Addressing the Diversity Gap in Health Care

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This story is from the 2024 issue of Discoveries, a UC San Diego Health Sciences magazine.

Christopher Vela was sitting beside his grandfather’s hospital bed when he decided to become a nurse. His beloved grandfather had been diagnosed with terminal cancer, and at the time he was receiving hospice and palliative care.

“It was in that moment sitting in my grandpa’s intensive care unit room that I knew what I was meant to do with my life,” said Vela. 

Vela’s grandfather sadly passed away a few days later, but the impact of that moment and those times left an indelible mark.

“Even now, I think about those nurses and what they did for my grandpa and our family, and I’ve wanted to do the same for others,” Vela said. “I want to help people go through some of the toughest moments in their lives and to be there for them.”

After graduating high school in South Bay San Diego, Vela became the first person in his family to go to college. However, as a first-generation Mexican-American citizen and the sole financial provider for his family, nursing school seemed a distant goal.

“I first started the associate degree nursing (ADN) program at Southwestern College in 2015. During that time, I was also working two different jobs to help provide for my grandma and family,” he said. “Unfortunately, due to personal circumstances, I had to drop out of school to work.”

“I thought my dream of becoming a nurse was over, but I wasn’t ready to give up.”

Years later, Vela reapplied to the nursing program. 

He graduated from Southwestern College with his ADN in 2022 and completed exams to become a Registered Nurse that same year.

Not Giving Up on His Dream

As part of his training, Vela applied to be part of UC San Diego Health’s D.R.E.A.M. Nurse Externship Program, which provides participants with career guidance and critical skills to support their transition to a professional clinical nurse.

D.R.E.A.M. stands for Diversity, Retention, Equality, Aspire, Mentor. 

One key goal of the program is to create and sustain a more inclusive nursing workforce to care for UC San Diego Health’s diverse patient population. This is accomplished through collaboration between the academic institution and local community colleges in San Diego, including Southwestern Community College, City College and Grossmont Community College.

“There is a disparity between the diversity of our nursing staff and the patients we serve,” said Cabiria “Bea” Lizarraga, nurse manager at UC San Diego Health. “To address this, we created a program that aimed to increase diversity within our team, as well as address opportunity gaps among nursing students currently underrepresented in the field.”

Lizarraga created the program with fellow UC San Diego Health nurse leader Gwendolyn McPherson, MSN, RN, in 2021. 

According to Lizarraga, there is a lack of diversity in nursing, noting that the majority of Hispanic and African American registered nurses obtain their ADN as their initial nursing education, which can be a barrier to entering the profession because many health care institutions prefer a Bachelor of Science in Nursing degree.

“Through this program, we’ve created a pathway for ADN students to join our institution, while partnering with them through mentorship to address any barriers and optimize each student’s success,” said Lizarraga.

Since its inception, they’ve hired 18 new grad nurses at UC San Diego Health from the D.R.E.A.M. program. 

Supporting Underrepresented Youth 

In addition to partnering with community colleges in the region, UC San Diego Health has also launched a program that seeks to encourage high school students in underrepresented communities to pursue health care careers.

Entitled the “UC San Diego Health Career Experience,” the program will offer exposure and experience with health career professions to high school students to stimulate interest toward pursuing careers in fields such as primary care, nursing and allied health professions. Students learn about health care roles including medical assistants, physical therapy assistants, radiologic technicians and certified nurse assistants. 

UC San Diego Health received $2.2 million in grant funding from the California Department of Health Care Access and Information (HCAI) to develop the program in December 2022.

The grant awards are issued through HCAI’s Health Professions Pathways Program, which focuses on students interested in entering fields of primary care, behavioral health, geriatrics, nursing, and oral and allied health.

In total, $40.8 million grant funds were awarded to 20 health care organizations from across the country, and UC San Diego Health is the only health care institution in the region to be awarded funds, which will be distributed over the next five years.

Approximately 240 students will take part in the program each year and will be coached on their health care profession of interest. Additional lessons cover relationship-based care, personal branding, health literacy and health care disparities, health care technology, cultural competence, professional communication and research and evidence-based practice.

“This program provides us with the opportunity to connect with high school students and offer comprehensive academic enrichment, career development and mentorship,” said Gerard Phillips, DNP, MBA, RN, senior director of nursing at UC San Diego Health. “We’re thrilled to be using this funding to help with efforts that will result in a more diverse and inclusive workforce.”

Studying under the direct supervision of a health care provider, students involved in the program will observe and participate in a variety of clinical experiences. Patient care areas that students will gain exposure to include behavioral health, geriatric health, primary care and general adult medical-surgical care.

Additionally, UC San Diego Health experts will speak at local high schools.

Since receiving the grant, the team has hired a program coordinator who is developing curriculum, training materials, coordination with local schools, and more.

The first cohort of high school students is expected to begin their training at UC San Diego Health in early 2024.  

Reducing Health Disparities

According to Vela, programs like the D.R.E.A.M. Externship provided him with valuable, real-world work experience that he couldn’t find elsewhere. 

The UC San Diego Health Career Experience seeks to shape students’ perspectives and provide them with connections that allow them to imagine a future for themselves as health professionals. 

“This has been such an incredible opportunity for associate degree nursing students like myself who might come from troubled upbringings or have emigrated from another country or who couldn’t devote their lives to nursing right away, but bring valuable life experiences that patients can relate to,” Vela said. “For the patients we treat, it’s like we’re taking care of family because we’ve been through so much of the same.”

Both programs are associated with UC San Diego Health’s overall mission to achieve health equity by reducing the health disparities that are often experienced by individuals from underrepresented communities, which is driven by structural and institutional racism. 

“We are committed to ensuring that UC San Diego Health is a place where all can thrive,” said Patty Maysent, CEO, UC San Diego Health. “The D.R.E.A.M. Externship and UC San Diego Health Career Experience are a direct reflection of our desire to proactively create a diverse workforce and to invite young minds into promising careers in academic medicine.” 

“These programs are helping foster a vibrant and welcoming health care environment that reflects our patients, providers and local community overall.”

The Principles of Health Equity at UC San Diego Health aim to reduce, and ultimately eliminate, health disparities in the community and their root causes, including social determinants of health.

The goal of these programs is to empower students to be future leaders in health care, including students like Vela. 

Vela, now working as a clinical nurse at UC San Diego Medical Center in Hillcrest, could not help but think back to the day that he sat in his grandfather’s hospital room.

“My grandfather’s nurses treated him with dignity and cared for him as if he was their own family,” said Vela. “They supported us and soothed our pain during our grief. It is such an honor of mine that I now get to provide that same level of support and care for others in need.”