Table of Contents
Executive Summary................................................................................................3 Introduction.............................................................................................................4 Workforce Summaries............................................................................................. Medical Fields Dentistry Dentists..........................................................................................5 Dental Assistants...........................................................................6 Dental Hygienists..........................................................................7 Clinical Practice General Physicians........................................................................8 Specialty Physicians......................................................................9 General Surgeons.........................................................................10 Specialty Surgeons.......................................................................11 Nursing Licensed Practical Nurses.........................................................12 Registered Nurses........................................................................13 Selected Nursing Specialties........................................................14 Optometrists..........................................................................................15 Pharmacists...........................................................................................16 Podiatrists.............................................................................................17 Chiropractors........................................................................................18 Allied Health Fields Dietitians..............................................................................................19 Physical Therapists..............................................................................20 Social Workers.....................................................................................21 Speech Therapists................................................................................22 Conclusions..........................................................................................................23 References............................................................................................................24
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Executive Summary Key outcomes from this sixth annual report of diversity in the Arkansas health care workforce include:
The majority of workers in health occupations are male including physicians, dentists, optometrists, chiropractors and podiatrists. Dental hygienists (99 percent female), dietitians (97 percent female), specialty surgeons (92 percent male), licensed practical nurses (93 percent female), and speech therapists (96 percent female) were occupations with less than 10 percent in a gender field. Pharmacists and physical therapists enjoyed the most equity in terms of gender.
Each profession was predominately white. In fact, there were only six professions (i.e., general physicans, speciality physicians, nurses (LPN, RN and Specialty nurses), pharmacists, podiatrists and social workers) in which the proportion of white workers was less than 90 percent. Optometrists were 98 percent white, making them the least diverse profession with respect to race, whereas social workers were 75 percent white and 21 percent African American, making them the most diverse group in 2019 . Race was not available for dental assistants at the time of reporting.
Geographic distribution followed a similar pattern for most professions. The highest concentration of workers tended to be in the central, northwest and northeast regions of the state (i.e., the more urban areas of the state). Some professions were absent in a large number of counties. Specialty surgeons, for example, lacked active professionals in 46 counties, and general surgeons lacked professionals in 36 counties. Other professions enjoyed much greater dispersion. For example, pharmacists and physical therapists appeared to be active in all 75 counties. Despite the legislative mandate requiring licensing boards to capture and report data on demographic characteristics of those licensed in Arkansas, data were not consistently provided. Two of the seventeen healthcare professions covered in this report failed to report some or all of the required demographic data, compared to 3/17 in 2018, 3/17 in 2017, 4/17 in 2016 and 7/17 in 2015.
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Introduction Monitoring the healthcare workforce is necessary to ensure it is large enough and skilled enough to deliver the vital public health services to the population. Observation provides data regarding the impact of investment; advocating for additional resources; evaluating gaps in workforce development; and developing recruitment and retention methods.1 An adequate supply and distribution of well-prepared health workers is imperative to guarantee health care needs of the population. In accordance with the population of Arkansas, a diverse workforce is extremely important to ensure accessible, affordable and quality health care.2 Diversity in healthcare allows for increased cultural competence,3 and increasing trust and communication between professionals and patients. In addition, because healthcare careers generally provide greater economic benefits in relation to other career paths, greater representation in the field leads to benefits for a wider range of individuals, families and communities. In order to understand more clearly where Arkansas stands with regard to diversity in the healthcare workforce, examination of current data is necessary. This examination is made possible by Arkansas Act 1489 of 2009,4 which requires state agencies, boards and commissions that license health professionals in the state to provide demographic data on licensees yearly. This report was developed utilizing this information, and incorporates the most recent data provided for selected health professionals in Arkansas, with a focus on race, age, gender and geographic distribution. All data were obtained from Arkansas’ professional licensing boards through the Arkansas Minority Health Commission.
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Dentists Source: Arkansas Board of Dental Examiners
Dentists by Age 2019 30%
24%
25%
19% 20%
20%
22%
15% In 2019, there were 1,516 dentists licensed in Arkansas.
10% 5%
In 2019, dentists tended to be middle aged, with a majority (61 percent) reporting ages between 40 and 69. In addition, the majority of dentists were white with only 9 percent being other races or ethnicities. Dentists were also more likely to be male than female. A review of the geographic distribution of dentists indicated that seven counties (highlighted on the map) had no dentist with an address in that county.
0%
9%
5%
1%
20-29 30-39 40-49 50-59 60-69 70-79 80-89
Dentists by Race 2019 100%
Dentists by Gender 2019
92%
80%
23%
60% 40%
77%
20% 0%
White
4%
5%
African American
Other
FEMALE
Counties with No Dentists, 2019
*Percentages may not add to 100 percent due to rounding.
