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The Health Equity Scholars Program: Innovation in the Leaky Pipeline

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Upshur, Carole C., Wrighting, Diedra M., Bacigalupe, Gonzalo, Becker, Joan, Hayman, Laura, Lewis, Barbara, Mignon, Sylvia, Rokop, Megan E. +4 more·2018·Journal of Racial and Ethnic Health Disparities
DOI 10.1007/s40615-017-0376-7PMC PMC5694706
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Abstract

Despite attempts to increase enrollment of under-represented minorities (URMs: primarily Black/African American, Hispanic/Latino, and Native American students) in health professional programs, limited progress has been made. Compelling reasons to rectify this situation include equity for URMs, better prepared health professionals when programs are diverse, better quality and access to health care for UMR populations, and the need for diverse talent to tackle difficult questions in health science and health care delivery. However, many students who initiate traditional "pipeline" programs designed to link URMs to professional schools in health professions and the sciences, do not complete them. In addition, program requirements often restrict entry to highly qualified students while not expanding opportunities for promising, but potentially less well-prepared candidates. The current study describes innovations in an undergraduate pipeline program, the Health Equity Scholars Program (HESP) designed to address barriers URMs experience in more traditional programs, and provides evaluative outcomes and qualitative feedback from participants. A primary outcome was timely college graduation. Eighty percent (80%) of participants, both transfer students and first time students, so far achieved this outcome, with 91% on track, compared to the campus average of 42% for all first time students and 58-67% for transfers. Grade point averages also improved (p = 0.056) after program participation. Graduates (94%) were working in health care/human services positions and three were in health-related graduate programs. Creating a more flexible program that admits a broader range of URMs has potential to expand the numbers of URM students interested and prepared to make a contribution to health equity research and clinical care.

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  • One similar program reports 69% (27/39) of graduates matriculated into or on-track to enter health professions graduate programs.

    “For instance, one similar program reports 69% (27/39) of graduates matriculated into or on-track to enter health professions graduate programs12”

    From Dreams Realized: A Long-Term Program Evaluation of Three Summer Diversity Pipeline Programs (2021) · cites this paper as [12]

    The Outcomes section (Graduation rate and post-graduation status; page unavailable) reports only 20 graduates, not 39. Of those, three were enrolled in graduate programs and three were applying to graduate or medical school—not 27 matriculated or on track to enter. (LLM, conf=0.88)

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  • Access to longitudinal mentorship networks and professional learning environments for URM prehealth students in low-income communities is severely limited.

    “Despite these and other national efforts, access to longitudinal mentorship networks and professional learning environments for URM prehealth students in low-income communities is severely limited.7,14”

    From Impact of the Bronx Community Health Leaders Program for Socioeconomically Disadvantaged Prehealth Students (2021) · cites this paper as [14]

    The Introduction identifies lack of mentoring and role models as barriers for URM students, and the Conclusions and Recommendations describe traditional programs whose requirements limit some URM students’ participation. These passages support the general concern about access, but do not establish that longitudinal mentorship networks and professional learning environments are severely limited specifically for URM prehealth students in low-income communities. Page numbers were not provided in our copy. (LLM, conf=0.85)

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  • The BxCHL selection approach aligns with health equity and holistic admission processes supported by other prehealth programs and medical school admission committees.

    “This approach aligns with health equity and holistic admission processes supported by other prehealth programs and medical school admission committees.14,18”

    From Impact of the Bronx Community Health Leaders Program for Socioeconomically Disadvantaged Prehealth Students (2021) · cites this paper as [14]

    Methods > Student Recruitment (page unavailable) describes HESP, a prehealth pipeline program, considering GPA, faculty recommendations, and applicants’ interest in health disparities rather than selecting only top academic performers. This supports the comparison to a health-equity-oriented, holistic prehealth selection process, but our copy does not establish that medical school admission committees support such a process. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Similarly designed programs with less rigid entrance metrics than traditional prehealth pathway programs have shown high success in advancing students into professional health care programs.

    “Similarly designed programs with less rigid entrance metrics than traditional prehealth pathway programs have shown high success in advancing students into professional health care programs.14”

    From Impact of the Bronx Community Health Leaders Program for Socioeconomically Disadvantaged Prehealth Students (2021) · cites this paper as [14]

    The Student Recruitment and Conclusions and Recommendations sections describe HESP’s more flexible entrance criteria, including consideration of students with lower GPAs. But Outcomes reports that only three of 20 graduates were enrolled in health-related graduate programs; its stronger results concern bachelor’s completion and health-related employment. The claim overstates the evidence for high success specifically in advancing students into professional health care programs. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • A holistic approach and flexibility to recruit students who have the potential and interest to matriculate into health professions schools and who need the "intangible" supports may lead to an overall decrease in the percentage of "successful" participants, but will likely lead to an increase in medical school matriculants from disadvantaged backgrounds and enhance overall diversification of the健康

    “We recognize this may lead to an overall decrease in the percentage of “successful” participants, but will likely lead to an increase in medical school matriculants from disadvantaged backgrounds and enhance overall diversification of the health care workforce in line with the social justice mission of many of these programs.12,13,16”

    From Dreams Realized: A Long-Term Program Evaluation of Three Summer Diversity Pipeline Programs (2021) · cites this paper as [12]

    The Abstract and Conclusions and Recommendations (pages not provided) support flexible recruitment and tailored support for disadvantaged students as ways to broaden participation in health careers. They do not predict a lower percentage of “successful” participants or an increase specifically in medical-school matriculants; the reported outcomes concern bachelor’s degree completion and a range of health-related careers. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 23

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Authors
Upshur, C. C., Wrighting, D. M., Bacigalupe, G., Becker, J., Hayman, L., Lewis, B., Mignon, S., Rokop, M. E., Sweet, E., Torres, M. I., Watanabe, P., & Woods, C.
Affiliations
  • University of Massachusetts Chan Medical School (US)
  • University of Massachusetts Boston (US)
Corresponding author
Upshur, Carole C.
ORCID
Venue
Journal of Racial and Ethnic Health Disparities
Publisher
Springer Science and Business Media LLC
Published
2017-05-19
Volume
5
Issue
2
Pages
342-350
ISSN
  • 2196-8837 (ISSN-L)
  • 2197-3792
DOI
10.1007/s40615-017-0376-7
PMC
PMC5694706
OpenAlex
W2616530316
Cited by
40
References
1
Citations by year
2026: 2 · 2025: 7 · 2024: 3 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 5 · 2019: 2
FWCI
3.97
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Racial and Ethnic Health Disparities (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Minority Health and Health Disparities (P60MD006912)
Topics
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
  • Social Sciences › Safety Research › Career Development and Diversity
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical Education and Admissions
Keywords
underrepresented minorities, transfer students, grade point average, program evaluation, health equity, health workforce diversity, African American students, Hispanic/Latino students, Native American students
MeSH terms
Mentoring, Academic Success, Black or African American, Education, Medical, Education, Nursing, Education, Professional, Female, Hispanic or Latino, Humans, Indians, North American, Male, Minority Groups, Students, Universities

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