Racial and Ethnic Composition of Departments of Health Policy & Management and Health Education & Behavioral Sciences

Abstract

The diversity of racial/ethnic representation in the health services and policy research (HSPR) workforce plays a crucial role in addressing the health needs of underserved populations. We assessed changes (between 2012 and 2022) in the racial/ethnic composition of students and faculty from departments of Health Policy & Management (HPM) and Health Education & Behavioral Sciences (HEBS) among the Association of Schools and Programs of Public Health member institutions. We analyzed annual data from over 40 institutions that reported student and faculty data in 2012 and 2022 within each department. Racial/ethnic populations included American Indian/Alaska Native (AI/AN), Asian, Hispanic, Native Hawaiian/Pacific Islander (NH/PI), Black, White, Unknown, and Multiracial. We conducted analyses by department and examined racial/ethnic composition by student status, degree level, faculty rank, and tenure status. We found statistically significant increases in Black assistant professors (HPM and HEBS) and tenured faculty (HPM), Hispanic graduates and tenure-track faculty (HPM), Asian professors (HPM: full and tenured, HEBS: associate and tenured), and Multiracial students and graduates (HPM and HEBS). Statistically significant decreases were observed in White professors (HPM: assistant and full, HEBS: all ranks) and tenure-track faculty (HPM and HEBS), AI/AN associate professors and tenured faculty (HEBS), Hispanic associate professors (HPM), Asian assistant professors (HEBS), and NH/PI students (HPM and HEBS). Our findings highlight the importance of increasing racial/ethnic representation. Strategies to achieve this include facilitating workshops to raise awareness about the structural barriers encountered by Hispanic faculty, providing research support, evaluating promotion processes, establishing more pathway programs, and fostering interdisciplinary academic environments studying AI/AN or NH/PI populations.

Keywords

social and behavioral sciences academic public health racial and ethnic diversity student and faculty diversity public health workforce diversity

Impact Statement

We evaluated changes in the racial/ethnic composition of students, graduates, and faculty from HPM and HEBS departments between 2012 and 2022. Implications for HPM and HEBS departments include facilitating workshops to raise awareness about the structural barriers encountered by Hispanic faculty; providing Hispanic faculty adequate research support; establishing inclusive criteria for annual evaluations, tenure considerations, and promotion processes; establishing pathway programs and partnerships with institutions that have a substantial number of AI/AN or NH/PI undergraduates; and fostering interdisciplinary academic environments studying AI/AN or NH/PI populations.

Introduction

Increasing racial/ethnic diversity in the workforce remains a pressing concern in health services and policy research (HSPR) (Chantarat et al., 2023; Cobian & Gutiérrez, 2021; Edmunds et al., 2015; Frogner, 2018; Leider, Yeager, et al., 2023; Simpson et al., 2022). AcademyHealth, the leading HSPR professional organization in the United States, highlighted this issue in its 2015 report (Edmunds et al., 2015), The Future of Diversity and Inclusion in Health Services and Policy Research. The report emphasized the importance of recruiting and retaining individuals from underrepresented backgrounds who can provide value to the HSPR workforce by leveraging their lived experiences (Edmunds et al., 2015).

Despite this potential, changes in the racial/ethnic diversity of the HSPR workforce have been small (Frogner, 2018; Leider, Yeager, et al., 2023). For example, in a study of health departments (state, large metropolitan, and local) from 2017 to 2021 (Leider, Yeager, et al., 2023), Hispanic representation increased from 13% in 2017 to 18% in 2021, a percentage-point difference (PPD) of 5. However, other minoritized racial group percentages decreased (Black or African American: from 16% in 2017 to 15% in 2021, PPD = −1), remained the same (Native Hawaiian/Pacific Islander: 0% in both years), or exhibited only a slight increase (American Indian: from 0% in 2017 to 1% in 2021, PPD = 1; Asian: from 5% in 2017 to 7% in 2021, PPD = 2) (Leider, Yeager, et al., 2023). Another report suggests that, among graduate students from HSPR-related programs, minoritized racial/ethnic representation has remained stagnant or nearly so among Hispanic (from 6% in 2011 to 7% in 2015, PPD = 1), Black (14% in both years), Native Hawaiian/Pacific Islander (<1% in both years), American Indian (<1% in both years), and Asian (from 10% in 2011 to 11% in 2015, PPD = 1) students (Frogner, 2018).

The health department study and the HSPR graduate program study have their strengths and limitations. The health department study garnered over 40,000 responses annually from 2017 to 2021, representing a national sample of city and state public health workers (Leider, Yeager, et al., 2023). However, researchers did not analyze students and graduates entering the workforce, specifically those from HSPR programs. In contrast, the HSPR graduate program study provided information on HSPR graduate students stratified by degree level (master’s and doctoral), and large sample sizes were analyzed from each study year (n > 14,000 in 2011 and 2015) (Frogner, 2018). However, neither study reported data on faculty, who play a crucial role in training students entering the HSPR workforce. Finally, in both studies, data were analyzed from up to 5 years, warranting further evidence to determine whether these findings hold over a longer period.

Examining trends in the racial/ethnic composition of faculty is crucial as a diverse professoriate impacts research, practice, and teaching in public health (Antonio et al., 2004; Cohen et al., 2002; Gurin et al., 2002; Hill et al., 2015; Mitchell & Lassiter, 2006; Whitla et al., 2003). Historically, the racial/ethnic composition of faculty in schools and programs of public health have primarily comprised individuals racialized as non-Hispanic White (Goodman et al., 2023; Healton, 1999; Khan et al., 2019; Ramirez-Valles, 2020; Ramirez-Valles et al., 2023; Rosenstock et al., 2011). These individuals have shaped public health curriculums and research among marginalized populations. Faculty members from structurally excluded groups are needed as their public health training and lived experiences can address the health needs of medically underserved populations (Duffus et al., 2014; Gold, 2010; C. S. Jackson & Gracia, 2014; Kirkland et al., 2024; Smith et al., 2009). They can conduct culturally appropriate research to inform health policy, implement behavioral interventions to reduce health inequities, and bolster the public health workforce during pandemics (Chantarat et al., 2023; Cobian & Gutiérrez, 2021; Edmunds et al., 2015; Hardeman & Karbeah, 2020; Simpson et al., 2022). In addition, a racially and ethnically diverse professoriate affects recruitment, as professors from minoritized backgrounds often mentor students from similar backgrounds (Gurin et al., 2002; Miner & Allan, 2014), which can lead to students pursuing academic public health careers. Minoritized professors can also ensure important topics are embedded into the curriculum, such as critical race theory (Crenshaw et al., 1995) and how to include variables for racism and socially-assigned race in regression models (Howe et al., 2022; VanderWeele & Robinson, 2014; Wizentier et al., 2023).

Exploring racial/ethnic trends among students in departments training future HSPR professionals is important for several reasons. First, study periods from the reports by Leider, Yeager, et al. (2023) and Frogner (2018) encompassed up to 5 years, warranting further evidence to determine whether these findings hold over a longer study period. Second, there is a lack of research examining the existence of a “leaky pipeline” within HSPR-related departments. This concept posits that gains in racial/ethnic diversity at the undergraduate level are not reflected at the graduate, faculty, and academic leadership levels (Barr et al., 2008; Grumbach & Mendoza, 2008; Hood et al., 2017; J. R. Jackson et al., 2019; Williams, 2019). Identifying a “leaky pipeline” can inform student recruitment and retention strategies, addressing retirements and job losses in the public health workforce (Coronado et al., 2020; Leider, Coronado, et al., 2018; Leider et al., 2016; Liss-Levinson et al., 2015; Morabia, 2024; Pourshaban et al., 2015; Turbow & Goodman, 2024). Evidence of a “leaky pipeline” may also indicate that social justice motivations for entering the HSPR field are outweighed by higher student loan debt and lower starting salaries compared with other graduate programs like business administration (Beck et al., 2020; Resnick et al., 2024). Finally, the recent U.S. Supreme Court ruling on race-conscious admissions will impact the racial/ethnic composition of HSPR students (Bather, Furr-Holden, et al., 2023; Schmidt et al., 2023). This ruling coincides with a demographic shift in the United States toward higher proportions of racial/ethnic minoritized populations (Sullivan Commission on Diversity in the Health care Workforce, 2004; Thorpe et al., 2021; Wessel, 2018). HSPR trainees often ascend to roles as health policymakers, governmental leaders, research scientists, and professors. If the field remains predominantly non-Hispanic White, health inequities and higher disease prevalence among marginalized populations are likely to persist.

