Questions and Answers

2008 Champions of Health Professions Diversity Award Honorees

Juanita Barrena

Q: Why did you choose to become an educator?

A: I pursued a PhD so I could become a professor and be in a position to help students from backgrounds like my own — people from underserved communities — become health professionals. My belief was that if you had enough of us, then we could have an impact. To really make a difference, we have got to get diversity in the professoriate.

Q: Can you tell us about someone you mentored or helped to enter the health profession?

A: I have been privileged in my life to work with thousands of students. In particular, through the Science Education Equity program, I have worked with an extraordinarily diverse population of students, primarily from underrepresented and economically disadvantaged groups, including many for whom English is a second language. One of my goals is to provide them the place where they can excel and realize their own potential. I believe that it’s the students who are the real champions. They’re the ones who struggle against tremendous obstacles. Our role is to provide support, a safe place where they can learn and grow, and a helping hand when they need it.

Q: Why do you think it’s important to diversify the health workforce?

A: There are different communities that are underserved. Whether you’re from a low-income background or from a medically underserved community, we know from the research the likelihood is that you’re going to go back to that community and serve there.

Q: What is the biggest challenge in diversifying the health workforce?

A: Our statewide master plan for higher education did a nice job initially with transferring students from community colleges into four-year institutions, but this master plan doesn’t speak to advancement from undergraduate to graduate or professional schools. So, even though we think we have a pipeline in California, we don’t.

The next critical step is to determine what kinds of arrangements can be made between the four-year or master’s-granting institutions and California institutions that grant PhDs and professional degrees. There need to be more ways of bringing together the leadership of community colleges, the California State University campuses, and the University of California to develop seamless mechanisms for students to move from one place to the other.

David Hayes-Bautista

Q: How did you get involved in diversifying the health workforce?

A: I was involved in the early days. In 1970, we set up a group of Latino health-professional students called the National Chicano Health Organization and we were going to save the world. We wanted to increase Latino enrollment in medical schools. We set out to deal with admissions, recruitment, retention and financial aid. We were going to set up community clinics. And we were going to stop the war in Vietnam and end poverty in the United States.

Obviously, we didn’t succeed in everything. The peak year for underrepresented minority enrollment in medical schools was 1992, and since then it has dropped off dramatically for Latinos, African-Americans, and American Indians. My big message this year is on the disappearing, underrepresented minority medical student in California. We need to do something about this and through this award, we can raise this issue. Our communities need those providers.

Q: What inspires you to do this work?

A: The inspiration for me — and for a lot of the folks that I have worked with —might seem a little strange. But, it was Cesar Chávez. Now you could say, “Cesar Chávez was up in Delano. He was working with farmworkers.” We are urban. I was born in L.A. I’ve lived in the city most of my life.

In many ways, we actually created a different segment of the Chicano movement that’s gotten very little recognition — what I call the Chicano health movement — which inspired the foundation of hundreds of clinics, public art and education. We really took to heart the model of Cesar Chávez. We wanted to emulate what he was doing at that time, and I think to a certain degree we have succeeded.

Q: Where do you think higher education should focus its efforts to diversify the health professions?

A: In California today, 95 percent of Latino, African-American and American Indian students pursuing post-secondary education start in a community college, and only a small percentage of those students actually transfer to a four-year institution. We decided that “we need to start fishing where the fish are.” We began a pipeline program from the community colleges. The California Wellness Foundation was very supportive of this.

Q: Please explain the connection between culture and health.

A: Medicine is medicine. It shouldn’t make any difference. But we’ve done our research, and we found that the human body is connected to other human bodies. It’s called a family. It’s called a neighborhood. Groups of people live in a certain area and they work in certain ways. They eat certain things. They move in certain ways. They perhaps smoke or don’t smoke certain things. They can drink or not drink certain things.

All of this comes from a culture that, in the end, has a lot of impact on an individual’s state of health. As we know from this end, the actual provision of medical services maybe accounts for 20 to 25 percent of someone’s overall health status. Far more important is the culture that people live in — the environment, family genetics and their social networking.

Linda Squires-Grohe

Q: Why do you think you’re being recognized as a Champion of Health Professions Diversity?

A: As dean of health at the City College of San Francisco for the last 10 years, I’ve worked very hard to create programs that help people from underrepresented groups achieve their goals in the health care field. Programs like “Welcome Back” offer training, assistance and counseling to foreign-born health care professionals who come to this country and don't know how to get into the system. We have counselors help these foreign-trained doctors, psychiatrists, social workers, nurses, technicians and technologists find a way back into the health care professions.

These professionals are a wonderful source of health care providers. We live in a multicultural community, and patients in our hospitals are of all ethnicities and cultures. We want to get these health professionals who are trained and generally bicultural and bilingual back into the health field.

Q: What role do you think community colleges play in creating opportunities for low-income and underrepresented minority students?

A: I think that a democracy is only as good as the community college that serves that community. Of all the institutions of higher education, it’s the one that provides access to all. The door is open for everyone. We must make sure that we keep that door open. That’s why I think the community college is so essential to educating a population who may not be able to get into the four-year California State University or University of California system.

I recently had the hospital council’s director ask me, “Why don’t your students just go to San Francisco State to become nurses?” I said, “Because they can’t get in.” But it doesn’t mean they aren’t going to be good nurses. It doesn’t mean that they aren’t going to have the skills. They’re starting from a different place than many of middle- and upper-class students who get to go to a four-year campus. That’s what community college is all about, taking them from where they are and getting them where they need to be so that they can become health care providers.

Q: Why are community colleges essential to the health care field?

A: We are essential to a community’s economic and workforce development. If you look at a hospital, the training for the majority of those jobs takes place at the community college, from the nursing positions to the x-ray technicians, from the nutritional assistant to cardiovascular technicians. Not only are we key because we produce people who have skills and can work in the community, but we also help those students who can’t get into the Cal State or the UC system. We help them become contributing members of their community. We open doors that would otherwise be closed.