_Estimates and Projections of Black and Hispanic Personnel in Selected Health Professions U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Health Resources Administration 1980-2000 | S, DEPOSITORY NOV3 1982 ''''Estimates and Projections of Black and Hispanic Personnel in Selected Health Professions 1980-2000 September 1982 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Health Resources Administration, Bureau of Health Professions } Division of Health Professions Analysis DHHS Publication No. (HRA)-82-10 '''' RA Ye Pref ace | _ The enactment of Federal legislation establishing programs of rimenetay Oe support for health professions education (during the late 1960's and ear ly 1970's) also provided a strong stimulus to the enrollment of minority persons and women in health professions schools. While progress has been made in expanding the numbers of minority persons enrolling in health professions schools, the gains have not been as dramatic as those for women. Increases in the number of minority students graauating from health professions schools auring the past decade have undoubtedly resultea in some increases in the number of minority practitioners among the total supply of active health care providers. Unfortunately, current statistics on the numbers, distribution, and characteristics of minority health care providers are not available through which to measure accurately such changes or through which to identify problems and progress. As a result, the Office of Health Resources Opportunity (OHRO) of the Health Resources Administration (HRA) asked the Bureau of Health Professions’ Division of Health Professions Analysis to examine available data on minorities in several of the major health professions, assess and analyze the changes that have occurred, and to forecast, under some clearly iaentifiable assumptions, what the future may hold for minority participation in the health professions. Their objective was to be able to identify more aaequate ly progress and problems of minorities in gaining entry into the health professions. This report responds to that UHRO request. It is hoped, too, that it can also be used more generally as a source document for others interested in the status of minorities in the health field. iii '' This report proviaes estimates of current (1980) levels of the supply of Black practitioners in medicine, dentistry, and pharmacy and Hispanic practitioners in pharmacy and an assessment of what the supply picture for these practitioners may be by the year 2000. These estimates were constructed by utilizing the Bureau of Health Professions general supply forecasting moael. Because of severe data weaknesses and data gaps, the four groups listed above were the only minority health professionals for which estimates ana projections coulda be made at this time. To improve the usetulness of the estimates generated, the report also presents statistics relating the supply estimates and projections to other data for Comparative purposes: proportional representation of Black ana Hispanic practitioners among the total supply of practitioners in the profession. ratios depicting the relationship between the supply of Black ana Hispanic practitioners and the total population in these racial/ethnic groups. This report was prepared in the Division of Health Professions Analysis, Howard V. Stambler, Director, by Ernell Spratley under the direction of Stuart Bernstein, Chief, Supply ana Utilization Forecasting Section ana Leonard Drabek, Chief, Supply and Requirements Forecasting Branch. Elizabeth Aguino and Cathy Cox provided secretarial assistance. iv ''Table of Contents IT. Summary and Overview.......ccccccccccccccccccccccccccccccccccce II. Methodological Overview...........ccccccccccccccccccscecseecs Development of Age-Specific Base Year SUPP]Y. cc ceccccccccces Separation Rates...cccccccccccccccccccccccsccceccccccccecece Caveates and Limitations of Supply Estimates and PROJECEIONS «owas wince ees ibs ado4e TES oe weeeneeeanucuNSamens III. Trends and Projections of Minority Enrollments....sscccceeccccs Trends in First-Year Enrollments......ccceccecceccecccececccs Future Demographic and Educational Trends and FYE levels Other Factors Affecting Future Minority First-Year EMNPOTIMENTS. .ccccscccccuncncscccvesnccusscscccencccsssecsecece Assumptions Underlying Projections of Black and Hispanic First-Year Enrollments. ..cccccccccccccvcccccrssescccveccecs VI. Supply Estimates and Projections....cccccccccccccccccccccceccecs MEdICING. .. eee c cece cece cece cece ccc cecccceccccecccccecccceees