We analyzed the racial/ethnic composition of students, graduates, and faculty from departments of Health Policy & Management (HPM) and Health Education & Behavioral Sciences (HEBS) among Association of Schools and Programs of Public Health (ASPPH) member institutions in 2012 and 2022. We aimed to quantify racial/ethnic composition changes and evaluate whether these changes were statistically significant over the 10-year period. On the basis of previous ASPPH analyses of schools of public health, epidemiology, biostatistics, and environmental health (Bather, Burke, et al., 2023; Goodman et al., 2020, 2023), we hypothesized that the total number of students, graduates, and faculty increased from 2012 to 2022 and that the minoritized racial/ethnic representation was similar among students, graduates, and faculty.

Methods

Data on Enrolled Students, Graduate Completions, and Faculty

Our analysis was based on data from the ASPPH Data Center, which annually collects institution-level data from ASPPH-member institutions. ASPPH had 57 members in 2012 and 138 members in 2022 (Figure 1). Of the 57 members in 2012, 49 (86%) reported enrollment, graduate completion, or faculty data. Of the 138 members in 2022, 119 (86%) reported enrollment, graduate completion, or faculty data. For this analysis, we limited graduate student and faculty data to HPM and HEBS departments. This resulted in a sample cohort of 49 member institutions with HPM or HEBS departments that reported enrollment, graduate completion, or faculty data. HPM departments include health policy and management, health services administration, hospital administration, health planning, health management, health services research, health law, and evaluation research. HEBS departments include health education, behavioral sciences, public health education, health education administration, health behavior, community health sciences, community health practice, and health promotion. We categorized students as enrolled (fall 2011 and fall 2021) or graduate completion (academic years 2011–2012 and 2021–2022) by degree level (master’s or doctoral). We categorized faculty members by academic rank (professor, associate professor, or assistant professor) and by tenure status (tenure-track or tenured) for tenure-eligible faculty members.

Figure 1.

Association of Schools and Programs of Public Health (ASPPH) Institutional Reporting Flow Diagram of Departments of Health Policy & Management (HPM) and Health Education & Behavioral Sciences (HEBS).

Institutional Reporting

Eighty-one ASPPH-member institutions reported data on enrolled students in HPM: 48 (100% of schools of public health) reported in both 2012 and 2022, 1 reported only in 2012, and 32 reported only in 2022. Data on graduate completion in HPM were reported for 79 institutions: 46 (100% of schools of public health) reported in both 2012 and 2022, one reported only in 2012, and 32 reported only in 2022. Eighty-four institutions reported data on HPM faculty: 45 (100% of schools of public health) reported in both 2012 and 2022, and 39 reported only in 2022. Eighty-one institutions reported data on students enrolled in HEBS programs: 47 (100% of schools of public health) reported in 2012 and 2022, two reported only in 2012, and 32 reported only in 2022. Eighty institutions reported data on HEBS graduate completion: 46 (100% of schools of public health) reported in both 2012 and 2022, three reported only in 2012, and 31 reported only in 2022. Eighty-two institutions reported data on HEBS faculty: 45 (100% of schools of public health) reported in both 2012 and 2022, and 38 reported only in 2022. The primary analyses focused on the cohort of member institutions that reported data in both 2012 and 2022. All members of this cohort were schools of public health.

The secondary analyses included all member institutions that reported data in 2022. In 2022, 80 HPM departments (19 programs [24%] and 61 schools [76%]) reported data on enrolled students, 78 (18 programs [23%] and 60 schools [77%]) reported student data on graduate completion, and 84 (22 programs [26%] and 62 schools [74%]) reported faculty data. Among HEBS departments, 79 (19 programs [24%] and 60 schools [76%]) reported data on enrolled students, 77 (18 programs [23%] and 59 schools [77%]) reported student data on graduate completion, and 83 (22 programs [26%] and 61 schools [74%]) reported faculty data in 2022. These analyses were considered exempt by the New York University Institutional Review Board.

Racial and Ethnic Composition

We analyzed the following racial/ethnic populations: American Indian/Alaska Native (AI/AN), Asian, Hispanic/Latinx (Hispanic), Native Hawaiian/Pacific Islander (NH/PI), Non-Hispanic Black or African American (Black), Non-Hispanic White (White), Multiracial (two or more races), and unknown race. In 2012 and 2022, the unknown race group included those with unreported race/ethnicity (students, graduates, and faculty) or non-U.S. citizenship (students and graduates). The faculty who reported data for both 2012 and 2022 did not contain information on citizenship. Therefore, faculty members from non-U.S. ASPPH-member institutions were classified by their race/ethnicity, regardless of U.S. citizenship status. The National Institute of Public Health of Mexico was the only non-U.S.-based institution in this analytic sample.

Analytic Approach

Our primary goal was to assess changes in the racial/ethnic composition of students and faculty in HPM and HEBS departments from 2012 to 2022. To achieve this, we conducted stratified analyses of student data by department, race/ethnicity, student status, and degree level. We also performed similar analyses of faculty data by department, race/ethnicity, academic rank, and tenure status. First, we calculated counts and percentages for 2012 and for 2022. Then, we computed the PPD. To determine the statistical significance of the PPD, we employed the two-sample test for proportions, considering a two-sided p-value < .05 as statistically significant. In our secondary analysis, we presented counts and percentages for data on student, graduate completion, and faculty from all member institutions reporting in 2022. All statistical analyses were performed using R (R Core Team, 2023).

Results

Enrolled Students

Table 1 shows the change in the number and percentage of enrolled students by department and race/ethnicity from 2012 to 2022. For HPM, the total number of enrolled students at the 48 institutions in the comparison cohort increased by 242 students (from n = 1,220 to n = 1,462). For HEBS, among the 47 reporting institutions, the number of enrolled students increased by 143 (from n = 867 to n = 1,010). Among enrolled students in HPM departments in the comparison cohort, we observed statistically significant PPDs in NH/PI (1.4% to 0.5%, PPD = −0.9, p = .039), unknown race (25.7% to 22.1%, PPD = −3.6, p = .031), and Multiracial (4.3% to 7.9%, PPD = 3.6, p < .001). Among enrolled students in HEBS departments, we also observed statistically significant PPDs in NH/PI (1.2% to 0.2%, PPD = −1.0, p = .022) and Multiracial (6.0% to 8.9%, PPD = 2.9, p = .022). No statistically significant PPDs were observed among enrolled students who identified as AI/AN, Asian, Hispanic, Black, or White in HPM and HEBS departments (all PPDs < 3.0, all p-values > .05).

Table 1.

Change in the Number and Percentage of Enrolled Students and Graduate Completions at Schools and Programs of Public Health by Department and Race/Ethnicity, 2012 to 2022.

	Students enrolled				Graduate completions
Race and ethnicity	2012, no. (%)	2022, no. (%)	PPD ^a	p-value^b	2012, no. (%)	2022, no. (%)	PPDa	p-value^b
Health Policy and Management	(n = 48 reporting institutions)				(n = 46 reporting institutions)
Total	1,220 (100.0)	1,462 (100.0)	—^c	—^c	653 (100.0)	788 (100.0)	—^c	—^c
American Indian/Alaska Native	22 (1.8)	23 (1.6)	−0.2	0.76	7 (1.1)	8 (1.0)	−0.1	0.99
Asian	190 (15.6)	235 (16.1)	0.5	0.76	105 (16.1)	137 (17.4)	1.3	0.56
Hispanic/Latinx^d	148 (12.1)	199 (13.6)	1.5	0.28	55 (8.4)	108 (13.7)	5.3	0.002
Native Hawaiian/Pacific Islander	17 (1.4)	8 (0.5)	−0.9	0.039	7 (1.1)	2 (0.3)	−0.8	0.10
Non-Hispanic Black or African American	181 (14.8)	235 (16.1)	1.3	0.41	96 (14.7)	116 (14.7)	0.0	0.99
Non-Hispanic White	295 (24.2)	323 (22.1)	−2.1	0.22	196 (30.0)	217 (27.5)	−2.5	0.33
Unknown	314 (25.7)	323 (22.1)	−3.6	0.031	164 (25.1)	141 (17.9)	−7.2	0.001
Multiracial	53 (4.3)	116 (7.9)	3.6	<0.001	23 (3.5)	59 (7.5)	4.0	0.002
Health Education and Behavioral Sciences	(n = 47 reporting institutions)				(n = 46 reporting institutions)
Total	867 (100.0)	1,010 (100.0)	—^c	—^c	445 (100.0)	522 (100.0)	—^c	—^c
American Indian/Alaska Native	17 (2.0)	18 (1.8)	−0.2	0.91	6 (1.3)	5 (1.0)	−0.3	0.79
Asian	110 (12.7)	134 (13.3)	0.6	0.76	62 (13.9)	81 (15.5)	1.6	0.55
Hispanic/Latinx^d	112 (12.9)	147 (14.6)	1.7	0.34	57 (12.8)	70 (13.4)	0.6	0.86
Native Hawaiian/Pacific Islander	10 (1.2)	2 (0.2)	−1.0	0.022	2 (0.4)	0 (0.0)	−0.4	0.41^e
Non-Hispanic Black or African American	139 (16.0)	174 (17.2)	1.2	0.53	71 (16.0)	94 (18.0)	2.0	0.45
Non-Hispanic White	221 (25.5)	233 (23.1)	−2.4	0.24	137 (30.8)	153 (29.3)	−1.5	0.67
Unknown	206 (23.8)	212 (21.0)	−2.8	0.17	86 (19.3)	71 (13.6)	−5.7	0.020
Multiracial	52 (6.0)	90 (8.9)	2.9	0.022	24 (5.4)	48 (9.2)	3.8	0.034

Note. Statistically significant p-values are bolded.

