Diversity In Nursing and Healthcare: A Look at the Numbers
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- In 2022, racial diversity among nurses was higher than it had been in 19 years.
- Racial diversity in nursing has grown faster in the last 19 years than in the healthcare field overall.
- Nurses and aspiring nurses have several options to start or further their nursing careers and expand racial diversity in the field.
It's no secret that patients benefit when their healthcare providers look like them. Research shows that greater diversity among healthcare professionals leads to better patient experience scores and outcomes.
Yet, people of color (POC) are underrepresented within healthcare. According to an analysis of data from the Bureau of Labor Statistics, 32% of all healthcare practitioners are Black/African American, Asian, or Hispanic/Latino/a, despite making up 39% of the U.S. population. Similarly, 33% of all nurses identify from these groups, including licensed practical nurses (LPNs), registered nurses (RNs), and nurse practitioners (NPs).
Over the past two decades, there has been a steady increase in diversity among healthcare providers and nurses. More institutions are focusing on hiring and retaining a diverse workforce to provide competent and comprehensive care. However, there is still work to be done to ensure that people of color are adequately represented in the nursing profession.
Underrepresented Populations in Nursing and Healthcare Compared
When compared to the diversity within the healthcare industry as a whole, racial diversity in nursing has outpaced that within healthcare in most years since 2003. In fact, the only years where healthcare diversity outpaced that of nursing were 2004 and 2005. Both these years saw a drop in LPNs for all groups.
As indicated by the table below, the representation of nurses of color has increased more in the last 19 years than in healthcare as a whole. Representation in nursing increased by 10 percentage points from 2003-2022, while representation in healthcare increased by 9.5 percentage points in the same period.
With over three million individuals, registered nurses make up the largest proportion of all healthcare workers (34%). Despite these advances, there is still a need for further diversifying the field. A more diverse nursing workforce results in more diversity for healthcare as a whole.
Underrepresented Populations in Nursing
Racial and ethnic representation in nursing has slowly and steadily increased over the last two decades. In fact, the representation of nurses of color has never been higher.
According to 2003 data from the BLS, 23% of LPNs, RNs, and NPs were Black/African American, Asian, Hispanic, or Latino/a. In 2022, 33% of all nurses identified as Black, Asian, Hispanic or Latino/a.
Black/African American representation among LPNs currently exceeds the percent of the U.S. population. According to the 2020 census, 13.6% of the U.S. population identifies as Black/African American. Black representation among LPNs has been over 20% for two decades. In 2022, 29% of LPNs were Black/African American.
In 2022, 31.5% of RNs identified as Black/African American, Asian, or Hispanic. Representation for these groups is lowest among NPs. In 2022, 22.8% of NPs identified as POC.
Focusing recruitment efforts on practicing LPNs and RNs interested in continuing their education in registered nursing, advanced practice nursing, or nursing education could continue the efforts to create a more representative nursing workforce.
More racial diversity in healthcare can lead to better healthcare outcomes, lower mortality rates for underserved populations, and more culturally competent care. Most of the studies analyzing the effects of culturally competent care and healthcare professionals that look like the patient are focused on physicians or providers, like NPs, being the same race or ethnicity as the patient.
These studies find that when the patient and provider share racial and ethnic backgrounds the patient is more likely to disclose sensitive health information, follow the treatment plan, and get better health outcomes. These improved outcomes are correlated with the provider creating a culturally competent treatment plan.
Additionally, the American Association of Colleges of Nursing aims to increase diversity in the nursing workforce by increasing representation in faculty, expanding funding for nursing education, and offering more mentorship opportunities.
Increased racial diversity in healthcare can lead to better healthcare outcomes for underserved populations and more culturally competent care.
Black Representation in Nursing
Black/African American nurses make up the largest percentage of LPNs, RNs, and NPs from underrepresented groups every year since 2003. Black representation in these three levels of nursing has consistently been above 10% since 2003. However, Asian and Hispanic or Latino/a representation has been consistently below 10% in the same 19 years.
Representation of Black nurses has been highest among LPNs over the last 19 years.
