On June 29, 2023 the Supreme Court ruled, in a 6-3 decision, that race-conscious admissions, using race as one of many factors that allow for admission into highly selective schools, was unlawful. According to experts this decision will have broad implications not just in higher education admissions but across the country in different industries, including health care. Experts, news coverage, and reactions from key officials and leading organizations have made clear this decision will harm efforts to address the growing racial and ethnic disparities in health care – most notably initiatives to diversify the health workforce, which are proven to reduce bias and improve health outcomes for people of color.
Statements
President of the United States Joe Biden. “[F]or forty-five years, the United States Supreme Court has recognized a college’s freedom to decide… how to build diverse student bodies and to meet their responsibility of opening doors of opportunity for every single American. Today, the Court once again walked away from decades of precedent and make — as the dissent has made clear. The Court has effectively ended affirmative action in college admissions. And I… strongly disagree with the Court’s decision. I’ve always believed that the promise of America is big enough for everyone to succeed and that every generation of Americans [has] benefitted by opening the doors of opportunity… wider to include those who have been left behind. I believe our colleges are stronger when they are racially diverse. We cannot let this decision be the last word. Today, I’m directing the Department of Education to analyze what practices help build a more inclusive and diverse student bodies and what practices hold that back, practices like legacy admissions and other systems that expand privilege instead of opportunity. Colleges and universities should continue their commitment to support, retain, and graduate diverse students and classes.” [6/29/23]
Secretary of the Department of Health and Human Services Xavier Becerra. “The Supreme Court ruling today weakens efforts to make higher education more accessible to members of historically underrepresented groups. People of color have been excluded from attending medical school and joining medical organizations for generations. While progress has been made, there is still a significant deficit in the number of Black and Latino doctors and medical students. We need more health workers, especially those who look like and share the experiences of the people they serve. This builds trust between provider and patient, and helps to improve the overall quality of care. This ruling will make it even more difficult for the nation’s colleges and universities to help create future health experts and workers that reflect the diversity of our great nation. The health and wellbeing of Americans will suffer as a result.” [6/29/23]
President of the American Medical Association Jesse M. Ehrenfeld, M.D., M.P.H. “Today’s decision by the U.S. Supreme Court undermines decades of progress centered on the educational value of diversity, and will reverse gains made in the battle against health inequities. This ruling restricts medical schools from considering race and ethnicity among the multiple factors in admissions policies and will translate into a less diverse physician workforce. Diversity is vital to health care, and this court ruling deals a serious blow to our goal of increasing medical career opportunities for historically marginalized and minoritized people. While our country grows more diverse, historically marginalized communities have been left behind on nearly every health indicator. A physician workforce that reflects the diversity of the nation is key to eliminating racial inequities. There is convincing evidence that racially diverse care teams produce measurably positive health outcomes for patients in historically marginalized populations. The goal is not racially segregated care, but rather a health care workforce in which racial and ethnic representation is a more common aspect of care teams. Eliminating health inequity requires more commitment to, investment in and support for Black, Latinx and Native American and Indigenous communities, and LGBTQ+ people. Yet, today’s ruling undermines policy that was producing positive results and improving the health of our patients, as well as making all physicians better practitioners. This ruling is bad for health care, bad for medicine, and undermines the health of our nation.” [6/29/23]
CEO and Chief Legal Officer of the Association of American Medical Colleges David Skorten M.D. and Frank Trinity JD. “We are deeply disappointed with the U.S. Supreme Court’s decision to dismantle its longstanding precedent in the 2003 case, Grutter v. Bollinger, which had recognized student body diversity as a compelling interest permitting the limited consideration of race in admissions. Today’s decision demonstrates a lack of understanding of the critical benefits of racial and ethnic diversity in educational settings and a failure to recognize the urgent need to address health inequities in our country. The AAMC, informed by decades of research, recognizes the undeniable benefits of diversity for improving the health of people everywhere. We remain committed to enhancing health professional education and practice by emphasizing critical thinking, innovation, effective communication with all patients, and increased access to patient care for an increasingly diverse population.” [6/29/23]