Percentage-point difference. ^bp-values determined by test for difference in 2 proportions; p < .05 considered significant. ^cThe em dash “—” represents “does not apply.” ^d Includes Hispanic Black or African American and Hispanic White. ^ep-value should be interpreted with caution because of the zero value in 2022.

The racial/ethnic composition of HPM and HEBS departments stratified by degree level is presented in Supplemental Table 1 (master’s) and Supplemental Table 2 (doctoral). Between 2012 and 2022, the proportions decreased in HPM enrolled master’s students of unknown race (24.7% to 19.4%, PPD = −5.3, p = .005) and HEBS enrolled master’s students who identified as NH/PI (1.5% to 0.1%, PPD = −1.4, p = .019). However, there was a statistically significant increase in Multiracial master’s students enrolled in HPM programs (4.5% to 8.7%, PPD = 4.2, p < .001). No statistically significant PPDs were found among the other racial and ethnic groups in HPM and HEBS departments at the master’s and doctoral levels (all PPDs ≤ 5.1, all p-values > .05).

Graduates

The number of students graduating with HPM concentrations among the 46 reporting institutions increased by 135 students (from n = 653 to n = 788; Table 1). For HEBS (46 reporting institutions), the number of students increased by 77 (from n = 445 to n = 522). We found statistically significant increases in HPM graduates who identified as Hispanic (8.4% to 13.7%, PPD = 5.3, p = .002) or Multiracial (3.5% to 7.5%, PPD = 4.0, p = .002). We also found statistically significant decreases in HPM graduates of unknown race (25.1% to 17.9%, PPD = −7.2, p = .001). Many of these PPDs were greater in magnitude at the master’s level (Supplemental Table 1). Hispanic HPM master’s-level graduates increased from 8.3% to 14.5% (PPD = 6.2, p < .001), and Multiracial HPM master’s-level graduates increased from 4.0% to 7.9% (PPD = 3.9, p = .007). The percentages decreased among HPM and HEBS master’s-level graduates of unknown race (HPM: from 24.6% to 16.3%, PPD = −8.3, p < .001; HEBS: from 19.6% to 12.7%, PPD = −6.9, p = .014). PPDs among the other racial and ethnic groups in HPM and HEBS departments (overall, master’s, and doctoral) were not statistically significant (all PPDs ≤ 5.6, all p-values > 0.05).

Faculty by Rank

Table 2 displays the change in the number and percentage of professors by rank, department, and race/ethnicity from 2012 to 2022. The total number of professors increased across ranks in HPM and HEBS departments. We observed the following increases among the 45 reporting HPM institutions: 89 assistant professors (n = 214 to n = 303), 124 associate professors (n = 185 to n = 309), and 110 full professors (n = 262 to n = 372). Among the 45 reporting HEBS institutions, the increases were the following: 124 assistant professors (n = 177 to n = 301), 81 associate professors (n = 189 to n = 270), and 90 full professors (n = 204 to n = 294).

Table 2.

Change in the Number and Percentage of Professors at Schools and Programs of Public Health by Rank, Department, and Race/Ethnicity, 2012–2022.

	Assistant professor				Associate professor				Full Professor
Race and ethnicity	2012, no. (%)	2022, no. (%)	PPD ^a	p-value^b	2012, no. (%)	2022, no. (%)	PPD ^a	p-value^b	2012, no. (%)	2022, no. (%)	PPD ^a	p-value^b
Health Policy and Management (n = 45 reporting institutions)
Total	214 (100.0)	303 (100.0)	—^c	—^c	185 (100.0)	309 (100.0)	—^c	—^c	262 (100.0)	372 (100.0)	—^c	—^c
American Indian/Alaska Native	0 (0.0)	0 (0.0)	0.0	—^e	3 (1.6)	0 (0.0)	−1.6	0.10^f	0 (0.0)	1 (0.3)	0.3	0.99^f
Asian	36 (16.8)	43 (14.2)	−2.6	0.49	13 (7.0)	26 (8.4)	1.4	0.70	4 (1.5)	30 (8.1)	6.6	<0.001
Hispanic/Latinx^d	12 (5.6)	13 (4.3)	−1.3	0.63	37 (20.0)	29 (9.4)	−10.6	0.001	30 (11.5)	37 (9.9)	−1.6	0.63
Native Hawaiian/Pacific Islander	2 (0.9)	1 (0.3)	−0.6	0.76	0 (0.0)	0 (0.0)	0.0	—^e	0 (0.0)	0 (0.0)	0.0	—^e
Non-Hispanic Black or African American	15 (7.0)	42 (13.9)	6.9	0.021	9 (4.9)	16 (5.2)	0.3	0.99	5 (1.9)	14 (3.8)	1.9	0.27
Non-Hispanic White	140 (65.4)	165 (54.5)	−10.9	0.016	120 (64.9)	192 (62.1)	−2.8	0.61	217 (82.8)	260 (69.9)	−12.9	<0.001
Unknown	8 (3.7)	34 (11.2)	7.5	0.004	3 (1.6)	45 (14.6)	13.0	<0.001	5 (1.9)	25 (6.7)	4.8	0.009
Multiracial	1 (0.5)	5 (1.7)	1.2	0.41	0 (0.0)	1 (0.3)	0.3	0.99^f	1 (0.4)	5 (1.3)	0.9	0.41
Health Education and Behavioral Sciences (n = 45 reporting institutions)
Total	177 (100.0)	301 (100.0)	—^c	—^c	189 (100.0)	270 (100.0)	—^c	—^c	204 (100.0)	294 (100.0)	—^c	—^c
American Indian/Alaska Native	4 (2.3)	2 (0.7)	−1.6	0.28	6 (3.2)	1 (0.4)	−2.8	0.043	4 (2.0)	2 (0.7)	−1.3	0.38
Asian	18 (10.2)	15 (5.0)	−5.2	0.049	6 (3.2)	32 (11.9)	8.7	0.002	4 (2.0)	17 (5.8)	3.8	0.06
Hispanic/Latinx^d	16 (9.0)	29 (9.6)	0.6	0.96	24 (12.7)	29 (10.7)	−2.0	0.62	28 (13.7)	28 (9.5)	−4.2	0.19
Native Hawaiian/Pacific Islander	0 (0.0)	1 (0.3)	0.3	0.99^f	1 (0.5)	0 (0.0)	−0.5	0.86^f	0 (0.0)	0 (0.0)	0.0	—^e
Non-Hispanic Black or African American	21 (11.9)	63 (20.9)	9.0	0.017	18 (9.5)	35 (13.0)	3.5	0.32	11 (5.4)	27 (9.2)	3.8	0.16
Non-Hispanic White	116 (65.5)	150 (49.8)	−15.7	0.001	132 (69.8)	148 (54.8)	−15.0	0.002	157 (77.0)	195 (66.3)	−10.7	0.014
Unknown	2 (1.1)	36 (12.0)	10.9	<0.001	2 (1.1)	22 (8.1)	7.0	0.002	0 (0.0)	23 (7.8)	7.8	<0.001 ^f
Multiracial	0 (0.0)	5 (1.7)	1.7	0.21^f	0 (0.0)	3 (1.1)	1.1	0.39^f	0 (0.0)	2 (0.7)	0.7	0.65^f

Note. Statistically significant p-values are bolded.

Percentage-point difference. ^bp-values determined by test for difference in 2 proportions; p < .05 considered significant. ^cThe em dash “—” represents “does not apply.” ^dIncludes Hispanic Black or African American and Hispanic White. ^eNo data were reported for 2012 or 2022. ^fp-value should be interpreted with caution because of the value of zero in 2012 or 2022.