In 2022, Black representation among registered nurses reached its highest point with 14.5% of all RNs identifying as Black despite making up 13.6% of the overall population, according to the U.S. Census Bureau. Black LPNs made up 29.1% of the LPN workforce in 2022.
Asian Representation in Nursing
Asian nurses make up less of the nursing workforce than Hispanic or Black nurses. When looking at the total number of nurses across all three license types, the number of Black nurses is nearly double the number of Asian nurses.
Asian representation in nursing reached its height in 2018, when 8.4% of nurses across all levels identified as Asian, and has stayed roughly the same as of 2022. This figure surpasses the 6.3% of people identifying as Asian in the U.S. Relatively high representation among Asian LPNs and NPs helped contribute to overall Asian nursing representation.
Hispanic or Latino/a Representation in Nursing
Hispanic or Latino/a representation in all three nursing levels has followed a gradual upward trend most years from 2003-2022. This trend is due to the slow increase of Hispanic and Latino/a representation in registered nursing. However, Hispanic and Latino/a representation as LPNs and NPs has been inconsistent.
Hispanic or Latino/a representation decreased in 2016 and 2022. Hispanic representation of LPNs dropped from 13.9% to 10.1% in 2016. In 2022, Hispanic representation for LPNs and NPs decreased slightly from 2021 to 2022.
Hispanic and Latino/a representation reached its highest point in 2021, making up 9.3% of nurses across all three license types, but then fell to 8.6% in 2022. The highest percentage of Hispanic RNs and higher than average Hispanic and Latino/a representations for LPNs and NPs explain the 2021 increase, but it remains unclear why the numbers diminished in 2022.
Regardless, this group is underrepresented in the nursing profession, as Hispanic and Latino/a people make up 19% of the U.S. population in 2022.
How to Increase Representation in Nursing
Representation among NPs and nurse educators across the board is at least 10 percentage points lower than representation in LPNs, RNs, and NPs combined. Only 19.2% of nurse educators were from underrepresented groups, according to the American Association of Colleges of Nursing (AACN) in 2021. In 2022, 22.8% of NPs were from underrepresented groups.
It is important to increase the numbers of underrepresented groups in nursing because all nurses, especially NPs, play important roles in improving healthcare for patients from underserved populations.
According to a 2022 article, NPs who share the same cultural background as their patients have been shown to communicate more effectively. They may also bring a more holistic understanding of their patient's cultural history and the events that shape their healthcare experience. NPs can use this understanding to foster respect and communication with their patients, which may improve patient outcomes and satisfaction.
How Professional Organizations Can Help You Build Your Nursing Career
It can be hard to increase representation in nursing when only a third of nurses are from underrepresented groups. However, professional nursing organizations like the National Black Nurses Association (NBNA), National Association of Hispanic Nurses (NAHN), and Asian American Pacific Islander Nurses Association (AAPINA) understand this struggle.
Mentorship and Networking Opportunities for Nurses of Color
The NBNA's collaborative nurse mentorship program helps grow the careers of current and future Black nurses through three levels of mentorship:
- Beginner for new nurses and student nurses at the undergraduate level
- Intermediate is for nurses transitioning into a new role like pursuing a graduate degree or pursuing a management position
- Advanced is for nurses pursuing leadership roles like earning a doctoral degree or becoming chief nursing officer (CNO) or a Fellow at the American Academy of Nursing
The NAHN also has a mentorship program for their members, but you have to sign up to become a mentee before you learn more about it.
Even if you cannot find a one-on-one mentorship opportunity, professional organizations like NBNA, NAHN, and the AAPINA host networking events where you can connect with nurses like you.
Financial Aid Opportunities to Help You Pay for Your Nursing Degree
Becoming a registered nurse costs between $8,000 and $120,000. The cost of nursing school varies greatly depending on whether you earn a two-year associate degree in nursing or a four-year bachelor's degree in nursing (BSN), attend public or private school, and live on or off campus.