National Hispanic Medical Foundation. “The National Hispanic Medical Association (NHMA) condemns the Supreme Court of the United States decision based on the cases against Harvard College and the University of North Carolina striking down race-based admissions in all colleges and universities across the country. This ruling against affirmative action in higher education rolls back decades of precedent to the 1950’s era of Brown v. Board of Education. Our nation’s future depends on racial equity and diversity in higher education to achieve upward mobility for our families and greater prosperity among our multicultural communities that leads to a thriving economy. We must continue to work together to achieve this goal. We call on government and philanthropy to commit long-term financial investments to community based organizations to develop innovative strategies that will continue to prepare students for the application process that will support diversity in higher education.” [6/29/23]
President of the National Medical Association Garfield Clunie, MD. “The Court has yielded a devastating opinion ruling race-conscious admissions processes unconstitutional. This is a major blow to this nation, including to the health of all Americans, especially those in underserved communities. Diversity in medicine is crucial to the health of this nation. This country should be doing all in its power to be more inclusive in the halls of higher education, not less. Affirmative action policies were designed to address racial bias and inequity, major barriers to ensuring diversity in medicine. These obstacles negatively impact not only the medical profession, but most importantly, the patients that we serve. This ruling is a colossal step backwards that will reverberate for decades to come.” [7/3/23]
President and CEO of the American Association of Colleges of Nursing Deborah Trautman Ph.D. “The American Association of Colleges of Nursing (AACN) joins with the larger higher education community in denouncing this decision, which threatens the creation of more diverse and inclusive learning environments,” said Dr. Deborah Trautman, AACN President and Chief Executive Officer. “AACN reaffirms our commitment to serving as a champion for diversity, equity, and inclusion, while recognizing the importance of a diverse nursing workforce to reducing health disparities, addressing social determinants of health, and improving patient outcomes. We stand with our schools of nursing and will work diligently to identify strategies, to ensure our student populations reflect the broad diversity of our society.” [6/29/23]
General Counsel and Chief Legal Officer of the American College of Obstetricians and Gynecologists Molly Meegan. “Today’s Supreme Court decision is a direct blow to people of color across the United States, who are already at risk of poor health outcomes. We know that racial diversity in health care literally saves lives: research and experience have shown time and time again that disparities in health outcomes decrease when patients are treated by health care professionals who have learned and worked alongside colleagues of different racial and ethnic backgrounds. The best way to ensure diversity in the medical workforce is through holistic considerations of medical school candidates that take into account race, ethnicity, and the lived experiences that each candidate could bring to their career as a physician because of their background. Comprehensive consideration of each medical student candidate as an individual can only benefit the communities for which they will ultimately provide care. More diversity in health care means better-educated physicians; higher quality of care; and healthier people, families, and communities everywhere. Less diversity in health care can mean physicians who may be less equipped to connect with and treat the diverse patient populations they serve and patients with worse health outcomes, both of which cause entire communities to suffer.” [6/29/23]
President of the American College of Physicians Omar T. Atiq, MD, FACP. “The American College of Physicians (ACP) was disappointed to see the Supreme Court decision issued today that rules against the use of affirmative action as a part of a college or university’s comprehensive admissions process. ACP believes that a diverse, equitable, and inclusive physician workforce is crucial to promoting equity and understanding. Diversity in the health care workforce not only benefits underserved patients but improves care for all patients. Evidence has shown diverse populations in educational and medical training settings improves learning outcomes by increasing active thinking and intellectual engagement skills and increases understanding of and empathy for diverse cultures. A diverse physician workforce should include individuals of all races, including Indigenous, Black, Latinx, Asian American, Native