We found statistically significant percentage-point increases among professors of unknown race across all ranks in HPM and HEBS departments. Among HPM faculty with unknown race, the proportion of assistant professors increased from 3.7% to 11.2% (PPD = 7.5, p = .004), associate professors increased from 1.6% to 14.6% (PPD = 13.0, p < .001), and full professors increased from 1.9% to 6.7% (PPD = 4.8, p = .009). Among HEBS faculty with unknown race, the proportion of assistant professors increased from 1.1% to 12.0% (PPD = 10.9, p < .001), associate professors increased from 1.1% to 8.1% (PPD = 7.0, p = .002), and full professors increased from 0.0% to 7.8% (PPD = 7.8, p < .001). However, statistically significant percentage-point decreases were found among White HPM assistant (65.4% to 54.5%, PPD = −10.9, p = .016) and full (82.8% to 69.9%, PPD = −12.9, p < .001) professors. Statistically significant decreases were also found in White HEBS assistant (65.5% to 49.8%, PPD = −15.7, p = .001), associate (69.8% to 54.8%, PPD = −15.0, p = .002), and full (77.0% to 66.3%, PPD = −10.7, p = .014) professors.

We observed statistically significant proportion increases among Asian HPM full professors (1.5% to 8.1%, PPD = 6.6, p < .001) and Asian HEBS associate professors (3.2% to 11.9%, PPD = 8.7, p = .002). In contrast, a statistically significant decrease was found among Asian HEBS assistant professors (10.2% to 5.0%, PPD = −5.2, p = .049). The percentage of Black assistant professors significantly increased in HPM (7.0% to 13.9%, PPD = 6.9, p = .021) and HEBS (11.9% to 20.9%, PPD = 9.0, p = .017) departments. The proportion of Hispanic HPM associate professors significantly decreased from 20.0% to 9.4% (PPD = −10.6, p = .001). A statistically significant decrease was also found among AI/AN HEBS associate professors (3.2% to 0.4%, PPD = −2.8, p = .043). No statistically significant PPDs were found across the professor ranks of departments in the other racial and ethnic groups (all PPDs ≤ 4.2, all p-values > 0.05).

Faculty by Tenure Status

Between 2012 and 2022, the total number of HPM tenure-track faculty increased slightly, by 17 (from 142 to 159); tenured faculty increased by 4 (from 316 to 320; 45 reporting institutions; Table 3). Despite a relatively large increase—by 78—among HEBS tenured faculty (n = 255 to n = 333), the total number of HEBS tenure-track faculty decreased by 1 (n = 143 to n = 142). We found statistically significant increases in the PPD of HPM tenure-track faculty who were Hispanic (2.1% to 8.2%, PPD = 6.1, p = .037), Asian (3.8% to 8.8%, PPD = 5.0, p = .016), or Black (2.5% to 6.3%, PPD = 3.8, p = .036). The percentage of HEBS tenured faculty increased among those who were Asian (2.7% to 8.7%, PPD = 6.0, p = .005) or of unknown race (0.0% to 2.4%, PPD = 2.4, p = .033). By contrast, statistically significant percentage-point decreases were exhibited among White HPM tenure-track faculty (66.9% to 53.5%, PPD = −13.4, p = .024), White HEBS tenure-track faculty (69.2% to 49.3%, PPD = −19.9, p < .001), and AI/AN HEBS tenured faculty (2.7% to 0.0%, PPD = −2.7, p = .008).

Table 3.

Change in the Number and Percentage of faculty at Schools and Programs of Public Health by Tenure Status, Department, and Race/Ethnicity, 2012–2022.

	Tenure-track^a				Tenured^a
Race and ethnicity	2012, no. (%)	2022, no. (%)	PPD ^b	p-value^c	2012, no. (%)	2022, no. (%)	PPDb	p-value^c
Health Policy and Management (n = 45 reporting institutions)
Total	142 (100.0)	159 (100.0)	—^d	—^d	316 (100.0)	320 (100.0)	—^d	—^d
American Indian/Alaska Native	0 (0.0)	0 (0.0)	0.0	—^f	3 (0.9)	1 (0.3)	−0.6	0.61
Asian	32 (22.5)	33 (20.8)	−1.7	0.81	12 (3.8)	28 (8.8)	5.0	0.016
Hispanic/Latinx^e	3 (2.1)	13 (8.2)	6.1	0.037	65 (20.6)	55 (17.2)	−3.4	0.32
Native Hawaiian/Pacific Islander	1 (0.7)	0 (0.0)	−0.7	0.95^g	0 (0.0)	0 (0.0)	0.0	—^f
Non-Hispanic Black or African American	8 (5.6)	20 (12.6)	7.0	0.06	8 (2.5)	20 (6.3)	3.8	0.036
Non-Hispanic White	95 (66.9)	85 (53.5)	−13.4	0.024	223 (70.6)	205 (64.1)	−6.5	0.10
Unknown	3 (2.1)	4 (2.5)	0.4	0.99	5 (1.6)	8 (2.5)	0.9	0.59
Multiracial	0 (0.0)	4 (2.5)	2.5	0.16^g	0 (0.0)	3 (0.9)	0.9	0.25^g
Health Education and Behavioral Sciences (n = 45 reporting institutions)
Total	143 (100.0)	142 (100.0)	—^d	—^d	255 (100.0)	333 (100.0)	—^d	—^d
American Indian/Alaska Native	5 (3.5)	2 (1.4)	−2.1	0.45	7 (2.7)	0 (0.0)	−2.7	0.008 ^g
Asian	13 (9.1)	12 (8.5)	−0.6	0.99	7 (2.7)	29 (8.7)	6.0	0.005
Hispanic/Latinx^e	9 (6.3)	19 (13.4)	7.1	0.07	48 (18.8)	44 (13.2)	−5.6	0.08
Native Hawaiian/Pacific Islander	0 (0.0)	0 (0.0)	0.0	—^f	1 (0.4)	0 (0.0)	−0.4	0.89^g
Non-Hispanic Black or African American	16 (11.2)	28 (19.7)	8.5	0.07	17 (6.7)	38 (11.4)	4.7	0.07
Non-Hispanic White	99 (69.2)	70 (49.3)	−19.9	<0.001	175 (68.6)	209 (62.8)	−5.8	0.16
Unknown	1 (0.7)	6 (4.2)	3.5	0.12	0 (0.0)	8 (2.4)	2.4	0.033 ^g
Multiracial	0 (0.0)	5 (3.5)	3.5	0.07^g	0 (0.0)	5 (1.5)	1.5	0.13^g

Note. Statistically significant p-values are bolded.

Among institutions that offer tenure. ^bPercentage-point difference. ^cp-values determined by test for difference in 2 proportions; p < .05 considered significant. ^dThe em dash “—” represents “does not apply.” ^eIncludes Hispanic Black or African American and Hispanic White. ^fNo data were reported for 2012 or 2022. ^gp-value should be interpreted with caution because of the value of zero in 2012 or 2022.

Despite not being statistically significant, notable increases were found in the proportions of Black HPM tenure-track faculty (5.6% to 12.6%, PPD = 7.0, p = .06), Black HEBS tenure-track faculty (11.2% to 19.7%, PPD = 8.5, p = .07), Black HEBS tenured faculty (6.7% to 11.4%, PPD = 4.7, p = .07), and Hispanic HEBS tenure-track faculty (6.3% to 13.4%, PPD = 7.1, p = .07). Other notable non-significant findings included the declines in Hispanic HEBS tenured faculty (18.8% to 13.2%, PPD = −5.6, p = .08), White HPM tenured faculty (70.6% to 64.1%, PPD = −6.5, p = .10), and White HEBS tenured faculty (68.6% to 62.8%, PPD = −5.8, p = .16). PPDs among the other racial and ethnic groups in HPM and HEBS departments (tenure-track and tenured) were not statistically significant (all PPDs ≤ 3.5, all p-values > .05).

Current Enrollment, Graduate Completion, and Faculty Data, 2022

Enrollment and Completion in 2022

Table 4 provides a 2022 snapshot of the racial and ethnic composition of students, graduate completions, and faculty in HPM and HEBS departments. In fall 2022, HPM graduate programs (80 reporting institutions) had 1,784 enrolled students. In 2022, HPM graduate programs (78 reporting institutions) had 1,012 graduate completions. The largest racial/ethnic representation tended to be students who identified as White (enrolled = 22.9%, completed = 29.2%) or unknown race (enrolled = 21.9%, completed = 18.0%), followed by Asian (enrolled = 16.0%, completed = 17.3%), Black (enrolled = 16.2%, completed = 14.2%), and Hispanic (enrolled = 12.7%, completed = 12.7%). Multiracial students comprised about 8% of the population, while AI/AN and NH/PI were each less than 2% of the population.

Table 4.

Number and Percentage of Students, Faculty, and Tenured Faculty at Schools and Programs of Public Health by Department and Race/Ethnicity, 2022.