PHAPMACY.. cece cccccccccccccccccccccccscccccscccccseccceecccees '' '' Table No. 1 10 1 12 List of Tables Estimated and Projected Active Supply of Total, Black, and Hispanic Practitioners for Selected Health Professions, and Practitioner to Population Ratios, 1980 and 2000 Estimated and Projected Active Supply of Total and Black Practitioners for Selected Health Professions and Representation of Blacks Among the Total 1980 and 2000 Projections of the Active Supply of Black Personnel in Selected Health Professions, 1985-2000 First-Year Enrollment in Schools of Medicine in the United States by Racial/Ethnic Category: Academic Years 1970-71 through 1980-81 First-Year Enrallment in Schools of Dentistry in the United States by Racial/Ethnic Category: Academic Years 1971-72 through 1980-81 Third-to-Last Year Enrollment in Schools of Pharmacy in the United States by Racial/Ethnic Category: Academic Years 1973-74 through 1979-80 Total Female and Minority Female First Year Enrollments in Schools of Medicine, Dentistry, and Pharmacy 1975-76 and 1980-8] Estimated Supply of Active Total and Active Black Physicians (M.D. and D.0.) 1980, and Projected Active Supply 1985-2000, Series I Estimated Supply of Active Total and Active Black Physicians (M.D. and D.O.) 1980, and Projected Active Supply 1985-2000, Series II Estimated Supply of Active Total and Active Black Physicians (M.D. and D.0.) 1980, and Projected Active Supply 1985-2000, Series III Assumptions Relating to Black M.D. Supply Forecasts First-Year Enrollment and Graduate Numbers and Assumptions for Three Series of Black M.D. Supply Forecasts 10 11 29 an 36 37 38 39 '' Table No. 13 14 15 16 7 18 19 20 21 22 23 24 25 List of Tables (continued) Levels of Black First-Year Enrollments and Graduates Necessary to Achieve Population Parity in 2000 Evaluation of Black M.D. First-Year Enrollment Parity Assuming a Low Series of Total First Enrollments Estimated Supply of Active Black Dentists, 1980 and Projected Supply, 1985-2000 Assumptions Relating to Black Dental Supply Forecasts First-Year Enrollment and Graduate Numbers and Assumptions for Three Series of Black Dental Supply Projections Levels of Black First-Year Enrollments and Graduates Necessary to Achieve Population Parity in 2000 Evaluation of Black Dental School First-Year Enrollment Parity Assuming a Low Series of Total First-Year Enrollments Estimated Active Supply of Total, Black, and Hispanic Pharmacists, 1980 and Projected Active Supply, 1985-2000 Assumptions Relating to Black Pharmacists Supply Forecasts Third-Last Year Enrollment and Graduate Numbers and Assumptions for Three Series of Black Pharmacist Supply Forecasts Assumptions Relating to Hispanic Pharmacists Supply Forecasts Third-Last Year Enrollment and Graduate Numbers and Assumptions for Three Series of Hispanic Pharmacist Supply Forecasts Levels of Black Third-Last Year Enrollments and Graduates Necessary to Achieve Population Parity in the Active Supply in 2000 viii 4] 45 46 47 48 49 54 56 57 58 59 ''Table No. 26 27 List of Tables (continued) Page Estimated Active Supply of Total and Hispanic 60 Pharmacists, 1980, Hispanic Pharmacists Necessary to Achieve Parity, and Projected Active Supply of Total and Hispanic Pharmacists, 2000 Evaluation of Black Third-Last Year Enrollment 61 Parity in Schools of Pharmacy Assuming a Low Series of Total Third-Last Year Enrollments ix ''''I. Summary ana Overview The number of active U.S.-trained Black physicians (M.D.'s and D.0.'s) is estimated at 11,700 in 1980, or 3.3 percent of the total supply of active U.S.-trained physicians. Black dentists and pharmacists are estimated to number 3,630 and 3,380, respectively, in 1980 comprising 2.9 and 2.3 percent of the total practitioners in these professions (table 1). The racial/ethnic composition of the supply of health professionals is far different from that of the general population. Black physicians, dentists, and pharmacists comprised only 2-3 percent of the total supply of practitioners in these professions in 1980 while Black persons comprised 11.7 percent of the total U.S. population. In medicine, an additional 27,560 M.D.'s and 1,700 D.0.'s would have been needea in 1980 in order for Black physicians to reach parity in supply, that is to comprise a proportion of total practitioners equal to the representation of Black persons in the total population (table 2). Similarly, in dentistry and pharmacy, the number of additional Black practitioners necessary to achieve parity in 1980 would have been 11,140 and 13,490 respectively. As table 1 illustrates, in 