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Disrupting Disparities: Addressing and supporting the health care workforce in Pennsylvania

The recent report published by AARP Pennsylvania and Drexel University shows the impact Pennsylvania’s workforce shortage has on Pennsylvanians. 

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Pennsylvania is facing a significant workforce shortage in healthcare professionals. 

This includes direct care workers, dentists, nurse practitioners, physical therapists, physicians, physician assistants, pharmacists, psychiatrists, registered dietitians, registered nurses, occupational therapists, and social workers.

This workforce shortage has led to unpreparedness in addressing complex and co-morbid conditions and a lack of education and training in integrated, collaborative, team-based approaches to care that supports and attends to social determinants of health.

The need for adequately trained medical providers is even more critical in Pennsylvania due to the fact that many older adults in the state live in counties designated as health professions shortage areas and/or medically underserved areas. 

A health professions shortage area is defined as a geographic area, population or facility with a shortage of primary care, dental or mental health providers and services. The criteria is based on population-to-provider ratio, percentage of the population below 100% of the federal poverty level, and travel time to the nearest source of care outside of the health professions shortage area. 

According to the Disrupting Disparities in Pennsylvania report, published by AARP Pennsylvania and Drexel University’s College of Nursing and Health Professions, an estimated 14% of Pennsylvanians live in a medically underserved area and 22% live in an area that is both medically underserved and designated a health professions shortage area.

“This has significant implications in terms of access,” said Rose Ann DiMaria-Ghalili, PhD, RN, FASPEN, FAAN, FGSA, Professor of Nursing, Associate Dean of Interprofessional Research and Development at Drexel University.

Residents of these areas primarily live in rural areas, or are people of color, poorly educated, live in poverty and have limited access to transportation. 

Rural communities currently have roughly half the physicians per capita as non-rural areas. Urban and suburban areas have one physician for every 382 residents, and rural Pennsylvania has one primary care physician for every 663 residents.

“Ensuring equitable access to care and using telehealth technology can go a long way for those individuals that live in both these rural and urban areas,” said DiMaria-Ghalili.

The shortage of direct care workers in the state is, in part, a result of turnover and increased demand. That turnover is related to direct care workers leaving the profession altogether or leaving for a higher paid employer, as many are often underpaid and live in poverty. 

“Not only do we need more health professionals and direct care workers, we need to prepare the health care workforce to be culturally competent and capable of addressing age-related health care issues including preventing and managing chronic conditions and their impact on everyday activities of living and aging in place at home,” said Laura Gitlin, PHD, FGSA, FAAN, Dean and Distinguished University Professor at Drexel University.

According to the report, the main recommendation to address these workforce shortage concerns is to provide support in a variety of different ways. 

“Solutions to help disrupt health disparities impacting the 50+ population in Pennsylvania are urgently needed,” said Angela Foreshaw-Rouse, Operations and Outreach Manager for AARP Pennsylvania. “The time is now to assure that all individuals are able to live long and healthy lives regardless of where they live or their racial/ethnic background.”

Specific recommendations listed in the report are requiring nursing homes to develop effective recruitment and retention strategies to attract and retain direct care workers to ensure adequate staffing; making concerted efforts to ensure direct care workers have access to COVID-19 vaccinations; ensuring that eligible direct care workers have access to health care benefits; developing training programs to support continual skill development of direct care workers; and creating career pathways for direct care workers, which includes support for continuing education and other educational opportunities. 

The entirety of the report can be found and downloaded here

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