	Graduate student, no. (%)		Professor, no. (%)			Tenure status no. (%)^a
Race and ethnicity	Students enrolled	Completions	Assistant	Associate	Full	Tenure-Track	Tenured
Health Policy and Management^b
Total	1,784 (100.0)	1,012 (100.0)	405 (100.0)	403 (100.0)	537 (100.0)	218 (100.0)	454 (100.0)
American Indian/Alaska Native	28 (1.6)	9 (0.9)	1 (0.2)	0 (0.0)	2 (0.4)	1 (0.5)	1 (0.2)
Asian	285 (16.0)	175 (17.3)	72 (17.8)	48 (11.9)	58 (10.8)	55 (25.2)	46 (10.1)
Hispanic/Latinx^c	226 (12.7)	129 (12.7)	14 (3.5)	33 (8.2)	42 (7.8)	14 (6.4)	60 (13.2)
Native Hawaiian/Pacific Islander	13 (0.7)	5 (0.5)	1 (0.2)	0 (0.0)	1 (0.2)	0 (0.0)	1 (0.2)
Non-Hispanic Black or African American	289 (16.2)	144 (14.2)	47 (11.6)	21 (5.2)	20 (3.7)	24 (11.0)	27 (5.9)
Non-Hispanic White	409 (22.9)	295 (29.2)	215 (53.1)	241 (59.8)	369 (68.7)	112 (51.4)	292 (64.3)
Unknown	391 (21.9)	182 (18.0)	47 (11.6)	58 (14.4)	40 (7.4)	8 (3.7)	23 (5.1)
Multiracial	143 (8.0)	73 (7.2)	8 (2.0)	2 (0.5)	5 (0.9)	4 (1.8)	4 (0.9)
Health Education and Behavioral Sciences^d
Total	1,406 (100.0)	734 (100.0)	418 (100.0)	399 (100.0)	391 (100.0)	212 (100.0)	474 (100.0)
American Indian/Alaska Native	24 (1.7)	9 (1.2)	5 (1.2)	2 (0.5)	2 (0.5)	4 (1.9)	0 (0.0)
Asian	184 (13.1)	105 (14.3)	24 (5.7)	56 (14.0)	29 (7.4)	22 (10.4)	44 (9.3)
Hispanic/Latinx^c	195 (13.9)	99 (13.5)	42 (10.0)	37 (9.3)	34 (8.7)	28 (13.2)	52 (11.0)
Native Hawaiian/Pacific Islander	10 (0.7)	0 (0.0)	1 (0.2)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
Non-Hispanic Black or African American	242 (17.2)	132 (18.0)	78 (18.7)	47 (11.8)	30 (7.7)	36 (17.0)	46 (9.7)
Non-Hispanic White	323 (23.0)	213 (29.0)	205 (49.0)	221 (55.4)	263 (67.3)	104 (49.1)	300 (63.3)
Unknown	300 (21.3)	111 (15.1)	53 (12.7)	31 (7.8)	31 (7.9)	8 (3.8)	26 (5.5)
Multiracial	128 (9.1)	65 (8.9)	10 (2.4)	5 (1.3)	2 (0.5)	10 (4.7)	6 (1.3)

Among institutions that offer tenure. ^bEighty institutions reported enrolled student data, 78 reported graduate completion student data, and 84 reported faculty data. ^cIncludes Hispanic Black or African American and Hispanic White. ^dSeventy-nine institutions reported enrolled student data, 77 reported graduate completion student data, and 83 reported faculty data.

The racial and ethnic composition among students in HEBS departments was relatively similar. Of the 1,406 enrolled students (from 79 reporting institutions), 23% were White, 21.3% were of unknown race, 17.2% were Black, 13.9% were Hispanic, 13.1% were Asian, 9.1% were Multiracial, 1.7% were AI/AN, and 0.7% were NH/PI. Of the 734 graduates in the class of 2022 (from 77 reporting institutions), 29% were White, 18.0% were Black, 15.1% were of unknown race, 14.3% were Asian, 13.5% were Hispanic, 8.9% were Multiracial, and 1.2% were AI/AN. No graduates identified as NH/PI.

Faculty by Rank in 2022

Eighty-four HPM departments reported faculty data in 2022 (Table 4). The total number of professors at each rank exceeded 400: 405 assistant professors, 403 associate professors, and 537 full professors. White HPM professors represented most of the sample at each rank: assistant (53.1%), associate (59.8%), and full (68.7%). Among the HPM assistant professors, 17.8% were Asian, 11.6% were Black, 11.6% were of unknown race, and 3.5% were Hispanic. Among the HPM associate professors, 14.4% were of unknown race, 11.9% were Asian, 8.2% were Hispanic, and 5.2% were Black. Among the HPM full professors, 10.8% were Asian, 7.8% were Hispanic, 7.4% were of unknown race, and 3.7% were Black. The percentages of AI/AN, NH/PI, and Multiracial HPM faculty members were each ≤ 2.0% across ranks.

In 2022, 83 HEBS departments reported data on 418 assistant professors, 399 associate professors, and 391 full professors. White faculty had the highest percentages at each rank: assistant (49.0%), associate (55.4%), and full (67.3%). Among the HEBS assistant professors, 18.7% were Black, 12.7% were of unknown race, 10.0% were Hispanic, and 5.7% were Asian. Among the HEBS associate professors, 14.0% were Asian, 11.8% were Black, 9.3% were Hispanic, and 7.8% were of unknown race. Among the HEBS full professors, 8.7% were Hispanic, 7.9% were of unknown race, 7.7% were Black, and 7.4% were Asian. The percentages of AI/AN, NH/PI, and Multiracial HEBS faculty members were each ≤2.5% across professor ranks.

Faculty by Tenure Status in 2022

The number of tenured faculty members was more than double the number of tenure-track faculty members in HPM (tenured: n = 454, tenure-track: n = 218) and HEBS (tenured: n = 474, tenure-track: n = 212) departments (Table 4). Over 60% of the tenured professors were White (HPM = 64.3%, HEBS = 63.3%). Among the HPM tenured professors, 13.2% were Hispanic, 10.1% were Asian, and 5.9% were Black. Among the HEBS tenured professors, 11.0% were Hispanic, 9.7% were Black, and 9.3% were Asian. About half of the tenure-track professors were White (HPM = 51.4%, HEBS = 49.1%). Among the HPM tenure-track professors, 25.2% were Asian, 11.0% were Black, and 6.4% were Hispanic. Among the HEBS tenure-track professors, 17.0% were Black, 13.2% were Hispanic, and 10.4% were Asian. The percentages of tenure-track and tenured professors who identified as AI/AN, NH/PI, unknown race, or Multiracial were each ≤ 5.5% in HPM and HEBS departments.

Discussion

We analyzed the 2012 and 2022 racial/ethnic composition of students, graduates, and faculty from HPM and HEBS departments at ASPPH-member institutions. We confirmed our hypothesis that the total number of students, graduates, and faculty would increase from 2012 to 2022. We found statistically significant increases in Black assistant professors (HPM and HEBS), Black tenured faculty (HPM), Hispanic graduates (HPM), Hispanic tenure-track faculty (HPM), Asian professors (HPM: full and tenured, HEBS: associate and tenured), and Multiracial students and graduates (HPM and HEBS). Statistically significant decreases were observed in White professors (HPM: assistant and full, HEBS: all ranks), White tenure-track faculty (HPM and HEBS), AI/AN associate professors (HEBS), AI/AN tenured faculty (HEBS), Hispanic associate professors (HPM), Asian assistant professors (HEBS), and NH/PI students (HPM and HEBS). Many of the PPDs were not statistically significant for the remaining racial/ethnic minoritized groups across student, graduate completion, and faculty categories. This partly confirms our second hypothesis that the percentage of racial/ethnic minoritized groups would be similar between 2012 and 2022.

Many of our findings are consistent with analyses of ASPPH data on environmental health, biostatistics, and epidemiology departments (Bather, Burke, et al., 2023; Goodman et al., 2023). For example, there have been increases over time in Hispanic graduates, Asian professors (associate, full, and tenured), and professors of unknown race (all ranks and tenured) across environmental health, biostatistics, and epidemiology departments. In addition, studies have demonstrated decreases in White professors (all ranks and tenure-track) and Asian assistant professors. Another common theme across these studies was that there were no substantial increases in AI/AN, Hispanic, and NH/PI professors (all ranks and tenured) (Bather, Burke, et al., 2023; Goodman et al., 2023). Inconsistent with findings in previous studies was the statistically significant increase in Black assistant professors and tenured faculty of all ranks. We observed relatively large increases in Black and Hispanic tenure-track faculty; however, these increases may not have been statistically significant due to sample size. Nonetheless, these increases may be due to the higher representation of doctoral graduates from racial/ethnic minoritized groups among HPM and HEBS departments compared with other public health disciplines (e.g., biostatistics and epidemiology) (J. R. Jackson et al., 2019).