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MALE
Dental Assistants Source: Arkansas Board of Dental Examiners
Dental Assistants by Age 2019 50%
38%
40% 30%
31% 16%
20% 10% In 2019, there were 7,208 dental assistants practicing in Arkansas.
0%
10%
5%
20-29 30-39 40-49 50-59 60-69 70-79
In general, dental assistants tended to be young – 85 percent were under the age of 50. No race or gender data was provided for dental assistants. A review of the geographic distribution of dental assistants in the state revealed there was one county (indicated in red on the map to the right) that does not have dental assistants listing an address living or working in the county.
Counties with No Dental Assistants, 2019
*Note: Percentages may not add to 100 percent due to rounding
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1%
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Dental Hygienists Source: Arkansas Board of Dental Examiners
Dental Hygienists by Age 2019 35%
32%
30% 25% 20% 15% In 2019, there were 2,229 dental hygienists practicing in Arkansas. Dental hygienists tended to be young, with 84 percent being under the age of 60. Dental hygienists were also primarily white, with African Americans and other racial minorities making up 5 percent of the profession. A review of the geographic distribution of dental assistants indicated that there were six counties in the state with no dental hygienist reporting a work or mailing address with that county (indicated in red on the map to the right).
21% 16%
14%
13%
10% 3%
5% 0%
20-29 30-39 40-49 50-59 60-69 70-79 Dental Hygienists by Gender 2019 1%
Dental Hygienists by Race 2019
95%
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
99% White
2%
3%
African American
Other
FEMALE
MALE
Counties with No Dental Hygienists, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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General Physicians Source: Arkansas Medical Board
General Physicians by Age 2019
In 2019, there were 1,331 general physicians active in Arkansas. Practically all general physicians were over the age of 30; the majority (49 percent) of physicians were between the ages of 40 and 70. General physicians were about 87 percent white. A majority of general physicians were male, only 21 percent of Arkansas general physicians were female.
40% 35% 30% 25% 20% 15% 10% 5% 0%
38%
22% 13%
4%
2%
30-39 40-49 50-59 60-69 70-79 80-89 90-99
General Physicians by Gender 2019
General Physicians by Race 2019 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
12%
9%
87%
21%
WHITE
7%
6%
AFRICAN AMERICAN
OTHER
79% FEMALE
MALE
Counties with No General Physicians, 2019
A review of the geographic distribution of general physicians indicated that 37 counties (indicated in red on the map to the right) had no practice address in these counties. *Note: Percentages may not add to 100 percent due to rounding.
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Specialty Physicians Source: Arkansas Medical Board
Specialty Physicians by Age 2019 30% In 2019, there were 5,840 specialty physicians active in Arkansas. Few specialty physicians were under the age of 30, presumably because of the additional training needed for specialty practice. The majority (69 percent) were between the ages of 40 and 69. Specialty physicians were predominately white, but about 19 percent identified with other races. A majority of specialty physicians were male, only about 30 percent of Arkansas specialty physicians were female.
24%
25% 20%
22%
23%
18%
15%
10%
10% 5%
3%
0%
0%
20-29 30-39 40-49 50-59 60-69 70-79 80-89
Specialty Physicians by Gender 2019
Specialty Physicians by Race 2019 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
82%
30% 14%
70%
5% WHITE
AFRICAN AMERICAN
OTHER
FEMALE
MALE
Counties with No Specialty Physicians, 2019
A review of the geographic distribution of specialty physicians indicated that 2 counties (indicated in red on the map to the right) in the state had no specialty physician providing either a work or home address within that county. *Note percentages may not add to 100 percent due to rounding.
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General Surgeons Source: Arkansas Medical Board
General Surgeons by Age 2019 30%
26%
25%
21%
20% In 2019, there were 235 general surgeons active in Arkansas. The majority (85 percent) of general surgeons were over the age of 40. General surgeons were predominately white, but about 10 percent identified with other races. A majority of general surgeons were male, only about 14 percent of Arkansas general surgeons were female.
16%
15%
14%
18%
10%
6%
5% 0%
30-39 40-49 50-59 60-69 70-79 80-89 General Surgeons by Race 2019
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
General Surgeons by Gender 2019
90%
14%
86%
White
A review of the geographic distribution of general surgeons indicated that 36 counties in the state had no general surgeon providing either a work or home address within that county (indicated in red on the map to the right).
6%
4%
African American
Other
FEMALE
Counties with No General Surgeons, 2019
*Note percentages may not add to 100 percent due to rounding.