1980 there was 1 black physician (M.D.'s ana D.O.'s) for every 2,264 Black persons in the population, comparea with 1 physician for every 647 persons in the general population. The disparity in these ratios for dentistry and pharmacy are similar, with 1 Black dentist for every 7,297 Black persons in the population and 1 Black pharmacist for every 7,838 persons, as compared with ratios for the general population of 1:1795 and 1:1571 for Gentistry ana pharmacy, respectively. '' The situation for Hispanic pharmacists is similar to that for Black practitioners. Hispanic pharmacists, estimated to number 1,930 in 1980 currently comprise about 1 percent of the total supply of pharmacists, while persons of Spanish Origin comprise 6.4 percent of the population. In 1980 there was 1 Hispanic pharmacist for every 7,568 persons of Spanish Origin in the population compared with a national ratio of 1 pharmacist for every 1,57] persons in the population (table 1). The number of additional Hispanic pharmacists necessary to achieve parity in supply during 1980 would be 7,300. The shortfall in the supply of these minority practitioners (relative to the supply level necessary for parity) exists despite the fact that the number of Black and other minority students entering the health professions schools have increased significantly since the early 1970's. In addition, narrowing of the gap between the existing supply and the supply necessary for parity has further been impeded for some minority groups by slowdowns in the increases in the number of new entrants to these schools since the mid-19/70's. In fact, as a result of the slowdowns in the number of new entrants ana the continuing increase in all first-year enrollments, the proportional representation of Black first-year entrants in schools of medicine ana dentistry has actually declined slightly since the mia-1970's. While the proportional representation of Hispanics in the first-year classes of schools of dentistry has doubled since 1975, their representation in schools of pharmacy has changed little since that time. In schools of medicine, the proportion of first-year Mexican-American and Mainland Puerto Rican students has remained stable while the proportion of other Hispanic students has increased four-fold (tables 4-6). '' Largely reflecting the 1970's increases in first-year enrollments, the number of Black and Hispanic practitioners in these professions is expected to increase substantially over the next 20 years, basea on the assumptions presented later in this report (table 3). By the year 2000, the supply of Black U.S.-trained physicians is projected to range from 23,900 to 30,000. These levels are more than double the 1980 estimatea supply of 11,700. Similarly, the supply of Black dentists in the year 2000 is projected to range from 6,300 to 7,350, increasing at least 74 percent over the next 20 years. Black pharmacists are projected to number 7,120 to 8,480 in 2000, or more than double the 1980 estimate of 3,380. The supply of Hispanic pharmacists is also expected to more than double by 2000, to a projected supply of 3,450 to 4, 360, as compared with 1,930 in 1980. Despite the projected large increases in the number of such minority practitioners, the concurrent increases in the total supply of practitioners in these professions means that the proportion that Blacks ana Hispanics represent of the total will increase much less than their numbers during the next 2 decades. Black physicians are expectea to increase from 3.3 percent of the total U.S.-trained physician supply in 1980 to no more than 5 percent in 2000. The proportional representation of Black dentists is expected to increase from the current 2.9 percent to about 4 percent in 2000. Expected changes for pharmacists are similar, with Black pharmacists increasing from 2.3 percent of the total supply to about 4 percent in 2000, and Hispanic pharmacists increasing from 1.3 percent of total supply in 1980 to about 2 percent in 2000. '' For all three professions, therefore, it is clear that minority practitioners are not likely to achieve representation among the total supply of practitioners equal to their proportion of the total population without substantial increases in minority enrollments in the health professions schools. Under the high series presented here, the number of Black persons per Black physician in the year 2000 is expectea to be more than double the national average (table 1). Similarly, the ratios for Black persons per Black dentist and Black pharmacists are expected to be triple the