Overview

With increasing awareness of changing American demographics and globalization, the U.S. medical community and health consumers understand that there exist disparities in health care delivery based on race, ethnic and cultural considerations. The IMDiversity.com Healthcare Industry Careers Channel discusses in more detail the trend toward programs and initiatives sponsored by government, educational institutions, philanthropic groups and corporations to address this issue -- with the goal to make the practice of medicine, pharmaceutical treatments, and other aspects of health care more accessible, affordable and "culturally competent."

The future of the American workforce will increasingly depend on people of color - by 2050, one out of every two workers will be nonwhite. Pharmaceutical and biotech companies are major employers of healthcare-degree professionals such as doctors, nurses, and those with PharmD degrees -- as well as an array of technicians, specially trained sales staffs and office workers, and other specialized workers for whom demand is greater than supply.

Employment diversity is more than just an operational imperative for industry companies, however.  Many experts argue that it is also increasingly necessary to serving diverse consumers. In the most obvious sense, culturally competent marketing is crucial in a highly competitive, global market for pharmaceutical and biotechnology products. At the same time, many experts also see employment diversity in the industries as closely related to the focus, safety, appropriateness and quality of the products that are researched, approved and created, since these companies may also create products to improve or save lives of patients from diverse ethnic populations who may have different and specific treatment needs.

As a result of both these conditions, many pharmaceutical employers are investing significantly in appealing to, hiring, and conducting research specific to the needs of women and minorities. Fast-hiring pharmaceutical companies are routinely ranked among the top employers for diversity in both general business and ethnic media.  Forward-thinking companies have in recent years been proactive in not only hiring a diverse workforce, but also leading educational and development initiatives to build a strong pipeline of the skilled workers that will be needed in the future. Some initiatives support women and minorities pursuing graduate degrees in medicine and research, technical and engineering fields, as well as training of academic educators in these areas.

Snapshot: Women & Minorities Working in the Pharmaceutical Industry

When this channel was first launched, the Equal Employment Opportunity Commission (reporting on figures before 2002) found the number of minorities in drug-related industries was well below half of their white counterparts. Since then, industry-wide hiring and science education initiatives, as well as strong hiring activity in the industry, have been slightly raising the numbers of workers from underrepresented groups, as well as the relative percentages of minorities to whites in certain occupations. But there is still considerable room for improvement.

According to the Equal Employment Opportunity Commission's 2005 EEO-1 AGGREGATE REPORT - NAICS 3254 Pharmaceutical & Medicine Manufacturing", the total numbers of women and men overall have hovered close to parity (51.2% men employed vs. 48.8% women employed). However, while the percentage of women in "Official & Managerial" positions increased slightly, to 36.4%, as Kristin Rand observed in Pharmaceutical Executive, a glass ceiling still hovers above women in the upper-level executive sphere of Big Pharma.

In an analysis of the magazine's 2006 "Top 50" ranking, Rand, who is associate director of professional education support for Wyeth, announced "the stark reality...that today's leading pharmaceutical companies are still run by men," citing the survey showing that only 12% of high executive offices were filled by women, while three of the top-ranked companies had no women executives at all. Rand found a silver lining, however, in the sub-industry of "biopharma," where the top 10 companies for 2006 ranked by Contract Pharma magazine had appointed, on average, 22% percent of women to executive roles. Rand concluded that while Women in Bio and and similar groups have helped to promote diversity in the industry, the heads of the world's largest pharmaceutical companies still had a responsibility and a long-term profit imperative to "do better at mirroring their consumer base" in their boardrooms and and executive suites. (Source: "Where are the Women?" in Pharmaceutical Executive.)

According to EEOC figures, the majority of those women who do fill "Official & Managerial" roles are white (29.2% of the total), while all minority women combined fill only 7.2% hold such positions. Between 2002 and 2005, the percentage of minority workers -- defined as Blacks, Hispanics, Asian Americans and American Indians, of all genders -- rose only slightly overall, by about one percentage point to 25.8%, and showed some increases in worker categories including Management, Professionals, Technicians, and Sales.

Notwithstanding the seemingly small proportional increases in nonwhite minority worker participation reported in the EEOC figures (see table below), rapid hiring throughout the industry has quickly raised the real numbers of minorities working in several occupational categories.

2005 EEO-1 AGGREGATE REPORT
NAICS-4 Code 3254 - Pharmaceutical & Medicine Mfg
Participation Rates in Select Occupations

Diversity Rankings of Industry Employers

As we mentioned earlier, only two Pharmaceutical/Biotech employers were listed on both the 2007 Fortune 500 list of the top pharmaceutical companies by industry and Fortune’s 2007 list of “100 Best Companies to Work For”  lists: Amgen and Genzyme.  However, a number of additional organizations large and small in pharmaceuticals and related industries were ranked among "Best Employers" in Fortune's January 22, 2007 issue, a listing that accounts for diversity among other worklife criteria.  The ranking according to Fortune's analysis also breaks down the companies by the percentages of the workforce that are occupied by minorities and by women, as shown to the right.

