Diversity exemplified Throughout Texas A&M Health Science Center

Newswise — Nearly a decade into the 21st Century, racial and ethnic minority populations continue climbing steadily, bringing together varied cultural and linguistic backgrounds to make the United States the “melting pot” it is today.

According to the U.S. Census Bureau, racial and ethnic minority populations will account for nearly 90 percent of the increase in overall U.S. population from 1995 to 2050. Hispanics will be the fastest growing ethnicity, with Asian and Pacific Islanders the fastest growing racial groups.

Unfortunately, the U.S. Department of Health and Human Services Office of Minority Health has found that race and ethnicity are associated with persistent, and often increasing, health disparities among various sectors of the population. Many of these discrepancies are caused by barriers of culture, language and education between the health care provider and patient.

The Texas A&M Health Science Center vision is that faculty, staff and students are united by a belief that all people – regardless of geography, economics or culture – deserve the benefits of compassionate care, superior science and exceptional health education.

Consistent with its mission, the HSC is called to recruit a diverse body of outstanding students, reflective of Texas and drawn not only from across the state but also from throughout the nation, along with a faculty as notable for its cultural richness as for its character and accomplishments. It also will take full advantage of its geographically dispersed locations to create a widespread, multi-cultural community.

By increasing racial and ethnic diversity among health professionals, an Institute of Medicine report found improved access to care for racial and ethnic patients. There also exists greater patient choice and satisfaction, better patient-provider communication, and improved educational experiences for allied health students.

School of Rural Public Health

From 1998 to 2008, the HSC-School of Rural Public Health has been nationally ranked in the top three in student body diversity among schools of public health.

Its founding dean, Ciro Sumaya, M.D., M.P.H.T.M., has been appointed the newest Chairman of the Board of Directors of the National Hispanic Medical Association (NHMA). Founded in 1994 and representing 36,000 licensed U.S. Hispanic physicians, the organization is frequently asked to provide testimony to Congress and other national organizations.

“A very unique feature of NHMA is that it is not a trade organization to further the welfare of physicians,” Dr. Sumaya said. “It was established to provide a health policy resource to advance the well-being of the underserved Hispanic and other vulnerable people. It also is not just a grouping of well-intentioned Hispanic physicians, but it welcomes the participation and support of non-Hispanics in improving the health of Hispanic populations across the United States.”

The dean is not the only one in the HSC-SRPH garnering recognition.
Elaine Hernandez, M.Ed., M.P.H., HSC-SRPH graduate, received an award from the Mexican Consulate in recognition of her “enthusiasm and dedication to the promotion of health and bi-national cooperation in the Rio Grande Valley.”

For the last six years, Hernandez has collaborated with the Consul Luis Manuel Lopez Moreno of the Mexican Consulate in McAllen to bring together stakeholders from both sides of the border interested in a “safe, healthy and prosperous border region.”

In her role, Hernandez supports tuberculosis prevention and control projects and their implications for those living with HIV/AIDS, as well as the impact on diabetics.

“The American Red Cross is completing its pilot TB project with the Mexican Red Cross in Matamoros, Tamaulipas, and is looking for ways to expand the model into Reynosa and along the Tamaulipas-Texas border,” Hernandez said. “Also, I am assisting Rotarians from Austin and Nuevo Laredo to prepare a $300,000 grant for the Rotary Foundation to develop the Reynosa Regional Center for Tuberculosis, which will improve the capacity of the Mexican Secretariat of Health to diagnose and treat TB patients.”

In addition, Sang Nam Ahn, an HSC-SRPH doctoral student, was awarded the 2007 Korean Honor Scholarship from the Republic of Korea ambassador – one of only 23 master or doctoral students in the United States and Canada to receive the honor.

“It is a great honor to receive the Korean Honor Scholarship that awards students with Korean heritage who have showed exemplary performance and potential to be world leaders in their field,” Ahn said. “My goal is to be Director-General of the World Health Organization.”

Demonstrating his early rise in the public health field, Ahn was selected to present his research at the U.S.-Korea Conference. He is the lead author of a paper investigating the predictors of community-dwelling elderly who receive or are applying for Medicaid home care services and who are overweight or obese compared to those of normal weight.

Ahn also was named president of the Texas A&M University International Graduate Student Association. The IGSA supports international students through advocacy on their behalf, as well as providing educational programs and creating social networking opportunities.

“I was attracted to serve international students who are relatively less informed, less outspoken and concerned about struggles at Texas A&M,” Ahn said. “In addition, it is a lot of fun to collaborate with people from different cultural backgrounds.”

