2013 LATINO HEALTH PROMOTION SUMMIT

Health Workforce Impact on Achieving Health Equity

Howard J. Eng, MS, DrPH, RPhAssistant Professor and Director, Southwest Border Rural Health Research Center

Center for Rural HealthMel and Enid Zuckerman College of Public Health

February 16, 2013

Sponsored by

© 2013, Center for Rural Health

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Presentation Overview

• Health Workforce - Health Services - Health Equity Relationship

• Workforce Equity

• Arizona Rural and Urban Selected Workforce Trends

• National Percentage Enrollments for Four Health Professional Programs by Race and Hispanic Origin: 2006-07

• AHSC Four Health Professional Colleges Multi-Year Enrollment Percentages, by Race and Hispanic Origin

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Workforce – Health Services – Health Equity Relationship

HealthOutcomes

(Equity)Health ServicesHealth

Workforce

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Workforce Equity

Geography

WorkforceDemographic

Health Sector

Practice Setting

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Workforce Equity

• Geography**– Rural (Remoteness, Reservations, and U.S. Mexico Border)– Urban (Inner City)

• Workforce Demographic**– Race/Ethnicity – Gender (Sex)

• Health Sector– Private Market– Public Funded (Medicaid, Medicare, DOD, VA, and IHS)

• Practice Setting– Primary Care– Specialties

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Center for Rural Health Workforce Trend Analysis

http://crh.arizona.edu/publications/studies-reports/workforce-study

Arizona Health Workforce for Selected Professions: 2000-2010

Source: Arizona Rural Health Workforce Trend Analysis: 2007-2010Note: Pharmacy Technicians were not certified until 2004.

© 2013, Center for Rural Health

Health Professionals Examined

• Physicians– Primary Care Physician– Physician Specialists

• Nurses– Registered Nurses– Nurse Practitioner

• Pharmacists

• Public Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

© 2013, Center for Rural Health

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Trend of All Physicians (MD and DO) per 100,000 Population in Arizona and by Four Rural-Urban Classifications (RUCA): 2000 to 2010

Source: Arizona Rural Health Workforce Trend Analysis: 2007-2010

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Trend of Primary Care Physicians (MDs and DOs) per 100,000 Population in Arizona and by Four Rural-Urban Classifications (RUCA): 2000 to 2010

Source: Arizona Rural Health Workforce Trend Analysis: 2007-2010

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Trend of Specialist Physicians (MDs and DOs) per 100,000 Population in Arizona and by Four Rural-Urban Classifications (RUCA): 2000 to 2010

Source: Arizona Rural Health Workforce Trend Analysis: 2007-2010

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Trend of Registered Nurses (RNs) per 100,000 Population in Arizona and by Four Rural-Urban Classifications (RUCA): 2000 to 2010

Source: Arizona Rural Health Workforce Trend Analysis: 2007-2010

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Trend of Nurse Practitioners (NPs) per 100,000 Population in Arizona and by Four Rural-Urban Classifications (RUCA): 2000 to 2010

Source: Arizona Rural Health Workforce Trend Analysis: 2007-2010

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Trend of Pharmacists per 100,000 Population in Arizona and by Four Rural-Urban Classifications (RUCA): 2000 to 2010

Source: Arizona Rural Health Workforce Trend Analysis: 2007-2010

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

National Health Professional Program Enrollments

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

8.6

60.860.2

75.2

62.9

11.6

6.7

12.4

7.33.9

5.47.6

12.3

21.2

6.3

21.2

0.70.50.70.90

10

20

30

40

50

60

70

80

Medicine (MD) Nursing (BSN) Pharmacy Public Health

White

Black

Hispanic

Asian/PI

AI/NA

National Percentage Enrollments for Four Health Professional Programs by Race and Hispanic Origin: 2006-07

Source: Health, United States, 2009, Table 113

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Arizona Health Sciences Center Four Colleges

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

AHSC Colleges of Medicine and Nursing Six-Year Enrollment Percentages, by Race and Hispanic Origin: 2006-07 to 2011-12

0

10

20

30

40

50

60

70

80

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

White Black Hispanic

AA/PI AI/AN Other

Medical Student Enrollment Nursing Student Enrollment

0

10

20

30

40

50

60

70

80

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

White Black Hispanic

AA/PI AI/AN Other

Source: University of Arizona College of Medicine Others include: Not specified and non-resident alien

Source: University of Arizona College of NursingOthers include: Unknown and 2 or more racesNote: 2011-12 transitioned the second degree

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

AHSC Colleges of Pharmacy and Public Health Six-Year Enrollment Percentages, by Race and Hispanic Origin: 2006-07 to 2011-12

0

10

20

30

40

50

60

70

80

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

White Black Hispanic

AA/PI AI/AN Other

Pharmacy Student Enrollment MPH Student Enrollment

0

10

20

30

40

50

60

70

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

White Black Hispanic

AA/PI AI/AN Other

Source: University of Arizona College of PharmacyOthers include: foreign students and other classificationsNote: Fall data used for academic year percentages.

Source: University of Arizona College of Public HealthOthers include: 2 or more races, race unknown, and international students

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Acknowledgements

• Arizona Rural Health Workforce Trend Analysis Report

– Dr. Joe Tabor (PI)

– Arizona Health Education Center

• Four AHSC Health Professional Colleges

– Ms. JoAnn di Filippo, College of Medicine

– Mr. Thomas Dickson, College of Nursing

– Ms. Sandra Rogers, College of Pharmacy

– Ms. Christopher Tisch, College of Public Health

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Thank You!

Questions?

© 2013, Center for Rural Health

2013 LAT

INO

HE

ALT

H P

RO

MO

TIO

N S

UM

MIT

Contact Information

Howard J. Eng, MS, DrPH, RPhDirector

Southwest Border Rural Health Research Center

Center for Rural Health

Mel and Enid Zuckerman College of Public Health

P.O. Box 245177

1295 N. Martin Ave.

Tucson, Arizona 85724

hjeng@email.arizona.edu

(520) 626-5840