A study published last week in the peer-reviewed journal, Annals of Internal Medicine, found that affirmative action bans negatively impacted enrollment of underrepresented students in public medical schools. The study showed that in states which enacted bans, five years later, the proportion of underrepresented racial and ethnic minority students fell by more than one-third.
The study, which was led by Dan Ly, MD, and an assistant professor of medicine at UCLA’s David Geffen School of Medicine, examined matriculants from 53 medical schools at public universities from 1985 through 2019. The researchers focused on students from underrepresented racial and ethnic groups including: Black, Hispanic, American Indian or Alaska Native, and Native Hawaiian or other Pacific Islander. Of the 53 medical schools, 32 were located within a state without an affirmative action ban and 21 were within a state with an affirmative action ban (Arizona, California, Florida, Michigan, Nebraska, Oklahoma, Texas, and Washington). The bans were enacted between 1997 and 2013, and Texas’s ban was reversed in 2003. On average, in the year prior to a state implementing a ban, underrepresented students made up 14.8 percent of the public medical school enrollment. Five years after the states’ bans, underrepresented student enrollment had fallen by an average of 37 percent.
Dr. Ly describes the importance of the findings. "We know that a more diverse physician workforce leads to better care for racial- and ethnic-minority patients," he said. "Our research shows that bans on affirmative action, like the one California passed in 1996, have had a devastating impact on the diversity of our medical student body and physician pipeline."
The authors note that the study did have limitations, which included the indirect effects of affirmative action on undergraduate admissions, the impact that public discussion of affirmative action may have had on medical school enrollment prior to the bans, and the possibility that some students may not have identified with the racial and ethnic groups defined by the study. Additionally, the study authors did not confirm if any schools in states without bans opted not to incorporate race or ethnicity in admissions decisions. However, the authors are optimistic that the study will provide policy-makers with a clearer understanding of the lag in diversifying medical student and physician populations, as well as informing them of the impact of affirmative action bans.
A co-author of the study, Utibe Essien, MD, and an assistant professor of medicine at the University of Pittsburgh, notes that the findings are particularly poignant at this juncture. "As our country has spent the last two years weaving through the twin pandemics of racial health disparities amplified by COVID-19 and structural racism at large, our findings are critically important," he said. "As we observed, affirmative action bans have resulted in a loss of underrepresented physicians, who could have been at the front lines of caring for vulnerable populations throughout the pandemic and helping to alleviate disparities in care.”
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