The growth among Hispanic graduates and tenure-track faculty in HPM may be explained by the racial/ethnic composition of institutions with moderate-to-high proportions of individuals of Latin American heritage. These include the University of Puerto Rico Graduate School of Public Health (San Juan, Puerto Rico) and the National Institute of Public Health of Mexico (Instituto Nacional de Salúd Publica [INSP]; Morelos, Mexico). We conducted a sensitivity analysis excluding these institutions. We observed smaller proportions of Hispanics in 2012 and 2022, and smaller percentage-point differences over the study period. It is also likely that these intuitions increased the number of students enrolled, graduates, and/or faculty over the study period.

The INSP was the only non-U.S. ASPPH-member institution in the analytic sample. Although the INSP was formed in 1987, it houses the School of Public Health of Mexico, which was founded in 1922 and has a history of confronting public health issues at the local, regional, and national levels (Lazcano-Ponce, 2022). Public health leaders and professors of Latin descent provide a viable career path for students from similar backgrounds, which may lead to students experiencing fewer structural and institutional barriers than their counterparts in US-based ASPPH-member institutions. The onset of the COVID-19 pandemic may have also increased interest in pursuing graduate degrees or professorships in HPM among this population. This would enable them to contribute to vaccination uptake efforts and explain epidemiologic concepts to their communities. Further examination of trends in the racial/ethnic composition of non-US ASPPH-member institutions is needed. Future investigations should include qualitative interviews among students from these institutions to assess their graduate school experiences and career aspirations.

We also identified several pipeline gaps that may impact the future landscape of the professoriate. For example, we observed no change in the total number of tenure-track HEBS faculty from 2012 to 2022, despite increases in the number of tenured faculty. We also observed that there were no NH/PI HEBS graduates in 2022. Several plausible explanations exist for these observations. One explanation is that employment wages in public health have fallen behind tuition increases for public health degrees (Beck et al., 2020). Prospective students may choose graduate degrees, such as computer science, with lower associated debt and higher initial earnings (Beck et al., 2020). Insufficient funding for scholarships and the limited options for student loan repayment programs for public health degrees exacerbate this issue (Beck et al., 2020). Another explanation could be linked to diversity, equity, inclusion, and belonging. Students, graduates, and faculty may not feel adequately supported by their department, school, or university, prompting them to consider alternative career paths (Merino, 2019; Ramirez-Valles, 2020; Ramirez-Valles et al., 2023). In addition, faculty members may resign from their positions to pursue higher-earning jobs in the private sector (Leider, Coronado, et al., 2018; Leider, Resnick, et al., 2018; Sellers et al., 2019).

Given the heightened emphasis on interventions, dissemination, and implementation science, HPM and HEBS departments merit more deliberate recruitment and retention efforts to ensure there is a strong early-career pipeline to continue to move the field forward. We also observed a doubling of Black and Asian faculty in HEBS and HPM in the past decade. It will be important to implement strategies to ensure we are able to retain minoritized tenure-track faculty in HEBS and HPM in the coming decade to avoid losing strides made in better diversifying the tenured professoriate.

Implications

Findings from this study and previous studies underscore the importance of increasing racial/ethnic representation in the HSPR workforce (Bather, Burke, et al., 2023; Frogner, 2018; Gondwe et al., 2022; Goodman et al., 2020, 2023; Healton, 1999; J. R. Jackson et al., 2019; Leider, Yeager, et al., 2023; Ramirez-Valles, 2021; Vichare et al., 2023). This is especially crucial since much of the policy work for equity is focused on eliminating inequities among non-Whites. However, the predominantly White professoriate currently reflects a significant proportion of the individuals driving health policy and shaping the education of future policy makers.

Increases observed among Hispanic tenure-track faculty and decreases among Hispanic tenured faculty indicate that HPM and HEBS departments should evaluate their retention and promotion processes for this population (McChesney & Bichsel, 2020; Ramirez-Valles, 2021; Zambrana, 2018). The recommendations drawn from a systematic review of the academic experiences of racial/ethnic minoritized professors suggest that these departments should facilitate workshops to raise awareness about the structural barriers encountered by Hispanic faculty (Turner et al., 2008). Alongside providing Hispanic faculty adequate research support, departments should assess whether inclusive criteria are established for annual evaluations, tenure considerations, and promotion processes (Turner et al., 2008).

The consistently low proportions of AI/AN and NH/PI students and faculty in 2012 and 2022 suggest that HPM and HEBS departments must overcome recruitment and hiring challenges. Establishing pipeline pathway programs and partnerships with institutions that have a substantial number of AI/AN or NH/PI undergraduates is recommended (Bather, Furr-Holden, et al., 2023; Husbands Fealing et al., 2015; Hutchinson, 2021; Turner et al., 2008). A primary objective should be to increase the number of AI/AN and NH/PI students enrolling in and graduating from HPM and HEBS departments. This will allow for AI/AN and NH/PI graduates interested in academia to obtain professorships, which, in turn, will enable them to encourage other AI/AN and NH/PI individuals to follow a similar career path (Gurin et al., 2002; Miner & Allan, 2014). Once they are in the professoriate, HPM and HEBS departments should foster interdisciplinary academic environments (e.g., research centers) studying AI/AN or NH/PI populations since AI/AN or NH/PI professors may research communities with similar racial/ethnic backgrounds (Cohen et al., 2002; Mitchell & Lassiter, 2006; Smith et al., 2009; Turner et al., 2008).

Limitations

The findings from this study should be interpreted with consideration for several limitations. First, the reporting of race and ethnicity may have differed across ASPPH-member institutions. However, these potential variations were likely minimized, as institutions followed reporting guidelines of the National Center for Education Statistics. Second, institutional missingness was a potential source of nonresponse bias. To mitigate this, we analyzed data from a comparable cohort of institutions that reported data in both 2012 and 2022. Third, we used U.S. social constructs of race/ethnicity, which might have introduced measurement error. These constructs also did not capture the subgroup heterogeneity within racial/ethnic populations (e.g., Jamaican, Lebanese, Moroccan).

In addition, individual-level data on age and other underrepresented groups (e.g., disabilities and low socioeconomic status) were not available through the ASPPH Data Center. Fourth, the COVID-19 pandemic may have affected fall 2021 student enrollment. Between March 2020 and March 2021, the ASPPH reported a 40% increase in graduate applications for public health programs (Warnick, 2021). In addition, increases in minoritized student enrollment may have been due to the removal of the Graduate Record Examination (GRE) as a requirement and to a call for public health workers in underserved communities (Peretz et al., 2020; Sullivan et al., 2022). Increases in fall 2021 enrollment also may have been a result of students deferring their fall 2020 registration. A comprehensive evaluation of the impact of COVID-19 on public health graduate admissions is needed, as these results will likely have substantial implications for the public health workforce. Finally, our analysis was constrained by the type and format of variables collected at the institutional level. As a result of these limitations, it was not possible to provide explanations for temporal changes over the study period.

Conclusion

In summary, we quantified and evaluated changes in the racial/ethnic composition of students, graduates, and faculty from HPM and HEBS departments at ASPPH member institutions between 2012 and 2022. Consistent with findings from previous research, our findings highlight the importance of increasing racial/ethnic representation in the HSPR workforce (Leider, Castrucci, et al., 2023). Implications for HPM and HEBS departments regarding Hispanic faculty include facilitating workshops to raise awareness about the structural barriers encountered by Hispanic faculty; providing Hispanic faculty adequate research support; and assessing whether inclusive criteria are established for annual evaluations, tenure considerations, and promotion processes. Implications for HPM and HEBS departments regarding AI/AN and NH/PI students and faculty include establishing pathway programs and partnerships with institutions that have a substantial number of AI/AN or NH/PI undergraduates, and fostering interdisciplinary academic environments studying AI/AN or NH/PI populations.

Supplemental Material

sj-docx-1-heb-10.1177_10901981241255611 – Supplemental material for Racial and Ethnic Composition of Departments of Health Policy, Management, Education, and Behavioral Sciences

Supplemental material, sj-docx-1-heb-10.1177_10901981241255611 for Racial and Ethnic Composition of Departments of Health Policy, Management, Education, and Behavioral Sciences by Jemar R. Bather, Debra Furr-Holden, Emily M. Burke, Christine M. Plepys, Keon L. Gilbert and Melody S. Goodman in Health Education & Behavior

Footnotes

Acknowledgements

We gratefully acknowledge the ASPPH Data Advisory Committee for their critical review and helpful comments on the concept paper for this manuscript. We thank the ASPPH for providing the data used in this study. We also thank the ASPPH member schools and programs of public health that contributed data to this study. We thank Sharese Terrell Willis, PhD, ELS, of Doc’s Editing Shop, LLC, for providing editing assistance on an early draft.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Center for Anti-racism, Social Justice, & Public Health at the New York University School of Global Public Health.

