Concern grows around US health

Oct 08, 2023

There is mounting concern among some US lawmakers about the nation's ongoing shortage of health-care workers, and the leaders of historically Black medical schools are calling for more funding to train a more diverse workforce.

As of Monday, in areas where a health workforce shortage has been identified, the United States needs more than 17,000 additional primary care practitioners, 12,000 dental health practitioners and 8,200 mental health practitioners, according to data from the Health Resources & Services Administration. Those numbers are based on data that HRSA receives from state offices and health departments.

"We have nowhere near the kind of workforce, health-care workforce, that we need," Vermont Sen. Bernie Sanders told CNN on Friday. "We don't have enough doctors. We don't have enough nurses. We don't have enough psychologists or counselors for addiction. We don't have enough pharmacists."

Only 5.7% of US doctors are Black, and experts warn the shortage harms public health

The heads of historically Black medical schools met with Sanders in a roundtable at the Morehouse School of Medicine in Atlanta on Friday to discuss the nation's health-care workforce shortage.

The health-care workforce shortage is "more acute" in Black and brown communities; the Black community constitutes 13% of the US population, but only 5.7% of US physicians are Black, said Sanders, chairman of the Senate Committee on Health, Education, Labor, and Pensions.

"What we’re trying to do in this committee – in our Health, Education, Labor Committee – is grow the health-care workforce and put a special emphasis on the needs to grow more Black doctors, nurses, psychologists, et cetera," Sanders said.

At Friday's roundtable, the leaders of the Morehouse School of Medicine, Meharry Medical College, Howard University and Charles R. Drew University called for more resources and opportunities to be allocated to their institutions to help grow the nation's incoming health-care workforce.

"Allocating resources and opportunities matter for us to increase capacity and scholarships and programming to help support these students as they matriculate through," Dr. Valerie Montgomery Rice, president of the Morehouse School of Medicine, told CNN.

"But also, the other 150-plus medical schools, beyond our four historically Black medical schools, owe it to the country to increase the diversity of the students that they train," Rice said, adding that having a health-care workforce that reflects the communities served helps reduce the health inequities seen in the United States.

Historically Black medical schools are "the backbone for training Black doctors in this country," Dr. Hugh Mighty, senior vice president for health affairs at Howard University, said at Friday's event. "As the problem of Black physician shortages rise, within the general context of the physician workforce shortage, many communities of need will continue to be underserved."

A new study commissioned by the National Institute on Minority Health and Health Disparities estimates that the economic burden of health inequities in the United States has cost the nation billions of dollars. Such inequities are illustrated in how Black and brown communities tend to have higher rates of serious health outcomes such as maternal deaths, certain chronic diseases and infectious diseases.

This is why US health care is so expensive

The researchers, from Johns Hopkins University and other institutions, analyzed excess medical care expenditures, death records and other US data from 2016 through 2019. They took a close look at health inequities in the cost of medical care, differences in premature deaths and the amount of labor market productivity that has been lost due to health reasons.

The researchers found that, in 2018, the economic burden of health inequities for racial and ethnic minority communities in the United States was up to $451 billion, and the economic burden of health inequities for adults without a four-year college degree was up to $978 billion.

"These findings provide a clear and important message to health care leaders, public health officials, and state and federal policy makers – the economic magnitude of health inequities in the US is startlingly high," Drs. Rishi Wadhera and Issa Dahabreh, both of Harvard University, wrote in an editorial that accompanied the new study in the journal JAMA.

CDC studies find racial and ethnic disparities in Covid-19 hospitalizations, ER visits

The Covid-19 pandemic "pulled the curtain back" on health inequities, such as premature death and others, Rice said, and "we saw a disproportionate burden" on some communities.

"We saw a higher death rate in Black and brown communities because of access and fear and a whole bunch of other factors, including what we recognize as racism and unconscious bias," Rice said.

"We needed more physicians, more health-care providers. So, we already know when we project out to 2050, we have a significant physician shortage based on the fact that we cannot educate and train enough health care professionals fast enough," she said. "We can't just rely on physicians. We have to rely on a team approach."

She added that the nation's shortage of health-care workers leaves the country ill-prepared to respond to future pandemics.

The United States is projected to face a shortage of up to 124,000 physicians by 2034 as the demand outpaces supply, according to the Association of American Medical Colleges.

The workforce shortage means "we’re really not prepared" for another pandemic, Sanders said.

"We don't have the public health infrastructure that we need state by state. We surely don't have the doctors and the nurses that we need," Sanders said. "So what we are trying to do now is to bring forth legislation, which will create more doctors and more nurses, more dentists, because dental care is a major crisis in America."

Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

In March, Bill McBride, executive director of the National Governors Association, wrote a letter to Sanders and Louisiana Sen. Bill Cassidy detailing the "root causes" of the health-care workforce shortage and potential ways some states are hoping to tackle the crisis.

"Governors have taken innovative steps to address the healthcare workforce shortage facing their states and territories by boosting recruitment efforts, loosening licensing requirements, expanding training programs and raising providers’ pay," McBride wrote.

"Shortages in healthcare workers is not a new challenge but has only worsened in the past three years due to the COVID-19 pandemic. Burnout and stress have only exacerbated this issue," he wrote. "The retirement and aging of an entire generation is front and center of the healthcare workforce shortage, particularly impacting rural communities."