The extent to which healthcare and pharmaceutical organizations have been increasingly proactive in their outreach to diverse college and graduate students is also reflected in the 2006 Top 100 Diversity Employers survey by Universum Communications, which was published by THE BLACK COLLEGIAN Magazine.  In the Universum IDEAL Employer™ Survey – Diversity Edition, more than 12,800 students at 115 schools across the country ranked their top companies and their top industries, and answered questions about career expectations and goals, IDEAL Employer™ characteristics, salary expectations and communication preferences.  In 2006, an unprecedented number of major and mid-sized industry employers were named to the extended Top 200 Diversity Employers list in 2006, including:

• Johnson & Johnson
• Pfizer
• Merck
• Abbot Laboratories
• Wyeth
• Bristol
• Eli Lilly
• Roche
• Novartis
• Amgen
• Hospira
• Bayer
• Takeda Pharmaceuticals North America

In addition, Johnson & Johnson, Pfizer, Mayo Clinic, Glaxo Smith Kline and Merck were all ranked in the top 40 among undergraduates.

As striking, however, was that for the first time in 2006, healthcare (including pharmaceuticals and biotechnology) unseated financial services as the most popular industry among diverse students overall, combining undergraduates and MBA students.  It was also the top preferred industry among undergraduate students followed by government/public service, financial services and education. 

Additional details and rankings can be seen at the THE BLACK COLLEGIAN Online Top 100 Diversity Employers 2006 report.

Diversity Imperatives and Disparities

As in other fields related to healthcare, cultural challenges and racial disparities exist in the pharmaceutical and biotechnology industries that can extend not only to the recruitment of those who work at various levels of the industry, but also to the research, creation and marketing of the industries' products/services.

Just one concern facing clinical researchers, for example, is the relative difficulty of recruiting nonwhite minorities for clinical drug trials. This problem was examined in a 2006 conference of BIO: The Biotechnology Industry Organization, which represents more than 1,100 biotechnology companies, academic institutions, state centers and related organizations in 32 countries.  Researchers have found evidence that some medications may have different effects in minority and white patients, so under-representation of minority subjects in trials and evaluations of new drugs could be an obstacle to establishing its efficacy and safety for use by all patients, as well as in the FDA approval process.  This organization's Minority Outreach Initiative seeks to encourage more African American and Hispanic/Latino scientists to participate in its annual conferences, fellowships, and leadership activities. In fact, the organization's May 2007 meeting in Boston, sponsored by Genentech, took on the topic more substantially in the supersession, "Improving Biotechnology Industry Access to Underserved Populations".  Another development in both pharmaceutical research and throughout the wider health care professions is the increasing deployment of bilingual staff and interpreters in conducting trials and providing clinical care in order to better communicate with a diversifying, increasingly immigrant population.

At the same time, however, the exact methods of accounting for "race" and "diversity" in confronting research disparities remains controversial.  For example, many research experts argue that the essentially social classification of "race" must not be confused for "ethnicity," which may be more scientifically useful for solving certain research problems. From a biological researcher's perspective, for example, observing different reactions to a drug treatment in "Hispanic" patients must account for whether subjects are, say, of indigenous and Mexican descent versus Caribbean descent.  Further, some research companies are pioneering development of medicines that are particular to a population group, such as drugs to specifically combat heart disease in African Americans.

In an article on "The Importance of Race/Ethnicity in Clinical Trials" published by the American Heart Association, the authors observe that both aspects of minority under-representation -- the social and biological factors -- must be understood when evaluating drug trials:

"The United States has the most affluent and sophisticated medical community in the world, yet large population differences in healthcare outcomes among racial/ethnic populations remain an imposing challenge for the twenty-first century. Although causes of healthcare disparities are many, a significant contributor is the absence of research to clearly identify the sources of differences in outcomes in racial/ethnic groups and to distinguish among biological, environmental, or social causes of disease differences."

Indeed, the answer to addressing disparities in minorities' healthcare and drug treatment access and outcomes appears to lie in addressing a complicated mix of both macro and micro factors, from the social and cultural to ethnic and biological and the individual and genetic.  As scientific breakthroughs allow for an ever-more finely targeted, "personalized medicine," a majority of those involved in planning, creating, testing and marketing treatments understand that persistent historical and social factors including race, ethnicity, language, gender roles, cultural profiles and other attributes can present real barriers to the industry's ability to effectively deliver medical advances to minority patients.

In this sense, education and workforce development initiatives emphasizing diversity should continue to be a priority among researchers and employers in these industries for some time to come.

(Also of interest on the channel: See, The Coming of Age of Multicultural Medicine by Gail McBride, Public Library of Science)

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