Addressing Racial Health Inequities: Understanding the Impact of Affirmative Action Bans on Applications and Admissions in Medical Schools

Mickey-Pabello, David; Garces, Liliana M.

doi:10.1086/699813

Cited by 12 publications

(16 citation statements)

References 40 publications

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“…A difference-in-differences strategy estimates the effect of affirmative action bans on URM enrollment. Many scholars have used this strategy to study bans on affirmative action (Backes 2012; Bleemer 2020; Garces and Mickey-Pabello 2015; Hinrichs 2012; Mickey-Pabello and Garces 2018). In this analysis, the “first difference” compares the proportion of URM enrollees before and after an affirmative action ban.…”

Section: Methodsmentioning

confidence: 99%

“…The results of this study are weighted by enrollment and unweighted. The weights are equal to the total number of enrolled students at a given institution (Afifi, May, and Clark 2003;Backes 2012;Garces and Mickey-Pabello 2015;Hill 2017;Hinrichs 2012Hinrichs , 2014Hinrichs , 2020Mickey-Pabello and Garces 2018). The analysis weighted by enrollment yields results concerning a typical student; the unweighted analysis yields results that reflect the typical school.…”

Section: Datamentioning

confidence: 99%

“…Unlike Bleemer (2020) and Sander (2004), who suggest the bans created a cascade pattern, I use the more disastrous term avalanche to emphasize the plight URM students have suffered due to the bans. Previous studies of affirmative action bans emphasize that URM enrollment changes due to these bans occurred almost wholly due to organizational responses to admitting students from particular racial groups and not changes in student application behavior (Bleemer 2020; Card and Krueger 2005; Mickey-Pabello and Garces 2018). I explore this mechanism of organizational racialization by estimating how URM student enrollment changed at each level of university selectivity.…”

Section: The Anti-affirmative Action Avalanchementioning

confidence: 99%

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The Anti-Affirmative Action Avalanche: The Rise of Underrepresented Minority Enrollment at For-Profit Institutions

Mickey-Pabello

2023

Sociol Educ

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The study of affirmative action bans suffers from focusing on the ivory tower as the site for the impacts of affirmative action bans. Prior literature on affirmative action bans has missed the bigger picture, failing to see that less glamorous schools have also been impacted by the bans. This article fully fleshes out the impacts of affirmative action on postsecondary education by their level of selectivity (Barron’s Admissions Competitiveness Index) and sector (private, public, and for profit) from a merged data set (Integrated Postsecondary Education Data System and the Current Population Survey) spanning 1991 to 2016. The results of a differences-in-differences analysis find that a small group of for-profit institutions with very large enrollments became a destination for underrepresented minority students in the wake of affirmative action bans.

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Section: Methodsmentioning

confidence: 99%

Section: Datamentioning

confidence: 99%

Section: The Anti-affirmative Action Avalanchementioning

confidence: 99%

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The Anti-Affirmative Action Avalanche: The Rise of Underrepresented Minority Enrollment at For-Profit Institutions

Mickey-Pabello

2023

Sociol Educ

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“…23 In the context of this debate, mainly in the United States, universities have had to face extensive questions and legal battles, leading some institutions to ban race-conscious affirmative action policies. [24][25][26][27][28] In medical schools, the arguments for and against affirmative action also have been the subject of vigorous debate, with studies showing contradictory results. 29,30 Those who defend affirmative action policies argue that they may also positively promote student diversity since a lack of it may affect medical education.…”

Section: Dovepressmentioning

confidence: 99%

Comparison Between Students Admitted Through Regular Path and Affirmative Action Systems in a Brazilian Public Medical School

