Dan P Ly1, Utibe R Essien2, Andrew R Olenski3, Anupam B Jena4. 1. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, and Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California (D.P.L.). 2. Division of General Internal Medicine, University of Pittsburgh School of Medicine, and Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (U.R.E.). 3. Department of Economics, Columbia University, New York, New York (A.R.O.). 4. Department of Health Care Policy, Harvard Medical School, Boston, Department of Medicine, Massachusetts General Hospital, Boston, and National Bureau of Economic Research, Cambridge, Massachusetts (A.B.J.).
Abstract
BACKGROUND: The percentage of U.S. physicians who identify as being from an underrepresented racial or ethnic group remains low relative to their proportion in the U.S. population. How this percentage may have been affected by state bans on affirmative action in public postsecondary institutions has received relatively little attention. OBJECTIVE: To examine the association between state affirmative action bans and percentage of enrollment in U.S. public medical schools from underrepresented racial and ethnic groups. DESIGN: Event study comparing public medical schools in states that implemented affirmative action bans with those in states without bans. SETTING: U.S. public medical schools. PARTICIPANTS: 21 public medical schools in 8 states with affirmative action bans matched to 32 public medical schools in 24 states without bans from 1985 to 2019. MEASUREMENTS: Percentage of total enrollment from racial and ethnic groups underrepresented in medicine (Black, Hispanic, American Indian or Alaska Native, and Native Hawaiian or other Pacific Islander). RESULTS: The percentage of enrollment from underrepresented racial and ethnic groups was 14.8% in U.S. public medical schools in the year before ban implementation in states with bans. The adjusted percentage of underrepresented students in ban schools decreased by 4.8 percentage points (95% CI, -6.3 to -3.2 percentage points) 5 years after ban implementation relative to the year before implementation, whereas the adjusted percentage in control schools increased by 0.7 percentage point (CI, -0.1 to 1.6 percentage points), for a relative difference, or difference-in-differences estimate, of -5.5 percentage points (CI, -7.1 to -3.9 percentage points). LIMITATION: Inability to account for the effect of these bans on undergraduate enrollment. CONCLUSION: State affirmative action bans were associated with significant reductions in the percentage of students in U.S. public medical schools from underrepresented racial and ethnic groups. PRIMARY FUNDING SOURCE: None.
BACKGROUND: The percentage of U.S. physicians who identify as being from an underrepresented racial or ethnic group remains low relative to their proportion in the U.S. population. How this percentage may have been affected by state bans on affirmative action in public postsecondary institutions has received relatively little attention. OBJECTIVE: To examine the association between state affirmative action bans and percentage of enrollment in U.S. public medical schools from underrepresented racial and ethnic groups. DESIGN: Event study comparing public medical schools in states that implemented affirmative action bans with those in states without bans. SETTING: U.S. public medical schools. PARTICIPANTS: 21 public medical schools in 8 states with affirmative action bans matched to 32 public medical schools in 24 states without bans from 1985 to 2019. MEASUREMENTS: Percentage of total enrollment from racial and ethnic groups underrepresented in medicine (Black, Hispanic, American Indian or Alaska Native, and Native Hawaiian or other Pacific Islander). RESULTS: The percentage of enrollment from underrepresented racial and ethnic groups was 14.8% in U.S. public medical schools in the year before ban implementation in states with bans. The adjusted percentage of underrepresented students in ban schools decreased by 4.8 percentage points (95% CI, -6.3 to -3.2 percentage points) 5 years after ban implementation relative to the year before implementation, whereas the adjusted percentage in control schools increased by 0.7 percentage point (CI, -0.1 to 1.6 percentage points), for a relative difference, or difference-in-differences estimate, of -5.5 percentage points (CI, -7.1 to -3.9 percentage points). LIMITATION: Inability to account for the effect of these bans on undergraduate enrollment. CONCLUSION: State affirmative action bans were associated with significant reductions in the percentage of students in U.S. public medical schools from underrepresented racial and ethnic groups. PRIMARY FUNDING SOURCE: None.
Authors: Sigurd Storehaug Arntzen; Hege Marie Gjefsen; Kjetil Elias Telle; Karin Magnusson; Ketil Størdal; Siri Eldevik Håberg; Jonas Minet Kinge Journal: BMJ Paediatr Open Date: 2022-08