Prior to beginning his Ph.D. in health services research at HSC-SRPH, Ahn earned a Master of Public Service and Administration degree from the George Bush School of Government and Public Service at Texas A&M. He completed his undergraduate work in Seoul, South Korea, his native country.

“After studying policy and public administration at Texas A&M University, I was seeking a field to merge my previous experience and academic specialty, which turned out to be health policy and management at the School of Rural Public Health,” Ahn said. “HSC-SRPH was a great choice for me. I realized that HSC-SRPH is one of the fastest-growing schools of public health in the nation with great faculty and a lot of opportunities.”

College of Medicine

For the third consecutive year, the HSC-College of Medicine has been named in the Top 20 U.S. medical schools for Hispanics by Hispanic Business magazine. Ranked No. 13 in the most recent edition, the College is noted for its commitment to diversity within the student body.

“It is such an honor to be recognized by Hispanic Business for the third year in a row,” said Christopher C. Colenda, M.D., M.P.H., Jean and Thomas McMullin Dean of Medicine. “Our commitment to diversity is an important part of who we are at the College of Medicine, so we are thrilled to be recognized on a national level.”

For the 2006-07 academic year, the HSC-COM had an enrollment of 324 students, including 34 Hispanics comprising approximately 11 percent of overall enrollment. It awarded 77 degrees last spring, including nine Hispanic recipients.

The growing diversity in the HSC-College of Medicine will continue as its incoming class – the Class of 2012 – has the highest percentage of underrepresented minority students in the College’s history at 21 percent, said Filo Maldonado, assistant dean for Admissions.

Within the HSC-College of Medicine, the Student National Medical Association (SNMA) is dedicated to increasing the number of underrepresented minorities interested in medicine as well as increasing admission and retention of these students. Much of the group’s work is geared towards eliminating health disparities in communities via education and services.

Founded in 2003, the College’s SNMA chapter is the youngest in Region III. This region encompasses Arkansas, Colorado, Louisiana, Mississippi, Oklahoma, New Mexico and Texas and is comprised of 15 chapters.

The College’s chapter has been active since its inception, holding a bone marrow drive in 2006, participating in annual local Martin Luther King, Jr. Day activities, organizing an annual Valentine’s Day fundraiser and hosting the Region III Conference in 2005.

The HSC-College of Medicine is also using partnerships like the Undergraduate Medical Academy (UMA) to recruit and train the next generation of medical professionals. In fall 2004, the College and Prairie View A&M University formed this innovative program, focusing on preparing students for medical school and careers in the medical field by offering opportunities for preceptorship and summer research experiences at the College Station and Temple campuses.

Through their education at the UMA, students are given a first-hand look into the daily schedules of physicians and researchers. HSC-College of Medicine faculty are highly involved in the program, acting as instructors and advisors and working with students to help them prepare for the Medical College Admission Test (MCAT).

As a testament to the program’s success, several UMA graduates are now students at the College.

These achievements respond to the Texas Higher Education Coordinating Board’s Closing the Gaps in 2015: The Texas Higher Education Plan. The report indicates the state’s Hispanic and black populations have enrolled in higher education at rates well below that of the white population. The educational enrollment and success rates for all Texans will have to rise more rapidly than ever to avoid a decline in educational levels.

Reaching the THECB goal will require greater numbers of faculty – including minority faculty – to be creative in utilizing resources and recognition of the need to reach every student. It also will require increasing participation from every population group, especially Hispanics and blacks.

Diversity within the HSC-College of Medicine also supports studies that conclude minority physicians, especially African Americans and Hispanics, are much more likely to practice in underserved areas comprised largely of minority and poor populations – as well as conduct research on the unique medical concerns of minorities – regardless of the patients’ race or ethnicity.

Further, more minority physicians also means more service for the growing minority population, more choices for patients, more administrative and leadership talent for health care organizations, and a broader range of research initiatives. The teaching of cultural competencies to medical students enhances patient satisfaction and trust, thereby improving doctor-patient communication, physician decision-making and the likelihood of patients obeying physician advice.

College of Nursing

As Texas and the rest of the country become more diverse, there is an ever-growing need for nurses. The Texas A&M Health Science Center met that need earlier this year with a new College of Nursing in Bryan-College Station, which will offer the B.S.N. beginning later this year.

“We are most pleased to add this very important arena of health professions training,” said Nancy Dickey, M.D., President of the Texas A&M Health Science Center and Vice Chancellor for Health Affairs for the Texas A&M System. “Nurses are key members of the health professions team, and it is appropriate and important that we have the capacity to offer degrees for this group of professionals. With the state facing significant nursing shortages, it is one of our missions to address the shortage.”