national average. The shortfalls in the number of practitioners necessary to achieve parity in 2000 (even in a situation where the lowest series of total supply estimates is realized along with the highest series of Black supply estimates) is 37,200 for Black M.D.'s, 3,500 for Black D.0.'s, 15,600 for Black Dentists ana 14,300 for Black Pharmacists (table 2). The low series of total supply estimates is coupled with the high series of Black supply estimates in table 2 to illustrate the lowest estimate of additional practitioners necessary to achieve parity in supply. Of course, if the “most likely" series of total supply projections (or a lower supply of Black practitioners) is realized in 2000, the shortfall would be even greater. Shortfalls are also apparent when parity is viewed from the perspective of achieving Black and other minority representation among first-year enrollees in health professions schools equal to the representation of these groups in the general population. For example, Blacks comprised 11.7 percent of the total population in 1980. In order to account for this same percentage of total new entrants to medical schools, Black new entrants would have to number 2011 or nearly 900 students more than the actual number Black first-year enrollees in that year. Similarly, Black dental first-year and phrmacy '' third-to-last-year enrollees would have to number 698 and 925, respectively, in order to parallel the representation of Blacks in the general population. Under the most "optimistic" assumptions presented here regarding the numbers of black students enrolling in the first-year classes from 1981-96, the number is expected to be no more than 62 percent of the level required to result in parity in first enrollment in medical schools. In schools of dentistry and pharmacy Black first-year enrollments are projectea to reach, at most, about 50 percent of the level required for parity even if the lowest series of total enrollments are realized. 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AuessaddN =. uadueag yOPL psqeurysy Saaqunn quaduag pue satuas ysoubiy payoefoug SUaqunN quaduedg pue pezewrzs3 LeuoLzippy Jaquny yORLG peqoefoug [euoLILppy daquny P2eqDaLaS 4OJ SuBuoLZLDeUg YORI G pue LeJOL yo AL ddng aatqoy pazoafoig puke paqeui3zsy 0002 PU O86L LBIOL eu Buowy syreLg yo UOLzeqUaSauday pu sUOLSSaJoug YILPeH “? alge '' Table 3. Projections of the Active Supply of Black Personnel in Selected Health Professions, 1985-2000 1985 1990 1995 2000 Series I1/ Total U.S. Trained Physicians (M.D.'s and D.0.'s) 15,300 18,400 21,200 23, 900 Medicine (U.S. Trained M.D.'s) 14, 900 17,800 20,500 23,100 Osteopathy 400 600 700 800 Pharmacy 4,620 5,600 6,380 7,120 Series I1l/ Total U.S. Trained Physicians (M.D.'s and D.0.'s) 15,500 19,200 22,700 26, 100 Medicine (U.S. Trained M.D.'s) 15,100 18, 600 21,900 25,100 Osteopathy 400 600 800 1,000 Dentistry 4,550 5,400 6,160 6,860 Pharmacy 4,680 5,930 7,140 8,290 Series III1/ Total U.S. Trained Physicians (M.D.'s and D.0.'s) 15,800 20,300 25,200 30,000 Medicine (U.S. Trained M.D.'s) 15,400 19,600 24,200 28,700 Osteopathy 400 700 1,000 1,300 Dentistry 4,580 5,540 6,470 7,350 Pharmacy 4,680 5, 980 7,260 8,480 |/ See the respective profession sections for discussions of assumptions Dentistry 4,530 5,270 5,800 6,300 underlying these projections. 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SL-v bl 2°0 ove L°0 9°L eve o°8 0°O0L pl-€Z6l LPO] JO JUdII94 SE L9E 8l 29 L8€ 696 $06 ‘2 08-6261 Sl 60€ Lt 9S LSE 258 l21°8 62-8 261 02 892 9L 62 98€ 618 ce2‘8 8l- LL61L L cbc él SEL 9S€ oSL 066° Z LL-9 261 L€ 0&2 vl vol elp 258 v6r's 9l-SZ6L vl LE? OL SOL O€€ 969 225 °8 Sf-v6l 02 9b2 Ol lel 99¢ 699 vl ‘8 pl-€L61L syuapnys 40 AoquNN AyL4OuLW ue Lsy ue L put dtuedsty ye Lg quaw| | Ou /[paULL osu Jed, 4340 ued | Wouly AYLUOULW ed Aes, 4SP] DLwapeody yse]-PAlLuyl ~PAlLyl LePOL Aaoba1ey DLuyzZ/[eLoey 08-6261 Ybnowyy pl-EL6L SAPS, Dwepesy :Auobaze) Dtuyzg/Leroey hq sayeys pazlun ayz ul Adeweyg JO SLOOYDS UL JUWLLOWUZ UkBA 4SET-OF-P4LUL *9 aLgqel 11 ''''II. Methodological Overview The estimates of the current (1960) and projected (2000) active supply of Black (and where applicable, Hispanic) practitioners in medicine, dentistry, and pharmacy were developed by the Division of Health Professions Analysis utilizing the Bureau of Health Professions (BHPr) general supply model. The estimates ana projections of the supply of minorities were derivea in a roughly similar manner, with both based on 1) the most recently available detailed information on the numbers and characteristics of