In a few weeks, voters in Colorado will decide whether to ban race-conscious admissions at the state’s colleges and universities. Amendment 46, the so-called “civil rights initiative,” would prohibit state-supported institutions, including the University of Colorado Denver School of Medicine, from considering race or ethnicity in admissions decisions.
Here is the bottom line about Amendment 46 from the perspective of medicine and public health: It is not about quotas and set-asides.
These are outmoded, unconstitutional and non-existent at the University of Colorado.
It is, instead, about medical education and workforce training. Colorado voters should oppose Amendment 46, so that the medical school can do its job.
Why is it necessary to consider race? The simple but compelling answer is that a racially, culturally, ethnically, socio-economically and geographically diverse medical student body enhances teaching and learning about medicine.
Every disease, from mental illness to cancer, has a cultural, social and racial context. Language and cultural differences between doctors and their patients can impair communication and lead to poorer health outcomes.
A socially, racially, culturally and geographically diverse student body helps all students – including the majority who are white – broaden their perspectives about health and disease.
Diversity helps medical students communicate better across races and cultures. Diversity enhances their civic commitment. It helps them break down racial and ethnic stereotypes and prepares them to care for Coloradans who are different from them.
The medical school does not use quotas. No “admission points” are ever awarded to bolster minority student applications. The school does not grant preference to under-represented minorities “in order to remedy the effects of past injustices.”
Here’s a fact worth noting: the medical school class that will graduate in May, 2009 does not include a single African-American student. There is no quota system at the medical school.
In Grutter vs. Bollinger (the 2003 Michigan affirmative action case) the Supreme Court affirmed that colleges may consider race as one factor, among many, in a holistic evaluation of an applicant in order to obtain the educational benefits that flow from a diverse student body.
That ruling guides admissions at the school of medicine. The admissions committee first considers an applicant’s college grades, essays and admission test scores.
But test scores are a poor predictor of a student’s clinical performance, so the committee gives additional weight to the applicant’s communication skills, compassion and potential for leadership. Then, the medical school considers diversity — but not just race.
It is not only African-American, Asian, Hispanic and Native American students who bring diversity and new perspectives to the classroom.
First-generation college students, those who have overcome hardships, those with “real-life” work experiences, and those with a record of community service or a rural upbringing also bring diversity and enhance the medical school learning environment.
The medical school considers race only as one factor among many, in a manner that is lawful, limited, flexible and necessary to achieve the fundamental educational goals of the school.
In Colorado and across the nation, disparities in health status exist across racial and ethnic lines. Minority Coloradans have higher infant mortality rates, lower immunization rates, shorter life spans, delayed detection of treatable cancers and more suffering and premature death from injuries, communicable diseases, depression, diabetes, asthma, heart failure and even pain.
All of this leads to decreased work productivity and increased health care costs. More than 500 published studies attest to these disparities. One reason for this excess suffering is lack of access to doctors in minority neighborhoods where most of the patients with these untreated conditions live. Doctors who are Hispanic or African American are 3 to 4 times more likely to practice in poor and underserved communities, just as medical schools graduates who come from rural communities are more likely to return there to begin their practices.
The task of the medical college is to prepare the next generation of doctors — doctors who are able to care for patients of all racial, ethnic and cultural backgrounds and from all walks of life.
Forty years ago, Alfred Haynes, an African-American physician presented a lecture to UC Denver medical students.
Citing the widespread health disparities that were apparent even then, he told the students, “We should not be comfortable when the poor have five times as much arthritis and rheumatism, six times as many mental and nervous conditions and eight times as many visual impairments as the well-to-do At one time it may have been respectable to generate, analyze and even to teach these statistics and then to remain in splendid isolation from the problem.”
Not any more. The School of Medicine is a public institution, supported by taxpayer dollars. The school must pay attention to the health care needs of all Coloradans.
As outlined in the School of Medicine’s Diversity Plan, the medical school’s interest in building diversity is based on the “state’s utilitarian interest in ensuring that the medical professionals who graduate can do their job.”
Steven Lowenstein is a faculty member and Associate Dean at the University of Colorado Denver School of Medicine.
EDITOR’S NOTE: This is an online-only column and has not been edited.