The new HSC-College of Nursing will help alleviate the severe nursing shortage across Texas, compounded by an existing nursing work force that is aging and ready to retire. The THECB agreed that increasing the number of registered nurse graduates is so important as to warrant designation as a specific target of success for Closing the Gaps in 2015: The Texas Higher Education Plan.

According to the U.S. Bureau of Labor Statistics projections, more than a million new and replacement nurses will be needed to fill vacancies during the next 10 years, and for the first time, the U.S Department of Labor has identified registered nursing as the top occupation in terms of growth through the year 2012.

“The United States is in the midst of a nursing shortage that will intensify as the population ages and the need for health care grows,” said Sharon Wilkerson, Ph.D., R.N., founding dean of the HSC-College of Nursing. “Yet, many qualified applicants are turned away from baccalaureate programs due to limited resources in existing nursing programs. We are pleased to be able to open the door for some of those applicants with our new program and to help address the nursing shortage.”

“The societal image is anybody can be a nurse, but that is very wrong,” Dr. Wilkerson continued. “It takes a highly motivated, caring individual with a desire to learn as much as possible to be an excellent nurse. We think those are the individuals that the College of Nursing will attract.”

Baylor College of Dentistry

HSC-Baylor College of Dentistry’s efforts to create an environment that more closely reflects the ethnic diversity of the state of Texas and those the College serves are paying off. This year’s first-year dental class is the most diverse of any dental school in the country.

The first-year dental class is made up of 44 percent underrepresented minorities (African-Americans, Hispanics and Native Americans) – up from 26 percent the previous year – and is comprised of 50 percent females. This year, HSC-BCD enrolled more Hispanic first-year dental students than either of the state’s other dental schools.

“Our dental students are selected by the Admissions Committee after careful evaluation of several criteria, which include academic performance, knowledge of the dental profession, motivation, leadership, community service, and volunteer activities and communication skills,” said Dr. Barbara Miller, executive director of recruitment and admissions. “We try our best to find well-rounded, highly motivated and qualified candidates and not just look at a grade point average.”

Using “whole file review” rather than a strict formula has increased the diversity of the class in many ways beyond the most obvious racial/ethnic view of diversity. It also includes more non-traditional students and people with different life experiences.

Increasing diversity is also noted in the College’s patient population, which closely mirrors the diversity of the population in Dallas and the state of Texas.

“As health care providers, our students are responsible for treating patients from diverse cultural backgrounds, not just the majority culture and not just their own group,” Dr. Miller said. “They learn from their classmates as well as from the professors and patients, so a diverse student body promotes this learning.”

This translates into better access to care for our population, especially for those who have traditionally been underserved by the dental profession, Dr. Miller said.

“The bottom line is that diversity means better access to care and better quality of care for more people,” Dr. Miller said.

Institute of Biosciences and Technology

At the HSC-Institute of Biosciences and Technology at Houston, the annual HOPE Luncheon and Fashion Show celebrates the Institute's birth defect prevention research. This work by the Spina Bifida Research Resource is one of several research efforts to understand the causes of spina bifida underway at the HSC-IBT. Studies in other populations and in animal models are also ongoing.

HSC-IBT is part of the Texas Medical Center, which has the world’s largest concentration of scientists from different backgrounds. The resulting various collaborations benefit everyone, especially minorities.

“At the Institute of Biosciences and Technology, we are proud of our diverse population,” said Robert Schwartz, Ph.D., director of HSC-IBT. “We have graduate students and scientists from many different cultures. By working and learning together, all of us develop mutual respect and teamwork.”

“In our community of education and research, we gain the ability to communicate with people from different cultures and backgrounds and to appreciate others for their contributions,” Dr. Schwartz continued. “These are critical skills to acquire in our rapidly changing world.”

Irma Lerma Rangel College of Pharmacy

Alongside these HSC programs and leaders, the HSC-Irma Lerma Rangel College of Pharmacy has reached a level of student diversity mirroring the diverse population of Texas in just its second year of classes.

Currently, 69 percent of the College’s students are representative of minority ethnic groups. Thirty-seven percent of those students are Hispanic, a reflection of Kingsville and the South Texas region where the College opened its doors in the fall 2006.

“Our bottom line is producing quality pharmacists,” said Indra K. Reddy, Ph. D., founding dean of the HSC-Rangel College of Pharmacy. “We can do it in a textbook fashion or by consensus-building as a team where we respect each other and value each other’s diversity, because the diversity of our people is our biggest strength. We are very proud of what we have accomplished so far, and not by making entitlements. They’ve earned this.”

Dean Reddy and the pharmacy students agree the diversity of the College’s student body is an asset to the educational process.

“There is a lot I’ve been able to learn from my classmates,” said Obinna Izundu, a first-year pharmacy student originally from Nigeria. “We’re able to feed off of each other in that aspect, because if you never really had a chance to look at something from a different perspective and you meet someone who has a different background or view, it broadens your perspective of things.”