ORCID iDs

Jemar R. Bather

Melody S. Goodman

Supplemental Material

Supplemental material for this article is available online.

References

Antonio

A. L.

Chang

M. J.

Hakuta

Kenny

D. A.

Levin

Milem

J. F.

(2004). Effects of racial diversity on complex thinking in college students. Psychological Science, 15(8), 507–510. https://doi.org/10.1111/j.0956-7976.2004.00710.x

Barr

D. A.

Gonzalez

M. E.

Wanat

S. F.

(2008). The Leaky Pipeline: Factors associated with early decline in interest in premedical studies among underrepresented minority undergraduate students. Academic Medicine, 83(5), 503–511. https://doi.org/10.1097/ACM.0b013e31816bda16

Bather

J. R.

Burke

E. M.

Plepys

C. M.

Goodman

M. S.

(2023). Racial and ethnic composition of students, graduates, and faculty in environmental health sciences, 2011 to 2021. Environmental Health Insights, 17, 11786302221150688. https://doi.org/10.1177/11786302221150688

Bather

J. R.

Furr-Holden

Ramirez-Valles

Goodman

M. S.

(2023). Unpacking public health implications of the 2023 supreme court ruling on race-conscious admissions. Health Education & Behavior, 50(6), 713–717. https://doi.org/10.1177/10901981231198785

Beck

A. J.

Leider

J. P.

Krasna

Resnick

B. A.

(2020). Monetary and nonmonetary costs and benefits of a public health master’s degree in the 21st century. American Journal of Public Health, 110(7), 978–985. https://doi.org/10.2105/AJPH.2020.305648

Chantarat

Rogers

T. B.

Mitchell

C. R.

M. J.

(2023). Perceptions of workplace climate and diversity, equity, and inclusion within health services and policy research. Health Services Research, 58(2), 314–324. https://doi.org/10.1111/1475-6773.14032

Cobian

K. P.

Gutiérrez

. (2021). Advancing diversity, equity, and inclusion in the health services and policy research workforce: Lessons and implications from case studies on diversity, equity, and inclusion interventions. AcademyHealth. https://academyhealth.org/publications/2021-06/advancing-diversity-equity-and-inclusion-health-services-and-policy-research-workforce

Cohen

J. J.

Gabriel

B. A.

Terrell

(2002). The case for diversity in the health care workforce. Health Affairs, 21(5), 90–102. https://doi.org/10.1377/hlthaff.21.5.90

Coronado

Beck

A. J.

Shah

Young

J. L.

Sellers

Leider

J. P.

(2020). Understanding the Dynamics of diversity in the public health workforce. Journal of Public Health Management and Practice, 26(4), 389–392. https://doi.org/10.1097/PHH.0000000000001075

10.

Crenshaw

Gotanda

Peller

Thomas

(1995). Critical race theory: The key writings that formed the movement. The New Press. https://scholarship.law.columbia.edu/books/101

11.

Duffus

W. A.

Trawick

Moonesinghe

Tola

Truman

B. I.

Dean

H. D.

(2014). Training racial and ethnic minority students for careers in public health sciences. American Journal of Preventive Medicine, 47(5 Suppl. 3), S368–S375. https://doi.org/10.1016/j.amepre.2014.07.028

12.

Edmunds

Bezold

Fulwood

C. C.

Johnson

Tetteh

(2015). The future of diversity and inclusion in health services and policy research: A report on the AcademyHealth Workforce Diversity 2025 Roundtable. AcademyHealth. https://academyhealth.org/publications/2015-09/future-diversity-and-inclusion-health-services-and-policy-research-report

13.

Frogner

B. K.

(2018). Update on the stock and supply of health services researchers in the United States. Health Services Research, 53(Suppl. 2), 3945–3966. https://doi.org/10.1111/1475-6773.12988

14.

Gold

R. B.

(2010). “I Am Who I Serve”—Community health workers in family planning programs. Guttmacher Policy Review, 13(3). https://www.guttmacher.org/gpr/2010/08/i-am-who-i-serve-community-health-workers-family-planning-programs

15.

Gondwe

Herbach

Cvitanovich

Begay

Santee

Buzzacott

Hidalgo

, & American College of Epidemiology Minority Affairs Committee. (2022). Racial/ethnic distribution of graduates from doctorate and masters epidemiology degree programs in the United States, 2008 to 2018. Annals of Epidemiology, 68, 32–36. https://doi.org/10.1016/j.annepidem.2021.12.004

16.

Goodman

M. S.

Bather

J. R.

Chu

Pagano

Plepys

C. M.

Sebro

R. A.

(2023). Racial and ethnic diversity among students, graduates, and faculty in biostatistics and epidemiology, 2010-2020. Public Health Reports, 138(3), 546–554. https://doi.org/10.1177/00333549221097653

17.

Goodman

M. S.

Plepys

C. M.

Bather

J. R.

Kelliher

R. M.

Healton

C. G.

(2020). Racial/ethnic diversity in academic public health: 20-year update. Public Health Reports, 135(1), 74–81. https://doi.org/10.1177/0033354919887747

18.

Grumbach

Mendoza

(2008). Disparities in human resources: Addressing the lack of diversity in the health professions. Health Affairs, 27(2), 413–422. https://doi.org/10.1377/hlthaff.27.2.413

19.

Gurin

Dey

E. L.

Hurtado

Gurin

(2002). Diversity and higher education: Theory and impact on educational outcomes. Harvard Educational Review, 72(3), 330–366. https://doi.org/10.17763/haer.72.3.01151786u134n051

20.

Hardeman

R. R.

Karbeah

(2020). Examining racism in health services research: A disciplinary self-critique. Health Services Research, 55(Suppl. 2), 777–780. https://doi.org/10.1111/1475-6773.13558

21.

Healton

C. G.

(1999). The shape of our river. American Journal of Preventive Medicine, 16(Suppl. 3), 1–4.

22.

Hill

C. V.

Pérez-Stable

E. J.

Anderson

N. A.

Bernard

M. A.

(2015). The National Institute on Aging Health Disparities Research Framework. Ethnicity & Disease, 25(3), 245–254. https://doi.org/10.18865/ed.25.3.245

23.

Hood

A. C.

Foksinska

Ajigbeda

Allman

C. M.

Munchus

Hannon

(2017). Preparing for a PhD: A transactive memory approach. Journal of Higher Education Theory and Practice, 17(1), Article 1. https://articlegateway.com/index.php/JHETP/article/view/1575

24.

Howe

C. J.

Bailey

Z. D.

Raifman

J. R.

Jackson

J. W.

(2022). Recommendations for using causal diagrams to study racial health disparities. American Journal of Epidemiology, 191(12), 1981–1989. https://doi.org/10.1093/aje/kwac140

25.

Husbands Fealing

K. H.

Lai

Myers

S. L

. (2015). Pathways vs. pipelines to broadening participation in the stem workforce. Journal of Women and Minorities in Science and Engineering, 21(4), 271–293. https://doi.org/10.1615/JWomenMinorScienEng.2015004760

26.

Hutchinson

(2021). Pathways not pipelines. https://www-linkedin-com-s.web.bisu.edu.cn/pulse/pathways-pipelines-jeff-hutchinson/

27.

Jackson

C. S.

Gracia

J. N.

(2014). Addressing health and health-care disparities: The role of a diverse workforce and the social determinants of health. Public Health Reports, 129(Suppl. 2), 57–61.

28.

Jackson

J. R.

Holmes

A. M.

Golembiewski

Brown-Podgorski

B. L.

Menachemi

(2019). Graduation and academic placement of underrepresented racial/ethnic minority doctoral recipients in public health disciplines, United States, 2003-2015. Public Health Reports, 134(1), 63–71. https://doi.org/10.1177/0033354918814259

29.

Khan

M. S.

Lakha

Tan

M. M. J.

Singh

S. R.

Quek

R. Y. C.

Han

Tan

S. M.

Haldane

Gea-Sánchez

Legido-Quigley

(2019). More talk than action: Gender and ethnic diversity in leading public health universities. Lancet, 393(10171), 594–600. https://doi.org/10.1016/S0140-6736(18)32609-6

30.

Kirkland

Dill

J. S.

Karnik

(2024). Retention of community health workers in the public health workforce: Public health workforce interests and needs survey, 2017 and 2021. American Journal of Public Health, 114(1), 44–47. https://doi.org/10.2105/AJPH.2023.307462

31.

Lazcano-Ponce

(2022). National Institute of Public Health/School of Public Health of Mexico: Contributions to social equity and knowledge-based public policies. Salud Publica de Mexico, 64, 612–623. https://doi.org/10.21149/14346

32.