Biazotto¹,

Bittencourt²,

Araújo³

et al. 2022

AMEP

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Affirmative action policies to provide access to higher education for socially vulnerable students have been implemented in several countries and have faced many questions nowadays. The aim of the study was to compare the socioeconomic background and performance during and after completing the undergraduate course of students admitted through the regular path and social quota systems in a public medical school in Brazil. Methods: A retrospective cohort study including students admitted to a medical school within the School of Health Sciences (ESCS), in Brazil, between 2005 and 2012, and followed until May 2020. In the first phase, data collection was performed by analyzing documents from the ESCS academic management system and Brazilian government agencies. In the second phase, a survey with 12 questions was sent to the medical school alumni. The social quota system criteria were the public school attendance in all primary and secondary education levels. Results: Among 707 students, 204 (28.9%) were from the social quota and 503 (78.5%) from the regular path system. The place of residence of social quota students had a lower Human Development Index (p < 0.001) and per capita income (p < 0.001) when compared to regular path students. Regular path students were associated with the highest dropout from medical school (OR: 50.552, 95% CI: 12.438-205.453, p < 0.001). There was no difference between regular path and social quota students attending medical residency programs (OR: 1.780, 95% CI: 0.957-3.309, p = 0.069). Out of the 308 alumni who completed the survey, regular path students had more family members who were health professionals than social quota students (p < 0.001). There were no significant differences regarding monthly income, job satisfaction, employment, or management activities. Conclusion: Affirmative action targeted students with a disadvantaged socioeconomic background. Regular path students had a higher dropout rate than social quota students.

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“…Despite decades of diversity initiatives in US medical schools, such as affirmative action, Project 3000 by 2000, and diversity standards for accreditation, only affirmative action has brought substantive change, and the consequences of its termination are myriad. 1 , 2 The need for physicians from structurally excluded groups, including Black or African American, Hispanic or Latinx, and Indigenous physicians, continues to grow; such physicians broaden access to care, advance cultural humility, and advocate for underresourced communities. 3 , 4 From 2021 to 2022, the percentages of both Black or African American and Hispanic or Latinx first-year medical students increased to new highs yet remained substantially lower than their growing proportions in the applicant pool.…”

Section: Introductionmentioning

confidence: 99%

US Medical School Admissions Leaders’ Experiences With Barriers to and Advancements in Diversity, Equity, and Inclusion

Henderson

Fancher

et al. 2023

JAMA Netw Open

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ImportanceDespite decades-long calls for increasing racial and ethnic diversity, the medical profession continues to exclude members of Black or African American, Hispanic or Latinx, and Indigenous groups.ObjectiveTo describe US medical school admissions leaders’ experiences with barriers to and advances in diversity, equity, and inclusion.Design, Setting, and ParticipantsThis qualitative study involved key-informant interviews of 39 deans and directors of admission from 37 US allopathic medical schools across the range of student body racial and ethnic composition. Interviews were conducted in person and online from October 16, 2019, to March 27, 2020, and analyzed from October 2019 to March 2021.Main Outcomes and MeasuresParticipant experiences with barriers to and advances in diversity, equity, and inclusion.ResultsAmong 39 participants from 37 medical schools, admissions experience ranged from 1 to 40 years. Overall, 56.4% of participants identified as women, 10.3% as Asian American, 25.6% as Black or African American, 5.1% as Hispanic or Latinx, and 61.5% as White (participants could report &gt;1 race and/or ethnicity). Participants characterized diversity broadly, with limited attention to racial injustice. Barriers to advancing racial and ethnic diversity included lack of leadership commitment; pressure from faculty and administrators to overemphasize academic scores and school rankings; and political and social influences, such as donors and alumni. Accreditation requirements, holistic review initiatives, and local policy motivated reforms but may also have inadvertently lowered expectations and accountability. Strategies to overcome challenges included narrative change and revision of school leadership structure, admissions goals, practices, and committee membership.Conclusions and RelevanceIn this qualitative study, admissions leaders characterized the ways in which entrenched beliefs, practices, and power structures in medical schools may perpetuate institutional racism, with far-reaching implications for health equity. Participants offered insights on how to remove inequitable structures and implement process changes. Without such action, calls for racial justice will likely remain performative, and racism across health care institutions will continue.

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Addressing Racial Health Inequities: Understanding the Impact of Affirmative Action Bans on Applications and Admissions in Medical Schools

Cited by 12 publications

References 40 publications

The Anti-Affirmative Action Avalanche: The Rise of Underrepresented Minority Enrollment at For-Profit Institutions

The Anti-Affirmative Action Avalanche: The Rise of Underrepresented Minority Enrollment at For-Profit Institutions

Comparison Between Students Admitted Through Regular Path and Affirmative Action Systems in a Brazilian Public Medical School

US Medical School Admissions Leaders’ Experiences With Barriers to and Advancements in Diversity, Equity, and Inclusion

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