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Why is D.C.’s Healthcare Sector So Inequitable?

In the previous blog, we discussed our team’s participation in a Mayoral Task Force formed in conjunction with D.C. Health. This task force assembled experts from D.C. in education, employment services, healthcare, and government, intending to critically analyze the barriers facing healthcare workforce development and healthcare issues in Washington, D.C. 

The issues that affect the healthcare workforce in D.C. have not arisen because of recent circumstances, such as the COVID-19 pandemic alone. There are, and continue to be, systemic challenges that hold back many of the residents. An important outcome of this Mayoral task force was to uncover recommendations that the healthcare industry should consider to eliminate barriers and strengthen the District’s workforce. 

The report uses the 2018 Health Equity Report for the District of Columbia as a foundation for assessing health equity and opportunities in the District. The report, primarily concentrating on the social and structural drivers of health, determined that 20% of overall population health is attributed to clinical health. The COVID-19 Health & Healthcare Pandemic Recovery Report from DC Health also stressed the importance of looking at healthcare needs from the lens of equity and determining the structural determinants as the primary source of inequity rather than just looking to solve immediate social needs. 

Similarly, the report mentions a study done in May 2020 by Brookings that presented evidence of racial and economic inequities in the healthcare workforce. It revealed that women and people of color occupied a majority of lower-paid positions. Despite being labeled as “essential,” many individuals in these roles expressed feelings of undervaluation and were inadequately compensated.

Over 80% of health care support services and direct care workers are women. They are disproportionately people of color. Like other low-wage jobs where women and people of color are concentrated, many of these positions are plagued by underinvestment and lack of benefits. A demographic data profile of workers in the health care and social assistance industry showed that out of all health care support, direct care, and service workers (6,964,410), 81% of workers were women and was heavily dominated by African Americans (25%). 

In addition to identifying current issues in the health workforce with the help of studies pre and post-pandemic, the task force, which was divided into six sub-committees, turned its attention to plan and identify key stressors in the District’s healthcare system and providing recommendations that address the following stressors: 

  1. Healthcare employer access to potential employees: To identify barriers influencing the recruitment and retention of healthcare workers and propose policy changes. These proposed recommendations would revise, alter, or enhance existing programs.
  2. District resident employment in healthcare occupations: To strategically address the dual challenge of reducing unemployment while increasing healthcare employment within the District, with a special emphasis on populations already experiencing high unemployment and underrepresentation in healthcare roles. Recommendations from this sub-committee would establish accessible pathways for said population to actively pursue and excel in higher-paying healthcare occupations. Our President and CEO, Lori Jackson, contributed to this sub-committee.
  1. Opportunities for advancement in health careers within the District: To answer the question: how can the existing healthcare workforce be leveraged to address critical vacancies? The sub-committee was encouraged to apply a targeted approach and develop recommendations to determine the best way to upskill employees in clinical and non-clinical roles.
  2. Access to high-quality allied health training programs: To look into ways to expand the number of institutions offering diverse healthcare programs (diploma and certificate) to support entry-level healthcare careers. JBRF’s Director of Strategic Programs, Manon Matchett, participated in this sub-committee as a contributor.
  3. Retention of health professional students post matriculation: To examine the factors influencing the retention of professional healthcare students and provide policy recommendations to enhance and retain professional healthcare students as licensed healthcare workers in the District.
  4. Health careers pipeline strategy: To examine current initiatives and develop recommendations for establishing a health careers pipeline strategy aimed at boosting the participation of middle and high school students in health-related fields within the District of Columbia.  Additionally, these recommendations would propose strategies to address any identified gaps in the health careers pipeline.  

As a foundation focusing on improving Black women’s economic status and health outcomes, our team was incredibly honored to have a seat at the table. By being involved in the task force, we hope our recommendations will provide the groundwork to improve access to high-quality healthcare training programs, reduce unemployment, retain skilled healthcare workers, and allow Black women the opportunity to pursue careers in underrepresented healthcare roles in the District.

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