Racial and Ethnic Concordance Between National Health Service Corps Clinicians and Underserved Populations

Area of Science:

• Health Services Research
• Health Equity
• Demographic Trends in Healthcare

Background:

• Racial and ethnic concordance between patients and clinicians is crucial, yet data on clinician diversity in underserved areas is lacking.
• The National Health Services Corps (NHSC) program aims to improve healthcare access in medically underserved areas.

Purpose of the Study:

• To evaluate trends in NHSC clinician diversity and racial/ethnic concordance with populations in Health Professional Shortage Areas (HPSAs).
• To assess changes in concordance before and after the 2009 NHSC program expansion.

Main Methods:

• Cross-sectional, population-based study analyzing NHSC Field Strength Database and Area Health Resources Files (2003-2019).
• Calculated annual community representativeness ratio to measure clinician-population racial/ethnic concordance.
• Analyzed trends across primary care, mental health, and dental specialties.

Main Results:

• NHSC clinician numbers significantly increased post-2009 expansion.
• Concordance improved for non-Hispanic White and Black individuals after 2009.
• Hispanic clinicians, initially overrepresented, became underrepresented post-expansion due to a sharp decline in their proportion.

Conclusions:

• The 2009 NHSC expansion improved concordance for some racial/ethnic groups but worsened it for Hispanic individuals.
• Targeted recruitment strategies are essential to enhance Hispanic clinician representation in underserved areas.
• Addressing clinician diversity is vital to align with the growing Hispanic population in the US.