Dr. Reddy agrees.

“I believe it is value-added, because it enriches all of us by bringing diversity to the table,” Dr. Reddy said. “They are learning so much from each other.”

By learning from each other in the classroom setting, the pharmacy students recognize that they will be more culturally competent when they work with patients from different cultural backgrounds.

“You really need different pharmacists to help different kinds of people, because you have to know their culture to try to explain their medications,” said Rudy Rangel, second-year pharmacy student. “I know with my culture (Hispanic), we are very family-oriented. If you want to get the husband or head of the household to change his ways, you wouldn’t tell him, you would tell his wife because when it comes to within the household, she has more power.”

Dr. Reddy has his own personal example.

“Once, a Muslim woman brought a prescription in for her son during the Ramadan period, where they eat only once a day,” Dr. Reddy said. “This certain prescription was for a 3-times-a-day dosage form, and the lady asked for a once-a-day dosage form to substitute for this. The pharmacist did not understand and said ‘Oh no, this is good for your son.’ That is why I think cultural competency in the professional setting is so important for us to understand.”

Coastal Bend and South Texas

At the HSC-Coastal Bend Health Education Center, Director Juan F. Castro, M.D., adapts the Center’s programs to better serve the predominantly Hispanic population of South Texas. The regional center has recently started offering its Diabetes Management Course in Spanish, and class attendance is growing.

“The Spanish language class is still being developed, but I strongly feel that every class is getting better and the patients are retaining more information,” Dr. Castro said.

Offered twice monthly, the Spanish language course is taught personally by Dr. Castro. He hopes that by drawing upon his personal experiences of the Hispanic culture, patients will be better able to relate to the information, and in turn, gain more knowledge from the class to apply to their lives.

“By saying certain phrases and by adjusting the lecture in a certain way, patients listen more because they can relate ‘Oh, he knows what he’s talking about,’ or ‘I can relate to him, I know where he is coming from,’” Dr. Castro said. “So, I try to relate a little in the lecture about my upbringing, this worked for me or this worked for my mother, and I know it clicks with the patients. I also know what they’re going to encounter when they go back home and lead their normal lives with their relatives and friends, because I know their culture.”

Sandra Garcia of HSC-CBHEC translates for the Center’s registered dietician during the Spanish language diabetes course.

“They want to learn how to control their diabetes,” Garcia said. “With those classes, it is really helpful. We are going to do a follow-up class in a couple of weeks, and they’re going to see if they’re taking what they’ve learned in the class and are using it. That will be good to see the difference the classes are making.”

Garcia also oversees HSC-CBHEC’s Prescription Assistance Program, which is making it possible for people who are not able to afford their medications to get the prescription drugs they need for little to no cost.

“A lot of people have to make choices as to whether they pay their bills or pay for their medication, and that’s a choice nobody should have to make,” Garcia said. “But, many people have to make that choice, and we understand that so we want to be able to reach out to them and help them.”

Through rapid expansion throughout the Coastal Bend region, the Prescription Assistance Program is literally meeting people where they are to provide them with the assistance they desperately need.

“We’ve gone to the colonias, we’ve had health fairs in the colonias, we go to different health fairs,” Garcia said. “We had a health fair at a rehabilitation facility where they help people get back on their feet who have previously lived out on the streets, and they help them out. We were able to meet with the people there and let them know about our program and how it works. They are on medications, and they do not know how to get their medications. We’re able to help them by meeting them where they are.”

In 2007, the Prescription Assistance Program served 253 clients, saving those clients an estimated $282,253 they otherwise would have had to pay for medications they instead were able to get from pharmaceutical companies for little to no cost through this Program.

“People are so grateful, it is unbelievable,” Garcia said. “They show their appreciation in so many different ways. You get people hugging you and crying because they are going to be able to get their medications, and they’ve been feeling so bad.”

Beginning in May 2008, the Prescription Assistance Program will be reaching out to even more people by expanding with an office in Hebbronville, a low-income community located in Jim Hogg County. This will bring the total number of Coastal Bend counties served by the Program to seven.

From dentistry to pharmacy, the Texas A&M Health Science Center is using its diversity to meet the growing, changing needs of Texans through compassionate care, superior science and exceptional education.

The Texas A&M Health Science Center provides the state with health education, outreach and research. Its seven colleges located in communities throughout Texas are Baylor College of Dentistry, the College of Medicine, the College of Nursing, the Graduate School of Biomedical Sciences, the Institute of Biosciences and Technology, the Irma Lerma Rangel College of Pharmacy, and the School of Rural Public Health.