practitioners in the profession, 2) adding the known and estimated graauates to the base year; and 3) subtracting the losses to the profession due to deaths and retirements. Age-specific graduate adaitions to the active supply of total and minority practitioners were based on the latest actual data available, largely from professional associations, and on expected future levels of first-year enrollments in health professions schools. Where first-year enrollments rather than actual graduate figures were used, attrition rates were applied to yield annual estimates of graduates from each class. These graduates were then added to the supply in the year that they were expected to complete the program. Generally, the most recent attrition experience for schools within a discipline was aaopted and this rate was maintained for the length of the projection period. Where estimates were thought to be questionable, a range of estimates of student attrition was used. 13 ''Estimates of annual losses to the workforce were computed by applying age-specific death and retirement rates to the active supply in each year. Since actual data on the supply of Black and Hispanic practitioners in the health professions are not available, estimates of Black physicians and dentists in 1980 had to be developed by updating data from the 1970 Census of Population, which currently provides the only data available on the age distribution of Black and Spanish Origin physicians and dentists. Current estimates of the supply of Black ana Hispanic pharmacists were developed from data from a 1974 survey of pharmacists. For each of the 3 health professions included in this report, projections of the supply of active minority practitioners in the year 2000 were developed on the basis of the most recent data available on first-year enrollments ana graduate additions, and on assumptions as to future enrollment levels in the respective health professions schools. For all the professions included, three series of supply projections are given, reflecting variations in the assumptions regarding future levels of Black and (in the case of pharmacy) Hispanic enrollments in schools ana variations in attrition rates for these groups. The assumptions and computations used for deriving the base year age specific supply, student attrition, and death ana retirement rates for each profession are discussed in the section which follows. First-year enrollments are discussed in a later, separate section, allowing for more detailed discussion of past enrollment trends and factors which are thought to influence future levels. 14 '' Development of Age-Specific Base Year Supply-Base year supply estimates only for Black physicians and dentists were aeveloped from data collected in the 1970 Census. Although the Census reported the number of physicians ana dentists of Spanish-origin, their figures include an unknown number of persons who were also classified as Black. Thus, the number of Hispanic practitioners derived from these data are distorted by the double-counting of practitioners Classified as Black and, therefore, precluded the calculation of reliable estimates on Hispanic physicians and dentists. No other aata were available on which to base estimates for other minorities in these professions. Estimates of the 1970 supply of Black physicians and aentists used in deriving the 1980 estimates and projections presented here were derived by applying the percentage that Black physicians and dentists comprised of total practitioners in the 1970 Census to a DHPA estimate of total active physicians and dentists in 1970. The age distributions for Black physicians ana dentists trom the 1970 Census were then applied to the revised totals in oraer to derive frequency distributions of these practitioners by age. The age-sex-specific supplies of Black and Hispanic pharmacists were derived from the BHPr 1974 survey of pharmacists. Separation Rates-Separation rates (death and retirement rates) specific to Black or Hispanic practitioners are not available for any of the health professions, so rates for total practitioners were used to develop the 1980 supply estimates and to project the supply to 2000. i ''Age-specific death and retirement rates for Black physicians (M.D.'s and D.O.'s) were assumed to be the same as those for all male physicians. These rates were derived from AMA data on the death and retirement patterns of M.D. 