of refugees and immigrants from all over the world and policies that promote the rights of women and people with different sexual orientation, identity, and disabilities. However, diversity programs or initiatives are often not sustainable or scalable because certain critical details about their design, implementation, and evaluation are glossed over, as discussed below.

It is not just about having people from different racial, ethnic, gender, sexual orientation, physical ability, or any other cultural background. It is about the way a profession values, leverages, and practices diversity through the policies and procedures of institutions that are part of the profession. Diversity’s contribution to innovation is not possible unless differences among professionals are considered an asset, understood, properly leveraged, and applied to problem-solving strategies. Otherwise, it can potentially have a negative impact on communication, role clarity, and job satisfaction (Dreachslin & Hunt, 1999). In healthcare settings, for example, gender and racial and ethnic segregation are common, and there is usually a glass ceiling for women and racial and ethnic minorities (Nivet, 2010; Smedley, Stith, & Nelson, 2003). To ensure that diversity fuels creativity, the glass ceiling has to be removed, and health professionals, regardless of their cultural background, must be treated equally. Thus, the change process must focus on the policies of the institutions that are part of a profession (e.g., hospitals, schools, police, courts, banks, universities) and must make sure the formal and informal workings of the institutions are aligned to value diversity (Community Science, 2012; Haynes, Toof, Holmberg, & Bond, 2012). To do this, the highest level of leadership in the institutions has to be willing to make the necessary policy changes and other adjustments to assure that cultural and religious differences among staff and volunteers are respected and transformed into strengths and not treated as problems.

Workforce diversification strategies should not focus only on increasing the number and percentage of people who have traditionally been excluded; they should also work to improve the capacity of the profession to be inclusive, just, and equitable. Many levers of change have to be activated in order for workforce diversification to be successful, impactful, and sustainable. Pipeline programs and other initiatives designed to diversify our workforces may be successful at producing highly qualified and competent professionals from different racial, ethnic, gender, and cultural backgrounds. However, the organizations and institutions they join and the people they serve may not be as accepting of them as those that trained them. A simultaneous and complementary strategy is needed to help increase the capacity of predominantly White institutions to recognize and dismantle implicit prejudices and biases in their policies and practices, and design team-building activities that facilitate intergroup relations.

Don’t confuse diversity, match, and fairness; they are related but distinct, and the fairness often gets less attention than diversity and match. Diversity refers to variation in race, ethnicity, gender, culture, and other demographic attributes in a particular context. To say a workforce is diverse means that there are individuals with these different attributes (Haynes, Toof, Holmberg, & Bond, 2012). Match, on the other hand, means that the demographic background of service providers is similar to those they serve which, as mentioned before, is helpful because we assume that these providers have the inherent ability to understand the people they serve (Haynes, Toof, Holmberg, & Bond, 2012). Racial and ethnic concordance between healthcare providers and healthcare recipients has been an important topic in our nation’s effort to build a culturally competent healthcare workforce. Even in this aspect, we must be careful not to assume that a match in race, ethnicity, culture, and language mean the same thing and have the same results (HRSA, 2006). Fairness suggests that people with different demographic attributes, particularly those of traditionally excluded groups, have equal ability to participate in a particular sector’s workforce across all ranks and were not hired to “represent” their group in order to make the organization “look good” (O’Leary & Weathington, 2006). These three constructs are not mutually exclusive and must be simultaneously considered in any strategy to diversify organizations and workforces. In fact, we often forget the issue of fairness, and consequently, diversity programs and initiatives fall short in their strategy to create an equitable work place or impact equitable outcomes in health, education, economic security, and other areas where disparities are evident.

The people who train the workforce and the people who hire the workforce must talk to each other. In the healthcare sector, for instance, the needs of healthcare institutions have to be vocalized to the colleges and universities training the workforce so that 1) emphasis is placed on those skills in the training, and 2) incentives are built into the colleges’ and universities’ systems for instructors who address issues of cross-cultural competency and equity (Greer, Clark, & Bankston, 2015). It is a similar situation with teachers, engineers, and other professions where diversification, cultural competency, and equity are salient issues.

Conclusion

In summary, diversification of our nation’s workforce is essential and urgent in order to promote and support cultural pluralism, ensure that our children benefit from different and diverse perspectives, and help reduce disparities. However, the change process is complex, and frequently, funders, program designers, and evaluators give a disproportionate amount of attention to identifying and recruiting people from diverse backgrounds and not enough on retaining these individuals in the profession, which includes building and sustaining the capacity of institutions that are a part of the profession to be inclusive. Certain details must be attended in order for the solutions and results to be scalable and sustainable and to maintain a focus on justice and equity.

References

Collins, P. & Hopson, R. (2014). Building a new generation of culturally responsive evaluators through AEA’s Graduate Education Diversity Internship Program, New Directions for Evaluation, Special Issue 143, 1-121.

Community Science. (2012). Evaluation Report: Addressing health disparities through organizational change. Denver, CO: The Colorado Trust.

Dreachslin, J. & Hunt, P. (1999). Communication patterns and group composition: Implications for
patient-centered care team effectiveness. Journal of Healthcare Management, 44, 252-266.

Fenwick, L. (2001). Patterns of excellence: Policy perspectives on diversity in teaching and school leadership. Atlanta, GA: Southern Education Foundation.

Greer, G., Clark, A., & Bankston, K. (2015). From policy to practice: A case for holistic review diversifying the nursing workforce. Online Journal of Issues in Nursing, 20 (3), 1-5.

Haynes, M., Toof, R., Holmberg, M., & Bond, M. (2012). Diversification of the workforce: Six research propositions for future research. The International Journal of Diversity in Organizations, Communities, and Nations, 11 (5), 163-173.

Health Resources and Services Administration, Bureau of Health Professions. (2006). The Rationale for diversity in the health professions: A review of the evidence. Rockville, MD: U.S. Department of Health and Human Services.

Herring, C. (2009). Does diversity pay? Race, gender, and the business case for diversity. American Sociological Review, 74, 208-224

Hilliard, Asa. (1988). Reintegration for education: Black community involvement with black schools. Urban League Review, 11 (1), 201-208.

Konrad, A. M. (2003). Defining the domain of workplace diversity scholarship. Group & Organization
Management, 28, 4-17.

Nivet, M. (2010). Minorities in academic medicine: Review of the literature. Journal of Vascular Surgery 51 (4), S53-S58.

Nivet, M. & Berlin, A. (2014). Workforce diversity and community-responsive health care institutions. Public Health Reports, 129 (Supplement 2), 15-18

O’Leary, B. & Weathington, B. (2006). Beyond the business case for diversity in organizations. Employee Responsibilities and Rights Journal, 18, 283-292.

Page, S. (2007). The difference. Princeton, NJ: Princeton University Press.

Smedley, B. D., Stith, A. Y., Nelson, A. R. (2003). Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Washington, DC: National Academies Press.