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MALE
Specialty Surgeons Source: Arkansas Medical Board
Speciality Surgeons by Age 2019 30% 25% In 2019, there were 417 specialty surgeons in Arkansas. No surgeons were under the age of 30, presumably because of the years of additional training required. The majority (73 percent) were between the ages of 40 and 69. Specialty surgeons were overwhelmingly white, with only 8 percent identifying as other races. Additionally, specialty surgeons were predominately male at 92 percent.
22%
25%
26%
20% 15%
13%
11%
10%
4%
5% 0%
30-39 40-49 50-59 60-69 70-79 80-89
Specialty Physicians by Gender 2019
Speciality Surgeons by Race 2019 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
91%
8%
92% 6%
2% White
A review of the geographic distribution of specialty surgeons indicated that the majority practice in metropolitan areas of the state. A total of 46 counties (indicated in red on the map to the right) have no specialty surgeon with an address listed in that county.
African American
Other
FEMALE
Counties with No Specialty Surgeons, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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MALE
Nurses-Licensed Practical Source: Arkansas Nursing Board
Licensed Practical Nurses by Age 2019 30%
25%
25% 20% In 2019, there were 14,685 active licensed practical nurses (LPNs) in Arkansas.
15%
Generally, LPNs tended to be younger, with 64 percent being under the age of 50.
0%
LPNs tended to be white, but 15 percent were African American, a proportion higher than that found in many other health professions in the state. LPNs tended to be female, making up 93 percent of the active LPNs in the state.
23%
16%
19% 14%
10% 5%
3%
20-29 30-39 40-49 50-59 60-69 70-79 80-89
Liscensed Practical Nurses Race Chart 2019 90%
78%
80%
Liscensed Practical Nurses by Gender 2019 7%
70% 60% 50% 40% 30% 20%
93%
15%
10%
6%
0%
WHITE
AFRICAN AMERICAN
OTHER
There was no geographic data provided for LPNs in 2019. *Note: These data may include duplicate licenses as nurses may hold multiple licenses in different specialties. Percentages may not add to 100 percent due to rounding.
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0%
12
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Female
Male
Nurses-Registered Source: Arkansas Nursing Board
General Nurses by Age 2019 30%
25%
25%
23%
20% In 2019, there were 44,085 active registered nurses (RNs) in Arkansas. Generally, RNs tended to be younger, with 61 percent being under the age of 50. RNs tended to be white, but 8 percent were African American, a proportion higher than that found in many other health professions in the state. RNs tended to be female, making up 89 percent of the active nurses in the state.
16%
13%
15%
20%
10% 3%
5% 0%
20-29 30-39 40-49 50-59 60-69 70-79 80-89
General Nurses by Gender 2019
General Nurses by Race 2019 90%
85%
80% 70% 60%
11%
50% 40% 30% 20%
White
89%
8%
7%
African American
Other
10% 0%
There was no geographic data provided for RNs in 2019. *Note: These data may include duplicate licenses as nurses may hold multiple licenses in different specialties. Percentages may not add to 100 percent due to rounding.
[
0%
13
[
Female
Male
Nurses - Selected Nursing Specialties Source: Arkansas Nursing Board
Specialty Nurses by Age 2019
In 2019, there were 5,047 active specialty nurses (including certified nursing midwives and registered nurse anesthesiologists) in Arkansas. Specialized nurses tended to be a little older, with nearly half (49 percent) between the ages of 40 and 59 and another 11 percent between 60 and 69 years. Specialty nurses were generally white, with about 14 percent making up other races. Specialty nurses tended to be female, making up 83 percent of the active nurses in the state.
40% 35% 30% 25% 20% 15% 10% 5% 0%
35%
18% 11% 4%
2%
20-29 30-39 40-49 50-59 60-69 70-79
Specialty Nurses by Gender 2019
Specialty Nurses By Race 2019 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
31%
86%
17%
WHITE
8%
6%
AFRICAN AMERICAN
OTHER
There was no geographic data provided for specialty nurses in 2019. *Note: These data may include duplicate licenses as nurses may hold multiple licenses in different specialties. Percentages may not add to 100 percent due to rounding.
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83% Female
Male
Optometrists Source: Arkansas Optometry Licensing Board
Optometrists by Age 2019 30%
26%
25%
22%
20%
15%
15%
In 2019, there were 540 active optometrists in the state. Optometrists tended to be younger, with 56 percent being below the age of 50. In addition, optometrists were generally white, with other races and ethnicities making up only 3 percent of the profession.