Hawaiian, Pacific Islander, and other persons affected by discrimination to better reflect the population for whom we care. Considering race as one of the many determining factors used when considering an individual’s admission to an education program can be an important way to combat the harm that systemic racism and discrimination has in the United States. Affirmative action is one means of helping to promote that diversity. Medical schools and other institutions of higher education should consider a person’s race and ethnicity, alongside other factors that are often considered like socioeconomic status and geographic location, as part of evaluating applicants to counter both past and current discrimination. ACP will continue to advocate for policies that can help to increase diversity and promote equity.” [6/29/23]
Executive Director of the American Public Health Association Georges C. Benjamin, MD. “Without affirmative action, we risk turning the clock back on years of progress that have led to improved outcomes and a more diverse public health and health care workforce. Affirmative action policies and programs have directly resulted in the diversification of the public health and health care workforce, with more practitioners of color working directly in communities that suffer some of the worst health disparities and outcomes. With a more diverse public health and health care workforce, we can address and redress years of systemic racism that has sustained poorer health outcomes for our communities of color. Countless studies confirm that diversity in the health care and public health workforce is critical to addressing health disparities, improving cultural competency, building trust and promoting equity. Public health professionals and physicians that bring different perspectives and experiences to their work and patients can better address socio-cultural factors that influence health and access to care. To not consider an applicant’s full background, especially as underrepresentation of certain minority groups in health professions remains an enduring problem, will ultimately lead to lower minority enrollment and worse overall national health.” [6/29/23]
A Coalition of 12 Civil Rights Groups Including the National Urban League and the NAACP. “The extreme decisions of the Supreme Court to overturn affirmative action in the college admissions process was incredibly disappointing. The conservative-majority court erased decades of momentous progress. The effects of this decision will further perpetuate the deep and structural racism that exists in this country. To claim that affirmative action violates the equal protection clause of the 14th amendment goes to show that there are members of the Supreme Court who are unfamiliar with the amendment’s history and intention. Our nation is stronger because of the unique experiences and talents of all people. Yesterday’s decision serves as a distressing reminder of the uphill battle we continue to face in dismantling systemic racism and the potential implications this decision can have on diversity, equity, and inclusion efforts in the workplace. Despite this Supreme Court ruling, we remain resolute in our commitment to constructing equitable pathways to higher education and the opportunity that comes with it.” [6/29/23]
Joint Statement of the National Council of Asian Pacific Americans. “This decision has implications not only for undergraduate admissions but also for graduate-level admissions, including medical and nursing school. Our communities’ health does best when medical professionals are more likely to understand our experiences. Native Hawaiians and Pacific Islanders continue to be grossly underrepresented in the medical profession, and health equity is further compromised by this decision – particularly in the shadow of the impact of COVID-19 on NHPI communities, which had one of the highest per capita death rates in our nation. The Supreme Court has chosen to ignore the reality of persistent racial discrimination and inequality in our country, and has undermined the efforts of educators and advocates to create more equitable and diverse learning environments. Inclusive education and representation for our communities isn’t just about what’s on the curriculum—it matters who is in the classroom to begin with. For decades, affirmative action has been an essential tool to ensuring that students from all communities have access to higher education. This ruling is a step backwards.” [6/29/23]
Robert Wood Johnson Foundation in a Philanthropic Joint Statement. “The Supreme Court’s decision impedes colleges and universities from selecting their own student bodies and fully addressing systemic racial inequalities that persist. The ruling threatens to return this nation to a time when education and opportunity were reserved for a privileged class. It endangers sixty years of multiracial movements to challenge our nation to live up to the ideals enshrined in our founding documents. In the realm of health, research shows that racially and ethnically representative medical schools produce better-trained physicians and care teams that reflect the communities they serve. Universities and colleges and those organizations supporting them deserve the resources and support to continue their critical mission. Our nation’s future prosperity, vitality, and unity depend upon America becoming a true multiracial democracy—an aspiration that requires racial equity and diversity in higher education. Despite today’s ruling, our foundations will not waver in our commitment to those making the nation’s high ideals a reality for all communities and all people.” [6/29/23]
