#73: Diversity in OT with Arameh Anvarizadeh

CE Courses
, , , , , , , , , ,
1

Take the Quiz to get 1 CEU

Listen: Apple | Spotify | YouTube
Full Course Details: Public course page
Learn more about our guest: Arameh Anvarizadeh OTD, OTR/L, FAOTA

:white_check_mark: Agenda

Intro (5 minutes)

Breakdown and analysis of journal article (5 minutes)

Discussion on practical implications for OTs (50 minutes)

00:13:00 Intro to Arameh Anvarizadeh
00:14:49 How Arameh was persuaded to join OT
00:19:27 Article impressions
00:25:54 Transparency around diversity statistics in education
00:29:05 Holistic admissions
00:33:47 Transparency around diversity statistics in our national association
00:39:36 Promoting OT versus protecting it
00:45:14 What can I as an individual do?
00:51:33 Closing thoughts

:white_check_mark: Supplemental Materials

:white_check_mark: Article Review

Read Full Text: Estimation and Comparison of Current and Future Racial/Ethnic Representation in the US Health Care Workforce
Journal: JAMA network open
Year Published: 2021

One of the primary ways OT professionals can improve care at scale is to increase the diversity of our workforce—with the ultimate goal of mirroring the diversity of our client population. This parity will ensure we have the variety of perspectives needed to effectively serve our clients.

So, what do the actual numbers say about the diversity of our current workforce? Are we headed in the right direction?

Well, it’s a mixed bag.

Today, we’ll look at a report from JAMA that estimates racial/ethnic representation in ten US healthcare professions.

While the evolving graduate pipeline suggests our future healthcare workforce will be more diverse overall, there is significant variance among professions. The authors specifically call out OT for having a smaller percentage of Black OTs in our educational pipeline than we have in our current workforce. This alarming revelation suggests that OT may actually become less diverse as time goes on—meaning we are headed in the wrong direction.

There is so much to unpack from this data, and we are excited to welcome back to the podcast a guest from one of our most popular episodes: Arameh Anvarizadeh, OTD, OTR/L, FAOTA.

Why is this research important?

A substantial body of literature suggests that fostering a diverse and inclusive workforce is critical to improving care access and quality for underserved populations.

For example:

  • Studies suggest that a diverse workforce may improve healthcare providers’ cultural competence and better prepare them to respond to the needs of the entire population.
  • Student body diversity is associated not only with better overall student preparation to care for minority populations, but also with more equitable access to care across the population as a whole.
  • A more diverse workforce with a broader set of experiences in leadership roles can help foster research and policy agendas that reflect a wider set of needs and priorities.

What’s missing from the research?

In the healthcare space, most workforce diversity research has focused on physicians. Few studies have assessed the diversity of other healthcare professions or tracked them over time…which leads us to this paper.

What was the intent of this research?

The authors sought to estimate the racial/ethnic diversity of the current workforce AND the graduate pipeline. They also set out to evaluate whether pipeline data suggests greater representation of Black, Hispanic, and Native American professionals in the future.

Methods

This cross-sectional study used publicly available 2019 data from two databases:

  1. American Community Survey

This survey collects data from 1% of the population annually, then weights it to represent the nation overall.

  1. Integrated Postsecondary Education Data System

This data set includes racial/ethnicity demographics collected annually from nearly all post-secondary institutions.

Developing a diversity index

From these massive data sets, the authors created a relatively simple metric to measure diversity in each health profession: a ratio of the percentage of different races/ethnicities in a particular health profession to their percentage in the total working age population. This is the diversity index.

For example, 12% of working age individuals in the US are Black. If 12% of practitioners in OT were Black, our diversity index would be 1. If only 6% of OT professionals were Black, our diversity index would be 0.5.

So, ideally your ratio is around 1—or at least trending that way!

Okay, let’s look at the actual numbers…

Results

This study comprised 148,358,252 people who were working or searching for work and 71,608,009 people in the educational pipeline. (This is a huge sample!)

There are so many numbers to explore in these results. But for the sake of this review, I am going to focus on the representation of Black OT practitioners and students, as the authors highlighted these findings as indicative of a particularly problematic shift.

(Note that OT’s diversity index for Hispanic individuals is actually increasing, and the diversity index for Native Americans is down by a very slight margin.)

Workforce estimates of current OT practitioners:

White: 80.5%
Black: 6.1%
Hispanic: 5.2%
Native American: 0.2%

Here’s how Black representation in OT compares to other healthcare disciplines. (Keep in mind that about 12% of the overall US workforce is Black.)