Leider

J. P.

Castrucci

B. C.

Robins

Hare Bork

Fraser

M. R.

Savoia

Piltch-Loeb

Koh

H. K.

(2023). The Exodus of state and local public health employees: Separations started before and continued throughout COVID-19. Health Affairs, 42(3), 338–348. https://doi.org/10.1377/hlthaff.2022.01251

33.

Leider

J. P.

Coronado

Beck

A. J.

Harper

(2018). Reconciling supply and demand for state and local public health staff in an era of retiring baby boomers. American Journal of Preventive Medicine, 54(3), 334–340. https://doi.org/10.1016/j.amepre.2017.10.026

34.

Leider

J. P.

Harper

Shon

J. W.

Sellers

Castrucci

B. C.

(2016). Job satisfaction and expected turnover among federal, state, and local public health practitioners. American Journal of Public Health, 106(10), 1782–1788. https://doi.org/10.2105/AJPH.2016.303305

35.

Leider

J. P.

Resnick

Bishai

Scutchfield

F. D.

(2018). How much do we spend? Creating historical estimates of public health expenditures in the United States at the federal, state, and local levels. Annual Review of Public Health, 39, 471–487. https://doi.org/10.1146/annurev-publhealth-040617-013455

36.

Leider

J. P.

Yeager

V. A.

Kirkland

Krasna

Hare Bork

Resnick

(2023). The state of the US public health workforce: Ongoing challenges and future directions. Annual Review of Public Health, 44, 323–341. https://doi.org/10.1146/annurev-publhealth-071421-032830

37.

Liss-Levinson

Bharthapudi

Leider

J. P.

Sellers

(2015). Loving and leaving public health: Predictors of Intentions to quit among state health agency workers. Journal of Public Health Management and Practice, 21(Suppl. 6), S91–101. https://doi.org/10.1097/PHH.0000000000000317

38.

McChesney

Bichsel

(2020). The aging of tenure-track faculty in higher education: Implications for succession and diversity. College and University Professional Association for Human Resources.

39.

Merino

(2019). What do schools of public health have to say about diversity and inclusion? Pedagogy in Health Promotion, 5(4), 233–240. https://doi.org/10.1177/2373379918811820

40.

Miner

Allan

(2014). Future of public workforce training: Thought leaders’ perspectives. Health Promotion Practice, 15, 10S–13S.

41.

Mitchell

D. A.

Lassiter

S. L.

(2006). Addressing health care disparities and increasing workforce diversity: The next step for the dental, medical, and public health professions. American Journal of Public Health, 96(12), 2093–2097. https://doi.org/10.2105/AJPH.2005.082818

42.

Morabia

(2024). Public health workforce: Retention, enumeration, and safety. American Journal of Public Health, 114(1), 42–43. https://doi.org/10.2105/AJPH.2023.307524

43.

Peretz

P. J.

Islam

Matiz

L. A.

(2020). Community health workers and Covid-19: Addressing social determinants of health in times of crisis and beyond. The New England Journal of Medicine, 383(19), Article e108. https://doi.org/10.1056/NEJMp2022641

44.

Pourshaban

Basurto-Dávila

Shih

(2015). Building and sustaining strong public health agencies: Determinants of workforce turnover. Journal of Public Health Management and Practice, 21(Suppl. 6), S80–90. https://doi.org/10.1097/PHH.0000000000000311

45.

Ramirez-Valles

(2020). Public Health Has an Equity Problem: A Latinx’s Voice. Frontiers in Public Health, 8, Article 559352. https://doi.org/10.3389/fpubh.2020.559352

46.

Ramirez-Valles

(2021). Racism within: Special journal issue on scholars of color. Health Education & Behavior, 48(3), 233–236. https://doi.org/10.1177/10901981211012681

47.

Ramirez-Valles

Neubauer

L. C.

Zambrana

R. E.

(2023). Inequity within: A call for inclusion of Latina/o/x scholars in faculty and leadership ranks in schools and programs of public health. Public Health Reports, 138(2), 386–388. https://doi.org/10.1177/00333549221077072

48.

R Core Team. (2023). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/

49.

Resnick

B. A.

Mui

P. C.

Maiorana

(2024). It can’t just be about the money: How to assure an adequate public health workforce. American Journal of Public Health, 114(3), 264–266. https://doi.org/10.2105/AJPH.2023.307563

50.

Rosenstock

Helsing

Rimer

B. K.

(2011). Public health education in the United States: Then and now. Public Health Reviews, 33, 39–65. https://doi.org/10.1007/BF03391620

51.

Schmidt

Gostin

L. O.

Williams

M. A.

(2023). The supreme court’s rulings on race neutrality threaten progress in medicine and health. JAMA, 330(11), 1033–1034. https://doi.org/10.1001/jama.2023.13749

52.

Sellers

Leider

J. P.

Gould

Castrucci

B. C.

Beck

Bogaert

Coronado

Shah

Yeager

Beitsch

L. M.

Erwin

P. C.

(2019). The state of the US governmental public health workforce, 2014–2017. American Journal of Public Health, 109(5), 674–680. https://doi.org/10.2105/AJPH.2019.305011

53.

Simpson

L. A.

Adams

Edmunds

Gluck

(2022). Setting the course to high impact, equitable health services research. Health Services Research, 57(1), 7–11. https://doi.org/10.1111/1475-6773.13927

54.

Smith

S. G.

Nsiah-Kumi

P. A.

Jones

P. R.

Pamies

R. J.

(2009). Pipeline programs in the health professions, part 1: Preserving diversity and reducing health disparities. Journal of the National Medical Association, 101(9), 836–840, 845–851. https://doi.org/10.1016/s0027-9684(15)31030-0

55.

Sullivan

L. M.

Velez

A. A.

Longe

Larese

A. M.

Galea

(2022). Removing the graduate record examination as an admissions requirement does not impact student success. Public Health Reviews, 43, 1605023. https://doi.org/10.3389/phrs.2022.1605023

56.

Sullivan Commission on Diversity in the Healthcare Workforce. (2004). Missing persons: Minorities in the health professions. The Sullivan Commission. https://campaignforaction.org/wp-content/uploads/2016/04/SullivanReport-Diversity-in-Healthcare-Workforce1.pdf

57.

Thorpe

R. J.

Young

K. H.

Bentley

K. M.

Liburd

(2021). Roadmap to increase public health and health care workforce diversity: Highlights from the first 10 years of the CDC undergraduate public health scholars program. Pedagogy in Health Promotion, 7(Suppl. 1), 5S–8S. https://doi.org/10.1177/23733799211054125

58.

Turbow

S. D.

Goodman

R. A.

(2024). The specialty of public health and general preventive medicine to modernize the public health workforce. American Journal of Public Health, 114(3), 260–261. https://doi.org/10.2105/AJPH.2023.307568

59.

Turner

C. S. V.

González

J. C.

Wood

J. L.

(2008). Faculty of color in academe: What 20 years of literature tells us. Journal of Diversity in Higher Education, 1, 139–168. https://doi.org/10.1037/a0012837

60.

VanderWeele

T. J.

Robinson

W. R.

(2014). On causal interpretation of race in regressions adjusting for confounding and mediating variables. Epidemiology, 25(4), 473–484. https://doi.org/10.1097/EDE.0000000000000105

61.

Vichare

Park

Y. H.

Plepys

C. M.

(2023). Diversity of the US public health workforce pipeline (2016-2020): Role of academic institutions. American Journal of Public Health, 113, 1000–1008. https://doi.org/10.2105/AJPH.2023.307352

62.

Warnick

(2021). Interest in public health degrees jumps in wake of pandemic: Applications rise. The Nation’s Health, 51(6), 1–12.

63.

Wessel

(2018). The U.S. in 2050 will be very different than it is today. Peter G. Peterson Foundation. https://www.pgpf.org/us-2050/research-summary#:~:text=America%20will%20also%20be%20more, will%20have%20more%20than%20doubled

64.

Whitla

D. K.

Orfield

Silen

Teperow

Howard

Reede

(2003). Educational benefits of diversity in medical school: A survey of students. Academic Medicine, 78(5), 460–466. https://doi.org/10.1097/00001888-200305000-00007

65.

Williams

M. T.

(2019). Adverse racial climates in academia: Conceptualization, interventions, and call to action. New Ideas in Psychology, 55, 58–67. https://doi.org/10.1016/j.newideapsych.2019.05.002

66.

Wizentier

M. M.

Stephenson

B. J. K.

Goodman

M. S.

(2023). The measurement of racism in health inequities research. Epidemiologic Reviews, 45(1), 32–43. https://doi.org/10.1093/epirev/mxad004

67.

Zambrana

R. E.

(2018). Toxic Ivory Towers: The consequences of work stress on underrepresented minority faculty. Rutgers University Press.

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