's./ Black dentists were assumed to exhibit the same age-specific death and activity patterns as total dentists. These mortality rates follow the pattern of White males in 1976 as derived from the 1976 edition of Vital Statistics of the United States, with activity rates by age reflecting the latest data availabie from the American Dental Association for total dentists. Black and Hispanic pharmacists were separated from the workforce according to the age-sex specific death and retirement rates assumed to prevail for all pharmacists. These death rates are those for the White population (by sex) in 1976 as derived from the 1976 edition of Vital Statistics of the Unitea States. Retirement rates are basea on tables of working life prepared by the Bureau of Labor Statistics, adjusted to reflect activity patterns specific to pharmacists. Student Attrition-Data on the retention of minority students in medical school indicate that 86-87 percent of Black students in the entering classes during the years 1968-73 were still in meaical school three years after |/ Death rates are from Goodman, L.J., "The Longevity and Mortality of American Physicians, 1969-73," Milbank Memorial Funa Quarterly, Summer 1975: 353-375. Retirement rates were prepared under contract for the Division of Health Professions Analysis by Mark Battle Associates using data from the American Medical Association for the years 1967 ana 1974. 16 '' admission.222/ Assuming that their attrition rate in the fourth year was the same as for all students (0.4 percent), an overall average attrition rate of 14 percent was assumed for Black M.D. and 0.0. first-year enrollees for the lowest series of projections. For the high series, it was assumed that the attrition rate for Black students entering in more recent years and in the future would be more similar to those for all students, so a rate of 5 percent attrition was assumed. The mia-point between these estimates of attrition (9.5 percent) was used in the intermediate series of projections. The estimated attrition rate for Black dental students has recently ranged from 12 to 15 percent.polLued 0OOZ-S86L 34} 4aAo pezyoefoud sayenpeub yoe,g LeUOLZLpPY SLOOYDS [POLpsu *S°p UL JUaW| LOuUa yYORLg JUa4UND UO pased H8-L GL poLuad ay} UBAO Sazenpeub [OOYDS [edLpswW yoRLYg szsedau04y ALddns “q*w yxoeLg JO Saluas dsauul yos suoljdwnssy pue suaquny azenpeug pue juaw| [Ou uedA-}SUL4 *Z] aLqey '' *$dqe1S Paylun eu} UL [eUuUdSAag SUOLSSajOug Y3LPaH JO SNzezS a4} UO SsauBuo) pue quSprsdsg BY} 07 B4OdeYy PuyL ayz wows aue sainbis sauag YyBLH pue *ALaxL7 3SOW *MOT, /T €6L°€ (UOL4tuzqe quadued g Burwnssy) gg9‘o9 759° lS 9p9%E (UOLzLUZIe quaduad g Bulunssy) (0002-186 S}UaweLqzeu pue syzeap Aq pajatdap A, ddns O86L SS®L O6€°69) OOE‘LY 6£8“E (uoLjLuqqe quaduad g*6 Bburwnssy) 22zp‘L9 86°Ss ELpE (UOLZLAI3e qued4ad g*¢ Bulwnssy) (O00Z-L86L S}UeWa4LJe4 pue syzeap Aq payatdep A, ddns O86L SS®L OSL‘ 29) 090‘6S 196 *€ (uoLqluzqe quadued pl Surwnssy) Lze‘eg 660‘ S LOE*E (UOL3L4z3e quadued pL Burwnssy) (OO0Z-L8S6L S}UeWa4LJe4 pur suzyeap Aq paya_dap A, ddns O86L SSPL 068°S9) O08‘ ZS 000Z ut Ajtued yoras 0} pautndbeu 96-186{ Butunp syoeLg 40 quaw[,Ouua ueaf- SuLy Lenuue aheuery 0002-7861 saqenpeubh Auessadau ul ypnsau 0} pOtuad 96-1 86L 342 4aA0 papasu syoe1g $0 Squaw] [OuUa ueef-4SUL4 poised 00dz-Ss86l 24} Butunp papesau sazenpeub yoR1g LPUOLILPpe JO YaquNN (p8-L86L) euLtadid ayq ut Ai quavund sayenpeub yor,g Jo yequny 000z ut AqLued uorqzejndod 04 Atddns‘q*w yoe1Lg Butag 02 COOZ-L86L POlved ayz 4aA0 poutnbau sajenpeub “q°w yoeLa ION 002‘0SS satuas ybtH 006 “Z€s saluas ALayxt] SOW suotjosfoug ALddng [eOL Jo satuas 006 ‘22S S8LUaS MOT 0002 UL Aqlueg uoLze[Ndog sAaLYoY 03 Aurssaday sazenpeuy pue SJUAsW|[OuUZ 4edA-JSULY YOeLgG JO SLaAoq “el OLqel /TP2IDEL Od $,°O°W PaULeuL~"S*N [BIOL 40 '' 0°29 6°09 ~°09 9°6S 6°8S 9°95 6°vS 8°25 2° LS 9°67 69L‘L OSL‘L LEL‘L ZL‘ €60‘L plO‘k SSO‘L 9E0‘L ZLO‘L 166 6°6P 6°64 €°0S 6°0S 8°LS 2°LS L°LS S*0S 2°67 9°60 206 206 206 €56 296 216 286 265 8l6 166 6 "bP 6°tY 2°Sb 2°St 9°SP 2°94 2° Lb Lilt L’°8b 9°6b v8 L¥8 08 18 v8 L& 106 LE6 196 166 £88‘ £88‘ 228‘ Z8‘L 958‘ 168‘ L 226‘ €96‘L 86 ‘1 LLO‘2 2°2l 2°2L L°2k L°2l O°2L O°2L 6° LL 6‘LL BLL “ul L9v‘Sl L9v°SL L9¢‘Sl L9v‘SL 19v*SL OLS ‘SL pS “OL 8609 28 ‘OL 98L* ZL 06-6861 68-886L 88- L861 /8-986L 98-S86L S8-786l 78" €86L €8-286L Z8-L86L L8-086L Squaw! [OUUZ }SULy [BIOL JO SaLuas Moy e Bulwnssy AYLaeg USL LOUUZ YeaA-3S4L4 “G°W YORLG JO uoLqenl eA “pl OLgel S,3A4 Aqtued so Judduad apeoap ysed aur JO Spuaur dO uoLzeLodeuzxa Buliwnsse S,FAd “OW YORLG paqoefoug S,3A5 AltLued Jo Juasduag auL{2ap %G BuLwnsse S,3Ad “OW ARLE paqzoefoug S,2A4 Aqtued JO Yuaduag BULLOap YS Bulwnsse s, 3,4 "O'W ALG paqoafoug S,3A4 ul Aqiued