Authors' objectives: Identify and summarize evidence regarding workforce racial and/or ethnic diversity and its impact on patient health and healthcare outcomes.

Authors' results and conclusions: EVIDENCE SUMMARY # Three reviews were included. One review evaluated racial and ethnic workforce diversity and performance outcomes, while two reviews evaluated patient-provider racial and ethnic concordance. While diversity may improve patient care quality, review findings regarding patient-provider concordance were less conclusive. # Thirteen primary studies were included: two focused on workforce racial and ethnic diversity, and eleven focused on patient-provider racial and ethnic concordance. Eight of the studies were retrospective, one was prospective, one was a randomized trial, and one was a secondary analysis of a pilot randomized trial. This highlights the limited and low-quality evidence base, along with the lack of causality. Inappropriate measurement of exposure was a common source of bias (e.g., provider race was patient-reported). # Both studies of diversity demonstrated health benefits associated with a diverse workforce, albeit not at the patient-level. In one study, state-level registered nurse diversity was associated with reduced risk of severe adverse maternal outcomes during childbirth in both non-Hispanic White mothers and minoritized racial and ethnic mothers. In the other study, greater Black primary care physician (PCP) representation was associated with higher life expectancy and was inversely associated with all-cause Black mortality and mortality rate disparities between Black and White individuals at the county-level. # Regarding the patient-provider concordance studies, relevant primary outcomes included healthcare utilization (most common), mortality, blood pressure, physical and mental health, medical expenditures, cancer screening, and flu vaccination uptake. Relevant secondary outcomes were only reported in two studies (medication adherence, communication, trust, and satisfaction). Although most outcomes had mixed (or neutral) results across studies, racial and ethnic concordance increased the likelihood of seeking preventative care for Hispanic, Black, and/or Asian patients in all four studies that reported the outcome. One of the four studies was the randomized trial, which observed greater preventative healthcare utilization among Black men with racially concordant providers. # Racial and ethnic diversity may be associated with improved health and healthcare outcomes which may alleviate disparities. Health systems are encouraged to invest in initiatives to expand diversity and track associated outcomes to evaluate impact.

Project Status: Completed

Year Published: 2024

URL for published report: https://www.med.upenn.edu/CEP/external-request-form.html

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: United States

Organisation Name: Penn Medicine Center for Evidence-based Practice

Contact Address: Penn Medicine Center for Evidence-based Practice, University of Pennsylvania Health System, 3600 Civic Center Blvd, 3rd Floor West, Philadelphia PA 19104

Contact Name: Nikhil Mull

Contact Email: cep@pennmedicine.upenn.edu

Copyright: <p>Center for Evidence-based Practice (CEP)</p>