Workforce Trends of Underrepresented Minority Nurses in the United States Over the Last Decade: Progress Towards Equal Representation?

Abstract

A healthcare workforce representative of the race/ethnicity composition of the population it serves is central to addressing systemic health inequities. The aim of this study was to assess workforce trends of underrepresented minority (URM) nurses using the National Sample Survey of Registered Nurses years 2008 and 2018 and the American Community Survey years 2010 and 2019. We examined changes over time in URM composition (Black/African American (B/AA), Latine, American Indian/Alaskan Native (AI/AN), Native Hawaiian/Pacific Islander (NH/PI)) for registered nurses (RN), nurse practitioners (NPs), educational attainment (diploma/associate, BSN, MS(N)/PhD), job type (patient care, research, administration/supervision, teaching, other), and rural/urban location using descriptive statistics and bivariate regressions. While the proportion of the URM RN workforce grew significantly, the only URM group demonstrating proportional gains in the APRN workforce were Latine nurses. URM representation in educational attainment grew across all degree types. By 2018/2019, Latine nurses have their largest representation in the Dipl./ASN degree group and saw a proportional decline for PhD educated nurses. B/AA nurses have their largest representation at the MS(N)/PhD level. However, smaller proportions of B/AA nurses were working as APRNs compared to their non-URM colleagues. At the PhD level, few B/AA nurses were represented in research and teaching positions. A subgroup analysis of unemployed nurses seeking work revealed that B/AA and AI/AN nurses were overrepresented among unemployed nurses. While today's nursing workforce is more representative of the nation than ever before, results show unequal representation of URM and non-URM nurses across the ranks of the nursing professions that suggest unequal career and labor market opportunities.