Jo} Auessadau saquny uoLzeyndod [b30} JO YORLgG JUadUAag (aULLDap quaduad QOL e BuLwnssy) S$, FAS L&}O} Pszewlysy 4] ''b°L9 6°L9 6°L9 6°L9 0°29 0°29 0°29 S,JA4 Auessadeu Jo Juad4a4 BLL AL*L AL‘ l {L*L {LL BL *t AL‘ apedap ysed ay} JO Spuauz $O uoLzelodeuzxa BuLtwnsse S,3Ad “O°W A9LLG paqoaloud L°8t L°6v L°6P L°6v S*60 S*60 6°60 S,JA4 Auessadau jo Juad4ed cv6 cv6 cv6 cv6 cb6 c6 cv6 auLLIap %G BHutunsse S,JAd “O°W 49RLg paqoefoud x 8° Et c° bP c bn eur S*tb S*tP 6°bv S,JAd Auessadau jo Jusd4ed ~ Lt8 Lv8 Lve Lv8 Lvs Lv8 Lt8 aULL IEP %G| BHurwnsse S,JAd “O°W 49VLG paqoefoug €€6‘L 8L6‘L 8L6°L 8L6‘L 206 “L 206 “L 88 ‘lt S,JA4 ul Aqtued Joy Auessarou vaquiny S*2l v°?cl veel vel e*2i e°2l 2°2l uoLze_ndog [2102 JO yOeLg JUadUAY L9p‘SL L9v°SL L9n°St L9v‘SL L9p‘SL L9v‘SL L9p°SL (@ULLIep quadued OL e& BHulwnssy) S,JA4d [2302 paqeutysy L6-966L 96-S66L S6- v66L v6- €66L €6- 2661 c6-L66L T6-066L (panutjuo0)) Squaw, [OuuZ 4SALy [PIO] JO SaLuas MOT e Bulwnssy A4Lueg WUIWLLO4WUZ ABIA-JS4LJ “GW HOLLG JO uOLzeNLeAZ “Hl LqeL '' Dentistry The supply of active Black dentists in 1980 is estimated at approximately 3630, comprising about 3 percent of the total supply of 126,200 active dentists. There were 13.7 black dentists per 100,000 black persons in the population, or 1 Black dentist for every 7297 Black persons (tables 1 and 15). Comparable ratios for the general population in 1980 were 56.4 active dentists per 100,000 population or 1 dentist for every 1795 persons in the country. As is the case for medicine, the increases in Black first-year enrollments in schools of dentistry during the 1970's were insufficient to bring the active supply of Black dentists to population parity. This will also be the case in 2000. As shown in table 15, the supply of Black dentists in the year 2000 is projected to range from 6300 to 7350 (with a mid-level of 6,860) based on the assumptions outlined in tables 16 and 17 regarding future first-year enrollment trends, attrition levels, and separations from the workforce. These numbers are double the 1980 figures resulting in practitioner-to- populations ratios of 19.2 to 22.4 Black dentists per 100,000 Black persons in the population--40 to 64 percent higher than the 1980 ratio. However, as table 15 further illustrates, even under the most optimistic scenario Black dentists are expected to comprise no more than 3.6 percent of the total supply of dentists. As a result, at best, the projected supply of Black dentists is projected to fall nearly 16,000 short of the 22,900 necessary to achieve parity. 43 '' In order to achieve parity in the supply by 2000, average first-year enrollment of Black dental students between 1981-96 would have to amount to about 1400 annually (table 18). This would require a 5-fold increase in Black dental school FYE's--which numbered 283 in 1980. If shared equally by all 60 dental schools, this increase of 1,117 additional Black students would amount to about 19 additional Black first-year students per school. If the total dental supply realized in the year 2000 is greater than the forecasts of the lowest series presented here, the number of Black first-year enrollments necessary to achieve parity would be even greater. In order to comprise 11.7 percent of the total entering class in 1980, equalling the Black proportional representation in the population, Black first-year enrollees in dental schools would have to number 706. The actual number of Black first-year enrollees in 1980 (283) represented about 40 percent of the number necessary for first-year enrollment parity. Under the most optimistic assumptions presented here regarding future trends in the number of Black first-year enrollees in dental schools, the number is expected to reach no more than 47 percent of the level required for first-year enrollment parity (table 79). 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There were 12.8 Black pharmacists per 100,000 Black population and 13.2 Hispanic pharmacists per 100,000 persons of Spanish Origin (table 20). The comparable rate for the total population in 1980 was 63.7 pharmacists per 100,000 population. As is the case for medicine and dentistry, past increases in the numbers of Black and Hispanic persons enrollments in schools of pharmacy have not been sufficient to result in current supply levels comparable to the representation of these groups in the population. Under the assumptions regarding pharmacy (as outlined in tables 21-24), the supply of Black and Hispanic pharmacists is expected to increase substantially by the year 2000. The supply of Black