  1. Respiratory therapists: 11.4%
  2. Registered nurses: 11.3%
  3. Pharmacists: 7.5%
  4. Advanced practice registered nurses: 7.3%
  5. Occupational therapists: 6.1%
  6. Physicians: 5.2%
  7. Speech-language pathologists: 4.7%
  8. Physician assistants: 5.2%
  9. Dentists: 4.4%
  10. Physical therapists: 3.3%

Here’s a breakdown of the OT graduate pipeline:

White: 78.2%
Hispanic: 7.7%
Black: 4.2%
Native American: 0.2%

Lastly, here’s how Black representation in the OT graduate pipeline compares to other healthcare professions:

  1. Advanced practice registered nurses: 14.2%
  2. Respiratory therapists: 13.3%
  3. Registered nurses: 11.3%
  4. Pharmacists: 9.5%
  5. Physicians: 5.8%
  6. Dentists: 4.9%
  7. Occupational therapists: 4.2%
  8. Speech-language pathologists: 3.9%
  9. Physical therapists: 3.2%
  10. Physician assistants: 3.1%

Okay. You can see above that the percentage of Black graduates in our educational pipeline is LESS than the percentage in our current workforce. That means our diversity index is trending downward. And, out of the ten professions included in this study, ours showed the largest shift in the wrong direction!

Discussion

While overall data does show greater diversity among new-grad healthcare professionals compared to the current workforce, it’s important to acknowledge that the healthcare graduate pipeline remains substantially less diverse than the general population.

In five of the ten professions, Black representation in the graduate pipeline trailed behind representation in the current workforce. For physician assistants and physical therapists, this may be due to increasing degree requirements.

Other factors that may contribute to lack of diversity in the healthcare workforce include:

  • Low-quality secondary education
  • Limited financial support
  • Lack of mentorship and role models
  • Unreceptive educational environments

Data transparency with regard to race/ethnicity may help boost efforts to address these factors—ultimately leading to more workforce diversity.

Additionally, annual reporting on racial/ethnic representation in different healthcare professions may foster accountability and motivate meaningful action to increase diversity.

Key stakeholders in this work include:

  • Educational institutions
  • National associations
  • State policymakers

The outcomes of this study are a clear call for introspection and review among healthcare leaders across professions in order to understand the causes behind our current lack of diversity—and to develop next steps for addressing these causes and improving the quality and diversity of the healthcare workforce.

Ep73-AOTA-Badge

:white_check_mark: Review %open%

After earning your certificate, please consider taking a moment to answer the following three questions:

1.) On a scale of 1-5 please indicate the degree to which the learning objectives were met.

  • 1
  • 2
  • 3
  • 4
  • 5
0 voters

2.) Please rate our instructors on a scale of 1-5.

  • 1
  • 2
  • 3
  • 4
  • 5
0 voters

3.) On a scale of 1-5, please rate the learning environment of the Club.

  • 1
  • 2
  • 3
  • 4
  • 5
0 voters

Please share any other feedback below! Including, ideas for future programming, and most importantly, how you feel this podcast will impact your practice!

3

Thank you for presenting this very important information. I think it speaks loudly to the condition of not providing equitable education in our very for profit educational system. I certainly don’t think it is a reflection of the value of our profession. I am looking foward to the Feb 8th discussion

1 Like
4

Sarah, this is a great topic and very much needed in our current time. I am a little sad to see that OT is trending in the wrong direction as far as future black OT professionals go.
I work in an OT program that is housed in a historically black college and university (HBCU) and is in the impoverished section of the town. When I started teaching here many years ago, I was surprised to see that there were more white students in our OT program than blacks though the undergrad student population was mostly black (same with PT but nursing programs did better even here). We started working aggressively towards improving this through early assurance programs (EAP) for our university students and other HBCU partners in the area. Additionally, we conduct regular information sessions for our students and nearby middle and high schools to inform students early about what OT is and what can they do to enter this profession if interested. Through the years, I have heard so many stories of marginalization of these students not only for the reasons you stated above but also due to lack of information, minimal or no support from home, lack of a role model, and many more.
With our efforts, we are gradually seeing a change in our OT student demographic where about half or more in our program are black or Hispanic now.
There is a lot more we all need to do so our OT profession becomes more diverse and mirrors the population they will eventually serve. I am interested in knowing what other programs are doing to recruit more black and Hispanic students in their OT programs. Thanks so much for bringing this in the limelight.

4 Likes
5

Wow… this really made me pause to think. I had mostly been thinking about how we can work within the current system. But, I think imagining how the whole educational system needs to change is crucial…

6

I love your school so much, @sanchala! And, I love hearing about your success.

