WASHINGTON, April 18, 2025 — A recent letter published in The Lancet cautions that choices across various sectors that contribute to a U.S. healthcare workforce that inadequately reflects and responds to the communities it serves will negatively affect public health and drive up medical expenses. The authors of “Population health and a representative U.S. health care workforce,” (Vincent Guilamo-Ramos, Marco Thimm-Kaiser, Adam Benzekri, and Danielle McCamey), emphasize the advantages of a healthcare workforce that mirrors the population (where patients and providers share characteristics like race, ethnicity, language, or cultural background). They also highlight the detrimental effects of recent significant judicial rulings, executive actions, and private sector decisions that weaken this provider-patient connection. Finally, they stress the importance of using scientific evidence to address the shortcomings of the American healthcare system.

Dr. Vincent Guilamo-Ramos, lead author and Executive Director of the Institute for Policy Solutions (IPS) and the Leona B. Carpenter Chair in Health Equity and Social Determinants of Health at Johns Hopkins School of Nursing, stated, “One major flaw in the U.S. health system is the lack of representation in the health workforce. Research indicates that a more representative workforce can enhance healthcare access, quality, and outcomes, reduce costs, and improve public health. Allowing the health workforce to become less representative, whether intentionally or through neglect, will worsen health disparities and significantly exacerbate the problem.”

Dr. Danielle McCamey, co-author, Founder-DNPs of Color & Faculty-Johns Hopkins School of Nursing, commented, “We are at a crucial point, and the evidence is irrefutable: a workforce that reflects the population saves lives. We must proactively build a healthcare system that caters to all communities.”

The letter highlights the pressing need for a representative health workforce in light of:

• The underperforming and costly U.S. health system.
• Growing and expensive health disparities among marginalized, racial, and ethnic minority communities (estimated at $400 billion), which cut across political lines in certain regions and lead to an increased number of premature deaths.
• The tangible and concerning consequences of: the U.S. Supreme Court’s decision to prohibit race-conscious admissions in higher education; recent executive actions aimed at promoting “colorblind equality” in the workforce; and other private sector initiatives that limit the nation’s ability to cultivate a representative workforce.
• The stated goals and policy inconsistencies of the “Make America Healthy Again” commission.
• The disproportionate impact of research funding cuts on underrepresented scientists who are conducting vital work to better understand and eliminate health disparities.

Guilamo-Ramos emphasized, “The data is clear: a less representative healthcare and scientific workforce will further erode trust, hinder effective communication, increase patient dissatisfaction, and perpetuate preventable costs and adverse health outcomes – impacting not only racial and ethnic minority groups, but everyone. We can improve the health system by being aware of the demographics, circumstances, and locations of people; recognizing and addressing the health inequities they encounter; and providing care that takes into account the social, political, and economic factors that greatly affect health outcomes and overall well-being. In short, we cannot improve America’s health without significantly increasing the representativeness of our health workforce.”

Note to editors

Link to The Lancet letter:

Find more information about the Institute for Policy Solutions at Johns Hopkins School of Nursing at

More background on the issue of a more representative health care workforce
The Millbank Quarterly:

Contact: Mark Daley at (202) 640-0482/via email

SOURCE The Institute for Policy Solutions at Johns Hopkins School of Nursing

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