pharmacists is expected to more than double between 1980 and 2000, with estimates of the supply in that year ranging from 7,120 to 8,480 (with a mid-level of 8,290) (table 20). Similarly, Hispanic pharmacists are expected to at least double over this period, reaching an estimated 3,450 to 4,400 (with a mid-level of 3,830) by 2000. Despite these expected gains in the numbers of Black and Hispanic pharmacists, the future supplies of these practitioners are still not expected to comprise proportions of the total supply comparable to their representation in the population. In 2000, Black pharmacists and Hispanic pharmacists are expected to comprise about 4 and 2 percent, respectively, of the total supply of pharmacists. ''In 1980, the estimated supply of 3,380 Black pharmacists fell short of the number necessary for population parity by about 13,490 practitioners. Even if the most optimistic series of Black supply projections is realized by 2000 along with the lowest series of total supply projections, the supply of Black Pharmacists in 2000 would fall more than 14,000 short of the 22,700 necessary for parity (table 2). Assuming that the lowest series of total pharmacy supply will be realized in 2000 and that the attrition rate for Black pharmacy students will remain Constant at 17.9 percent for males and 14.3 percent for females, the average third-to-last year enrollment of Black pharmacy students from 1981-97 would have to amount to about 1,400 annually in order to achieve parity in the 2000 supply (table 25). This would require nearly a quadrupling of the number of Black third-to-last year students in 1981 or an increase of about 1,013 students. This increase, if shared equally by all 72 schools of pharmacy, would amount to approximately 14 additional students per school. Additionally, if the total pharmacy supply realized in the year 2000 is greater than the estimates of the lowest series presented here, the number of Black third-last year enrollments necessary to achieve parity would be even greater. Currently, the supply of Hispanic pharmacists falls short of parity by about 7,300 practitioners (table 26). Although the number of persons of Spanish Origin in the population in the year 2000 has not been projected, this group comprised 6.4 percent of the population in 1980, and, as one of the fastest ''growing minority groups, can be expected to increase its representation in the population somewhat by 2000. Clearly, the 2 percent of the total supply of pharmacists which they are expected to comprise in 2000 will fall far short of parity. The number of Black third-to-last year enrollees necessary to achieve a representation among total third-last year enrollees equal to their population representation would be more than 900 Black students, more than 500 students above the current level of enrollments. As table 27 illustrates, under the most optimistic scenario presented here, the number of Black enrollments is expected to reach, at most, about 5] percent of the number required to result in enrollment parity. 53 ''Table 20. Estimated Active Supply of Total, Black, and Hispanic Pharmacists, 1980 and Projected Active Supply, 1985-2000 1980 1985 1990 1995 2000 Total Pharmacists!/ 144,200 160,500 169,400 175,500 180,200 Black (Series I) 3ya50 4,620 5,600 6,380 7,120 Percent of Total Pharmacists 2.3 2.9 3.3 3.6 4.0 Rate per 100,000 Black Population 12.8 16.5 18.8 20.3 flat Hispanic (Series I) 1,930 2,460 2,850 3,170 3,150 Percent of Total Pharmacists 1.3 1.5 1.7 1.9 2.0 Rate per 100,000 Spanish Origin Population 13.2 N/A N/A N/A N/A Total Pharmacists2/ 144,200 161,100 172,500 181,000 195,900 Black (Series II) 3,380 4,680 5,930 7,140 8,290 Percent of Total Pharmacists 2.3 2.9 3.4 3.9 4.2 Rate per 100,000 Black Popu lation 12.8 16.7 19.9 22.7 eoee Hispanic (Series II) 1,930 2,480 2,980 3,440 3,830 Percent of Total Pharmacists 1.3 1.5 1.7 1.9 2.0 Rate per 100,000 Spanish Urigin Population 13.2 N/A N/A N/A N/A Total Pharmacists3/ 144,200 162,000 176,400 187 ,500 197 , 100 Black (Series III) 3,380 4,680 5,980 7,260 8,480 Percent of Total Pharmacists 263 2.9 3.4 3.9 4.3 Rate per 100,000 Black Population 12.8 16.7 20.1 23.1 25.8 Hispanic (Series III) 1,930 2,510 3,170 3,800 4,360 Percent of Total Pharmacists 1.3 1.5 1.8 2.0 2.2 Rate per 100,000 Spanish Origin Population 13.2 N/A N/A N/A N/A +/ joval rnarmacists Tigures are Trom tne Low Series ot projections of tne national supply of active pharmacists as presented in A Report to the President and Congress on the Status of ‘Health Professions Personnel in the United States.