10%
18% 10%
8%
5%
1%
0%
20-29 30-39 40-49 50-59 60-69 70-79 80-89
Optometrists by Gender 2019
Optometrists by Race 2019 120% 98%
100% 80%
35%
60%
Optometrists were also more likely to be male, with only one third of active optometrists being female.
65%
40% 20% 0%
WHITE
As with other health related professions, optometrists tended to be located in the more urban areas of the state. There were 18 counties (indicated in red on the map) with no optometrists listing an address in that county.
2%
1%
AFRICAN AMERICAN
OTHER
FEMALE
Counties with No Optometrists, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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MALE
Pharmacists Source: Arkansas Board of Pharmacy
In 2019, there were 6,604 active pharmacists in the state. Pharmacists tended to be younger, with 60 percent reporting ages under 50 years. Pharmacists were predominantly white, but about 12 percent identified with other races. Pharmacists were fairly evenly divided between males and females.
35% 30% 25% 20% 15% 10% 5% 0%
Pharmacists by Age 2019 30% 23%
14% 7%
5%
Pharamacists by Gender 2019
88%
45% 55% 8%
4% WHITE
A review of the geographic distribution of pharmacists in the state indicated that every county in the state had at least one pharmacist. No counties are shaded red in the map to the right, indicating coverage in each county.
AFRICAN AMERICAN
OTHER
FEMALE
Counties with No Pharmacists, 2019
*Note: Percentages may not add to 100 percent due to rounding.
[
1%
20-29 30-39 40-49 50-59 60-69 70-79 80-89 Pharmacists by Race 2019
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
20%
16
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MALE
Podiatrists Source: Arkansas State Board of Podiatry Examiners
Podiatrists by Age 2019
40%
36%
30%
22%
20% In 2019, there were 119 active podiatrists in Arkansas. Podiatrists tended to be middle-aged with 77 percent falling between the ages of 40 and 69. Although 84 percent of podiatrists are white, about 16 percent make up other races. Podiatrists tended to be male, with 76 percent of active podiatrists being men.
20%
15%
7%
10% 0%
30-39
40-49
60-69
70-79
Podiatrists by Gender 2019
Podiatrists by Race 2019 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
50-59
84%
24%
WHITE
A review of the geographic distribution of podiatrists in the state indicated there were 52 counties (indicated in red on the map to the right) that do not have podiatrists listing an address in that county.
8%
8%
AFRICAN AMERICAN
OTHER
76% FEMALE
Counties with No Podiatrists, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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MALE
Chiropractors Source: Arkansas Board of Chiropractic Examiners
25%
Chiropractors by Age 2019 21%
20%
24% 22% 22%
15% In 2019, there were 1196 active chiropractors in Arkansas. Chiropractors tended to be middle-aged with a majority (67 percent) between the ages of 30-59. Chiropractors were predominantly white, with only 4 percent of chiropractors being made up of other races. Approximately 3 out of 4 chiropractors were male. A review of the geographic distribution of chiropractors in the state revealed there were 13 counties (indicated in red on the map to the right) that do not have chiropractors listing an address living or working in the county.
8%
10% 5%
3%
0%
20-29 30-39 40-49 50-59 60-69 70-79
Chiropractors by Gender 2019
Chiropractors by Race 2019
96%
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
23%
White
2%
2%
African American
Other
77%
Counties with No Chiropractors, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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Female Male
Dietitians Source: Arkansas Dietetics Licensing Board
Dietitians by Age 2019 35%
30%
30% 25%
22%
20%
17%
15% In 2019, there were 830 active dietitians in Arkansas. Dietitians tended to be middle-aged with a majority (67 percent) between ages of 30-59. Dietitians were predominantly white, with only 6 percent being made up of other races. A majority of dietitians were female, only about 4 percent of Arkansas dietitians were male.
15%
13%
10% 3%
5% 0%
20-29 30-39 40-49 50-59 60-69 70-79
Dietitians by Gender 2019
Dietitians by Race 2019 94%
100%
3%
80% 60% 40% 20% 0%
WHITE
A review of the geographic distribution of dietitians in the state revealed there were 13 counties (indicated in red on the map to the right) that do not have dietitians listing an address living or working in the county.
3%
3%
AFRICAN AMERICAN
OTHER
97% FEMALE
Counties with No Dietitians, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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MALE
Physical Therapists Source: Arkansas Board of Physical Therapy
Physical Therapists by Age 2019
In 2019, there were 3,941 active physical therapists in the state. Physical therapists tended to be younger, with the majority (72 percent) being under the age of 50. Approximately 9 in every 10 physical therapists were white. Physical therapists were predominantly male, with only 33 percent being female in 2019. A review of the geographic distribution of physical therapists throughout the state revealed a common pattern, with higher proportions located in urban areas. However, there were not counties without physical therapists living or working in that county.