Headlines
NBC News: The Affirmative Action SCOTUS Ruling Will Have a Negative Impact on Health Equity Efforts. “The Supreme Court’s affirmative action ruling will have far-reaching consequences for Black and Latino students hoping to attend medical school and, in turn, only worsen the health disparities among people of color across the country, experts said. After the high court’s ruling Thursday struck down affirmative action programs at the University of North Carolina and Harvard, many fear that medical and nursing schools and other professional institutions will no longer be able to foster diversity by considering race in their admissions processes. The decision will result in fewer Black physicians and more racial bias in the medical field, said Dr. Uché Blackstock, a physician who is the founder of Advancing Health Equity. Justice Sonia Sotomayor highlighted the ruling’s potential impact on health care… Data and decades of research support Sotomayor’s opinion. Black and Latino people are both more likely to have chronic and life-threatening health conditions and to lack health insurance as a result of systemic racism, according to the Kaiser Family Foundation. However, research has shown that those health outcomes for Black and Latino patients are better when they are treated by doctors who share their race or ethnicity.” [NBC News, 6/29/23]
Bloomberg (Opinion): Supreme Court Ruling on Affirmative Action Will Hurt Health Care. “The Supreme Court’s decision to end affirmative action at universities lands at a time when the US health-care system is already struggling to close egregious racial gaps in health outcomes. Diversifying the health-care workforce has been a critical part of that effort—and something that this ruling could make much harder. Patients, especially Black, Hispanic and Native American patients, now could be worse off. The health-care community has long acknowledged that diversifying the medical workforce is essential for addressing health-care inequities. Study after study shows that when a patient and physician have a shared characteristic, health outcomes improve. Black patients who receive care by Black doctors, for example, receive more time and attention, are more likely to adhere to treatment regimens like taking heart medicine, and are better able to manage complex diseases. Black newborns cared for by Black physicians have better survival rates. Black doctors are also more likely to believe their Black patients’ descriptions of pain and treat them accordingly. Doctors and educators also say that attending medical school with diverse student bodies made them better health-care providers. An analysis of public medical schools in states with affirmative action bans found a 4.8% drop in underrepresented students in the five years after those bans were implemented. Meanwhile, schools without bans had a modest increase in underrepresented students during that time. In ending affirmative action, the Court’s conservative majority just raised a new barrier to addressing inequities in health care. That will take a bad situation and make it even worse.” [Bloomberg (Opinion), 7/3/23]
Stat: Affirmative Action in Medical Schools Has Saved Lives, SCOTUS Ruling Ends That. “Despite decades of research and advocacy, along with millions of dollars committed to eliminate health disparities, generations of Black and brown patients continue to be mistreated and die from the effects of racism in the U.S. This has continued even amid the recent racial reckoning that sounded the alarm for racism as a public health issue. Time after time, studies have shown that class is not protective. Social status is not protective. And in the experience of our fellow physicians, even being a doctor cannot save you from racism in medicine. One solution to address these disparities has been to diversify the medical workforce — a solution that was severely handicapped Thursday when the Supreme Court ruled against affirmative action and race conscious admissions. The latest data on medical school diversity is dismal: 5.7% of all doctors in the U.S. are Black, while 7% are Hispanic, far lower than figures of 13.6% and 18.9% of the general population, respectively. Yet having Black and brown physicians is integral to questioning the status quo in medicine. Put simply, these doctors literally save lives. In fact, a recent study showed that for every 10% increase in the number of Black primary care physicians in a county, there was a 31-day higher life expectancy for Black individuals living there. The Supreme Court has now established a policy that will keep more individuals of color out of the pathway to medicine. By abolishing race-conscious admissions, we are simply quitting while we are behind.” [Stat, 6/30/23]