As we looked at the decrease in diversity numbers from 2019, we wondered if perhaps a program at a HBCU closed? Or maybe the push towards the doctorate at the time, impacted the demographics of the student population.

Ideally, we see our profession’s diversity stats year over year, and even from different schools to really understand the trends.

As to your question of what other schools are doing, I enjoyed reading this article from @cristina4 and her colleagues at the Medical University of South Carolina:

Holistic Admissions: Strategies for Increasing Student Diversity in Occupational Therapy, Physical Therapy, and Physician Assistant Studies Programs.

7

Thank you. I agree with all the factors stated in the article and glad to see their efforts working.
My collegues and I wrote an article highlighting our efforts in the AOTA SIS quarterly that has won the "excellence in writing award’. It is titled as below-
• Sen S.K., Ingram CD., Collins ME., Bell CS. (2023). Developing intentional partnerships for enhancing diversity in occupational therapy education. AOTA Education SIS Quarterly, Feb 2023
Looking forward to the Feb 8th podcast.

4 Likes
8

Here’s the link and thank you for sharing this @sanchala! https://www.aota.org/publications/sis-quarterly/academic-education-sis/aesis-2-23

What comes to mind as low hanging fruit for where to BEGIN is directly also spoken to in your article @sanchala. I am inspired to:

  • PICK A FOCUS AREA TO BEGIN.

We had a wonderful training this year at Oakwood and it also helped me realize more options in where I could begin, including defining diversity, equity and inclusion and really beginning to understand each. And then to begin advocating for policy/procedural changes within my own organization such as beginning a DEU committee or in our case beginning to advocate for more diverse representation on our board of directors and even Dementia Friendly Task Force. We also now speak more openly about our areas of growth and who we can invite in to the work we are doing but also were we can go to learn NEW and different ways of doing things.

This topic will never get old. Where else have others been inspired or already begun this work in their own work/community (of expanding intentional inclusion in ethnic representation in OTP work)?

2 Likes
9

Thanks Sanchala ! Sure was an eye opener re all that you stated in your response.
Retrospectively, I now realize that all through my long career as an OT, I’ve hardly seen any Black OTs. I really used to literally long to see them and work with them. Not with any great research or educative intent, but just as somebody different/ diverse to exchange work experience, thoughts and ideas. And just hang out with one. Especially so cos I came as an immigrant, cleared the OTR and then there was no looking back.
I figured that I was just not lucky enough to bond with one of them. Just once or twice I interacted but this was on a very temporary basis. And I thought to myself, well therapists come and go all the time……………
However, I think I now understand that there is a much deeper reason for this. In fact more than one reason I guess. Yes, I think all that Sanchala mentioned could very well be true/real : lack of information, minimum or no support from home and lack of a role model.

2 Likes
10

Thanks Monica and Ruth also

1 Like
11

I am also printing this right now, @sanchala and will probably add it to the course resources! Thank you to you and @cynthia3, Megan, and Chinno for putting this paper together!

12

like Bell, Cynthia reacted to your message:

13

Wow.
What an impactful podcast/ OT potential production. I want to say that I am a devotee of Arameh probably old enough to be her mom but I feel like I planted a seed…… where she landed early in her career at CCS in Reseda. CA and have since been inspired by her as I followed her career as a Black OT Leader. I often refer to her as Arameh Anvisonarizedeh as she is about DOING …. and this subject is about doing! In our Black American culture it has been said “ if you can see it, you can be it” … being both a Visual & Auditory “sensor”, I have added “if you hear it, you bear it” and as a self-admitted senior with ADHD I’m hoping to organize and mobilize! I’ve had great intentions across my very long career and the impact I have made has been at the intervention and FWE levels ……NOT at the policy level!
Looking at these numbers and hearing Sarah & Arameh …. as I am only 4 months away from Medicare eligibility ……Health Equity looms LARGE. I feel this may be my jumping in point to the Double Dutch Action Rope!
Thank you Sarah and Arameh for this very important podcast especially as it comes in January ushering in February Black History Month and March Women’s History Month while bumping up against April OT Month.
Wow how strategically positioned was this for me and I hope for many many others.
Let’s get into some “Good Trouble”
Janyce
MJOT-2-West

1 Like
14

This is uncanny! I was literally just texting with our capstone student @alana1 about this episode, when I pulled open my computer to see this comment.

@arameh is such an inspiration, and I’m so thankful that since this recording she was elected as out AOTA pres!

Can’t wait to see what kind of good trouble you get into, @janyce