The need for health professionals across the nation and in California is on the rise, and demand for health professionals is projected to rise considerably in the near future. In 2019, California was short 240,000 nurses, and that was before COVID-19 put our healthcare system under greater strain than it has ever seen. Without bold action, the demand for health professionals and healthcare workers will not be met.
Moreover, there is a disproportionate need for diverse health professionals, especially for health professionals from racially and ethnically minoritized communities in California. Today Latinx Californians account for 39.4% of the state’s population, but just 5% of our healthcare professionals are Latinx. A more diverse workforce would better represent the state’s patient population and improve healthcare quality, access, and patient care. For example, one study showed the mortality rate for Black infants was cut in half when they were cared for by Black doctors during initial hospital stays.
The California Community Colleges (CCC) are ground zero when it comes to training the next generation of health professionals and supporting students to transfer to universities for bachelor’s and advanced health degrees. Over the past 5 years, the CCC has awarded 57,333 health associate degrees and 7,555 of them have been Associate Degrees for Transfer (ADTs), a transfer pathway which guarantees admission to the California State University system. In 2019-20 alone, the CCC awarded 12,796 total associate degrees in health, 2,194 of which were ADTs.
The Associate Degree for Transfer (ADT) is one of the best tools California has to address the high demand for diverse health care professionals. The transfer process in California remains elusive for far too many students, but the ADT – with its streamlined pathway and guarantee of admission with automatic junior standing to the California State University (CSU) system – can fast track students toward a bachelor’s degree in health fields.
Community Colleges: ADT Earners who Majored in Health
Students pursuing health professions at the California Community Colleges have three options for an ADT award: Nutrition and Dietetics, Public Health Science, and Kinesiology. In 2018-19, Clovis Community College (in Fresno, CA), Columbia College (in Sonora, CA), and Cabrillo Community College (in Santa Cruz, CA) awarded the highest number of health Associate Degrees for Transfer per full-time equivalent students (FTEs).
1,854 students earned an ADT in a health field from the CCC system in the 2018-19 academic year. To put this number in perspective, the CCC awarded 58,811 Associate Degree for Transfer awards in 2018-19 and 3.15% were in a health major. In the 2019-20 academic year, this number was 3.17% (2,114/66,649). From 2017-18 to 2018-19, the number of ADTs in health grew by 384 awards. The latest numbers suggest that out of all Associate Degrees in the Arts (AA) and Associate Degrees in the Sciences (AS) awarded, about 26% of them were in health majors.
The top three community colleges that are performing above and beyond are Clovis Community College, Columbia College, and Cabrillo Community College. These colleges award the highest number of health ADTs per full-time equivalent students (FTEs). These colleges are leading the way for students interested in health and in transferring to a college/university.
Another way to measure success is by tracking improvement over time. The community colleges with the most growth in health Associate Degrees for Transfer (from 2017-18 to 2018-19) are College of the Canyons, Fresno City College, and Long Beach City College (see Table 1).
It is important to note that in 2018-19, only 37 community colleges accounted for over 70% of the Health Associate Degree for Transfer awards. Some campuses may be struggling to institutionally support students interested in health and in transferring to the CSU system.
Ninety-eight California Community Colleges offer Kinesiology ADTs, 26 California community colleges offer Public Health Science ADTs, and 45 California community colleges offer Nutrition and Dietetics ADTs.
CSU Health ADTs
Another way to gain insights about the transfer pathways of students interested in health is to look at transfer students in the CSU system. In the Fall of 2019, 3,318 incoming transfer students had a health major (compared with 3,070 in Fall 2018). CSUs with the highest number of health major transfers in the Fall of 2019 were Northridge, Fullerton, and San Diego State.
Associate Degree for Transfer earners represent a small share of transfer students who enter the CSU system. For instance, 44 of the 426 (10.33%) incoming transfer students in health majors had earned an Associate Degree for Transfer at CSU Northridge in the Fall of 2019. This number is 23 of 333 at CSU Fullerton (6.91%). Table 2 shows these numbers for each CSU in 2018 and 2019.
Most CSU transfer students with a health major do not have an Associate Degree for Transfer, likely because there are only three available ADTs in the health professions compared to a number of majors at the CSU for which the ADTs do not align. Much work can be done to expand the number of ADTs in the health professions at the community college level while urging the CSU to match the current ADTs to the widest possible array of existing CSU majors in the health professions.
Figure 1 shows the breakdown of transfer pathways in CSU Fall 2019 incoming transfers. This figure shows data for the top 10 majors and the percent of incoming students who earned an ADT, an AA/AS, or no degree before transferring. Notably, health professions and related programs had the lowest percent of students with an ADT (with a guarantee) and an ADT (without a guarantee). Among the 23 CSUs, 21 have a kinesiology major, 14 have a nutrition major, 16 have a public health or related major, and 19 have a nursing major. Clearly, more can be done to strengthen transfer pathways in one of the most in-demand fields.
California has a high and urgent need for health professionals from diverse backgrounds. Community colleges represent an accessible and affordable entryway into higher education for low-income students from racial/ethnic minority backgrounds who are interested in health careers. The California State University system awarded 7,871 bachelor’s degrees in health professions in the 2019-2020 academic year. In the past five years, the CSU has awarded 38,791 bachelor’s degrees in the health professions. The California Community College and California State University have been leading way in training health professionals in California. Strengthening transfer pathways, especially the Associate Degree for Transfer pathway by expanding the availability of health ADTs in community colleges, can help California meet the demand for a diverse healthcare workforce.
Josefina Flores Morales