Checking the Pulse of Diversity among Health Care Professionals:An Analysis of West Coast Hospitals

What factors are associated with variation in the racial/ethnic composition of hospital health care professionals? Institutional theories suggest that organizations react to external environmental and internal structural pressures for the racial/ethnic integration of workers. Using an institutional framework, we bring to bear new insight into how hospitals respond to such pressure for diversity. Models estimated with original data from 328 U.S. West Coast hospitals provide evidence that establishment size and a hospital’s minority patient base promote diversity among health care professionals. The state legal environment is also associated with the racial/ethnic composition of professional hospital workers, indicating the importance of fair employment laws and court decisions in signaling expectations about workplace diversity. Last, the findings show that factors within hospitals’ competitive and internal environments have positive consequences for diversity among health care professionals. We discuss implications for our findings, especially in the context of health care worker shortages and ongoing health care reform