Racial and Ethnic Representation Among Complementary and Integrative Health Program Graduates

被引:0
作者
Whitley, Margaret D. [1 ,2 ]
Malika, Nipher [1 ,2 ]
Herman, Patricia M. [1 ,2 ]
Coulter, Ian D. [2 ,3 ]
Maiers, Michele [2 ,4 ]
Bradley, Ryan [2 ,5 ,6 ]
Khamba, Baljit [7 ]
Mccarey, Jacob [8 ]
Keyes, Tiffany [1 ,2 ]
机构
[1] RAND, Dept Behav & Policy Sci, Santa Monica, CA USA
[2] RAND, Res Complementary & Integrat Hlth Inst REACH Ctr, Santa Monica, CA USA
[3] RAND, Dept Econ Sociol & Stat, Santa Monica, CA USA
[4] Northwestern Hlth Sci Univ, Ctr Res & Innovat, Bloomington, MN USA
[5] Univ Calif San Diego, Herbert Wertheim Sch Publ Hlth & Human Longev Sci, San Diego, CA USA
[6] Natl Univ Nat Med, Helfgott Res Inst, Portland, OR USA
[7] Bastyr Univ, Sch Naturopath Med, San Diego, CA USA
[8] Palmer Coll Chiropract, Palmer Ctr Chiropract Res, Davenport, IA USA
来源
JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE | 2025年
基金
美国国家卫生研究院;
关键词
complementary therapies; integrative medicine; workforce diversity; professional education; PATIENT; CARE; CONCORDANCE; RACE; COMMUNICATION; DISPARITIES; DIVERSITY;
D O I
10.1089/jicm.2024.0745
中图分类号
R [医药、卫生];
学科分类号
10 ;
摘要
Background: Use of complementary and integrative health care (CIH) varies across racial and ethnic groups in the United States. Lack of racial and ethnic diversity among CIH providers may hinder access to CIH for underrepresented groups. This study aimed to (1) document racial and ethnic representation in licensed CIH professions (chiropractic, acupuncture, traditional East Asian medicine, naturopathic medicine, direct-entry midwifery, and massage therapy), non-licensed CIH professions, and conventional health care; (2) compare diversity in these professions with the U.S. population; and (3) examine changes in CIH diversity in recent years.Methods: We conducted a repeated cross-sectional study design with the 2011-2022 Integrated Postsecondary Education Data System to examine race and ethnicity among graduates in licensed CIH professions, compared with non-licensed CIH professions and conventional health care. Our sample included 53,393 programs representing 3,524,494 individuals. We examined the proportion of graduates from each racial and ethnic group, compared results with the U.S. population, and graphically explored changes between 2011 and 2022.Results: Inclusion or exclusion of massage therapy influenced interpretations across all questions. With massage therapy, licensed CIH professions appeared more diverse, with a higher proportion of Latino and Black graduates. Without massage therapy, diversity in licensed CIH professions was similar or slightly reduced compared with non-licensed CIH professions and conventional health care. Notable differences emerged among licensed CIH professions: acupuncture and East Asian medicine had larger proportions of Asian graduates than other CIH programs and the U.S. population. Racial and ethnic diversity in CIH increased modestly between 2011 and 2022.Discussion: While professions such as massage therapy, acupuncture, and traditional East Asian medicine have greater diversity, a disparity persists between the racial and ethnic composition of licensed CIH professions and the diversity of the overall U.S. population.
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页数:11
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  • [1] Levesque J-F, Harris MF, Russell G, Patient-centred access to health care: Conceptualising access at the interface of health systems and populations, Int J Equity Health, 12, 1, (2013)
  • [2] Shen MJ, Peterson EB, Costas-Muniz R, Et al., The effects of race and racial concordance on patient-physician communication: A systematic review of the literature, J Racial Ethn Health Disparities, 5, 1, pp. 117-140, (2018)
  • [3] Jang Y, Yoon H, Kim MT, Et al., Preference for patient-provider ethnic concordance in Asian Americans, Ethn Health, 26, 3, pp. 448-459, (2021)
  • [4] Moore C, Coates E, Watson AR, Et al., “It’s important to work with people that look like me”: Black patients’ preferences for patient-provider race concordance, J Racial Ethn Health Disparities, 10, 5, pp. 2552-2564, (2023)
  • [5] Janevic T, Piverger N, Afzal O, Howell EA, Just because you have ears doesn’t mean you can hear”—Perception of racial-ethnic discrimination during childbirth, Ethn Dis, 30, 4, pp. 533-542, (2020)
  • [6] Takeshita J, Wang S, Loren AW, Et al., Association of racial/ethnic and gender concordance between patients and physicians with patient experience ratings, JAMA Netw Open, 3, 11, (2020)
  • [7] Cooper LA, Roter DL, Johnson RL, Et al., Patient-centered communication, ratings of care, and concordance of patient and physician race, Ann Intern Med, 139, 11, pp. 907-915, (2003)
  • [8] Traylor AH, Schmittdiel JA, Uratsu CS, Et al., Adherence to cardiovascular disease medications: Does patient-provider race/ethnicity and language concordance matter?, J Gen Intern Med, 25, 11, pp. 1172-1177, (2010)
  • [9] Strumpf EC ., Racial/ethnic disparities in primary care: The role of physician-patient concordance, Med Care, 49, 5, pp. 496-503, (2011)
  • [10] Anderson SR, Gianola M, Perry JM, Losin EAR, Clinician-patient racial/ethnic concordance influences racial/ethnic minority pain: Evidence from simulated clinical interactions, Pain Med, 21, 11, pp. 3109-3125, (2020)