Yet, you can take advantage of financial aid opportunities, like grants and scholarships, to help you pay for your nursing degree. Unlike loans, you do not have to repay scholarships and grants. You may find scholarships and grants specifically for underrepresented nursing students or first-generation nursing students.
Nursing Career Options
If you want to become a nurse or advance your nursing career, there are several options available depending on where you are in your nursing career.
If you want to become a nurse, consider earning your bachelor’s degree in nursing (BSN) and becoming a registered nurse. If you don’t have four years to dedicate to full-time study, consider starting your career with a one-year licensed practical nursing (LPN) program or a two-year associate degree in nursing (ADN) program. Then, after you’ve started your nursing career, and you have the time and money, you can earn a BSN with an LPN-to-BSN or RN-to-BSN bridge program.
If you’re a current nurse looking for the next step in your career, consider becoming a charge nurse, precepting nursing students, or joining committees at your hospital. If you’re ready to go back to school for your advanced nursing degree and want to stay in clinical practice, think about becoming a nurse practitioner or pursuing another advanced practice registered nurse role.
About 70% of nurse practitioners deliver primary care, according to the American Association of Nurse Practitioners (AANP). If you become an NP who specializes in primary care, you could help improve the patient outcomes of people in your community. When their healthcare provider is their race or ethnicity, patients tend to
- Respect their healthcare provider
- Disclose more sensitive healthcare information
- Adhere to the treatment plan
If you want to leave the clinical side of nursing, you can help train the next generation of nurses from underserved communities to consider pursuing positions in nursing leadership or becoming a nurse educator.
These roles require a master’s degree in nursing (MSN) or a doctorate in nursing practice (DNP) and several years of nursing experience. More representation in nursing faculty may encourage more people from underrepresented groups to enter the profession when they see that nursing values diversity.
Methodology and Limitations
The data in the "Underrepresented Groups in Nursing and Healthcare" tables were calculated using the Current Population Survey (CPS) from the Bureau of Labor Statistics (BLS) from 2003-2022.
Changes in occupation classifications in the 2010 census affected 2011 and all future years. Before 2011, BLS classified nurse practitioners as registered nurses, so the data from before 2011 is not comparable with later data. However, the trend of the slow and steady growth of underrepresented groups in nursing stayed consistent before and after the classification change, so the data was included here.
Data was collected on the representation of Black, Asian, and Hispanic individuals for three types of nurses: licensed practical nurses, registered nurses, and nurse practitioners. Then, each percentage was multiplied by the total number of LPNs, RNs, or NPs for each year to find out the number from each underrepresented group of each license type by year.
The representation of Black, Asian, and Hispanic nurses was calculated by adding all three license types from each underrepresented group. Next, the number of nurses from all three license types from each underrepresented group was divided by the total number of nurses with that license that year and multiplied by 100 to determine the percentage of nurses from all three license types from each underrepresented group.
The percentage of LPNs, RNs, and NPs from underrepresented groups was calculated by adding the total number of nurses at each license level. Then, the total number of nurses from underrepresented groups at each license level was added together. Finally, the total number of nurses at all three license levels was divided by the total number of nurses from underrepresented groups at each license level and multiplied by 100 for each year.
The data does not include nurses from all underrepresented groups. Populations, such as multiracial and Indigenous individuals, are not included in the BLS data.
Individuals who identify as Hispanic or Latino/a may be of any race.
This data set does not include representation data from all nursing roles. Roles such as certified nurse anesthetist and certified nurse midwife were excluded from the data because BLS does not track demographic data for roles with less than 50,000 workers.
According to the BLS, data from 2020 is not strictly comparable to other years.
Enhancing Diversity in the Nursing Workforce. (2023). AACN
NP Fact Sheet. (2023). AANP
Quick Facts. (2023). U.S. Census Bureau
Takeshita J, et al. (2020). Association of Racial/Ethnic and Gender Concordance Between Patients and Physicians With Patient Experience Ratings. JAMA Network
Wilbur K. et al. (2020). Developing Workforce Diversity in the Health Professions: A Social Justice Perspective. Science Direct
Page last reviewed on October 20, 2023
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