35% 30% 25% 20% 15% 10% 5% 0%
31% 25% 16%
8% 1% 20-29 30-39 40-49 50-59 60-69 70-79 Physical Therapists by Gender 2019
Physical Therapists by Race 2019 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
20%
91%
33% 67% WHITE
3%
6%
AFRICAN AMERICAN
OTHER
FEMALE
Counties with No Physical Therapists, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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MALE
Social Workers Source: Arkansas Social Work Licensing Board
Social Workers by Age 2019 30%
23% 24%
25% 20%
17% 16%
15% In 2019, there were 5,962 active social workers in the state.
9%
5%
Social workers tended to be younger, with 74 percent being under the age of 60. Social workers were more diverse than other health professions, with 26 percent identifying as a minority.
10%
10%
1%
0%
20-29 30-39 40-49 50-59 60-69 70-79 80-89 Social Workers by Gender 2019
Social Workers by Race 2019 80%
75%
70%
14%
60% 50% 40%
Social workers were predominately female, with only 14 percent being male in 2019.
30%
21%
20% 10%
86%
5%
0%
WHITE
A review of the geographic distribution reveals social workers in the state revealed there were 15 counties (indicated in red on the map to the right) that do not have social workers listing an address living or working in the county.
AFRICAN AMERICAN
OTHER
FEMALE
Counties with No Social Workers, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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21
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MALE
Speech Therapists Source: Arkansas Speech Pathology and Audiology Board
Speech Therapists by Age 2019 80%
70%
60% 40% In 2019, there were 5,197 active speech therapists in the state. Speech therapists tended to be younger, with 81 percent being under the age of 60. Approximately 7 in every 10 speech therapists were white. Speech therapists were predominately female, with only 4 percent being male in 2019. A review of the geographic distribution reveals speech therapists in the state revealed there were 2 counties (indicated in red on the map to the right) that do not have social workers listing an address living or working in the county.
20% 0%
1%
1%
20-29
30-39
40-49
50-59
60-69
4%
72%
70%
9%
Speech Therapists by Gender 2019
Speech Therapists by Race 2019 80%
19%
60% 50% 40% 26%
30% 20%
96%
10%
2%
0%
White
African American
Other
FEMALE
Counties with No Speech Therapists, 2019
*Note: Percentages may not add to 100 percent due to rounding.
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22
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MALE
Conclusions Increased diversity in the state’s healthcare workforce could have positive effects on both the health of minority populations and the quality of care in Arkansas. This report examines demographic data provided by the state’s various healthcare workforce licensing boards to the Arkansas Department of Health, and seeks to illustrate age, race, gender and geographic disparities found within various segments of the workforce. This report was made possible by the Arkansas General Assembly’s 2009 mandate that required all licensing boards to provide this information on its licensees. Despite Act 1489, some 2019 data were missing, preventing a complete analysis of workforce characteristics. Of the 17 professions contacted to report data for examination, only one was missing race and gender data, which is an improvment from the previous year. Racial disparities are a reality in Arkansas’ workforce. The racial and ethnic diversity found in the state’s population is not necessarily reflected in the healthcare system. Gender and age disparities are evident, as well. Healthcare professionals are not, in many cases, equitably distributed throughout the state. While it is not unexpected that professionals would be clustered in the population centers found in the central and northwestern parts of the state, it is of some concern that some counties (for example, Lafayette and Calhoun counties) were consistently lacking active professionals. Such geographic disparities can be harmful when they prevent an individual or family from accessing needed care. Few differences were evident between the data obtained this year and those obtained last year. While some professions may have improved or declined in terms of diversity, any differences were slight and possibly due to chance. To see true development and improvement (or decline) over time, frequent and complete reporting is required over a long period to allow for policy changes to manifest in workforce improvements. This report highlights important issues in workforce diversity in Arkansas. While awareness is important in the early stages of demographic data collection and can form the basis of future development, systematic and ongoing demographic data collection, it is imperative to maintain momentum in understanding our changing workforce.
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References References 1.University of Michigan Center of Excellence in Public Health Workforce Studies. Public Health Workforce Enumeration, 2012. Ann Arbor, MI: University of Michigan; 2013.
2.U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. Sex, Race, and Ethnic Diversity of U.S. Health Occupations (2010-2012), Rockville, Maryland; 2014.
3.Brusin, J.H. (2012) . How cultural competency can help reduce health disparities. Radiologic Technology, 84(2).
4.State of Arkansas - General Assembly - Act 1489. (2009). Available from http://www.arkleg.state.ar.us/assembly/2009/R/Acts/Act1489.pdf
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