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Perspectives

The dynamics of poverty, educational attainment, and the children of the disadvantaged entering medical school

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Pages 667-676 | Published online: 21 Aug 2019

References

  • McKay S. Benefits, poverty and social justice. J Poverty Social Justice. 2014;22(1):3–10. doi:10.1332/175982714X13910760153802
  • Petersen MB, Slothuus R, Stubager R, Togeby L. Deservingness vs values in public opinion on welfare: the automaticity of the deservingness heuristic. Eur J Polit Res. 2011;50(1):24–52. doi:10.1111/j.1475-6765.2010.01923.x
  • Schofield T, Butterworth P. Patterns of welfare attitude in the Australian population. PlosOne. 2015. doi:10.1371/journal.pone.0142792
  • Edwards AN. Dynamics of Economic Well-Being: Poverty, 2009–2011. Current Population Reports, P70-137, U.S. Census Bureau, Washington, DC, 2014. Available from: https://www.bls.gov/cps/cpsaat07.htm. Accessed July 05, 2018.
  • Eurostat Data Explorer. Available from: https://ec.europa.eu/eurostat/en/web/products-datasets/-/ILC_LI22B. Accessed May 06, 2018.
  • DeNavas-Walt C, Proctor BD. Income and poverty in the United States 2015. U.S. Census Bureau. Available from: https://www.census.gov/content/dam/Census/library/publications/2016/demo/p60-256.pdf. Accessed December 28, 2017.
  • Association American Medical Colleges. Matriculating Student Questionnaire. All Schools Summary. Association American Medical Colleges; Washington DC, 2017. Accessed July 7, 2018.
  • Jolly P. Diversity of U.S. medical students by parental income. AAMC Anal Brief. 2008;8(1). Available from: https://www.aamc.org/download/102338/data/aibvol8no1.pdf. Accessed May 17, 2018.
  • Youngclaus J, Roskovensky L. An updated look at the economic diversity of US medical students. AAMC Anal Brief. 2018;18(5):1–3.
  • Seiyan K, Greenhalgh T, Dorling D. The Standardized Admission Ratio for measuring widening participation in medical schools: analysis of UK medical school admissions by ethnicity, socioeconomic status, and sex. BMJ. 2004;328(7455):1545–1546. doi:10.1136/bmj.328.7445.934
  • Krogstad JM. One in 4 Native Americans and Alaskan natives are living in poverty. Fact Tank Pew Research Center. June 13, 2014. Available from: http://www.pewresearch.org/fact-tank/2014/06/13/1-in-4-native-americans-and-alaska-natives-are-living-in-poverty/FutureofRacial/EthnicPoor. Accessed July 1, 2018.
  • Fontenot K, Warren LH, Mohanty A. Monthly and average monthly poverty rates by selected demographic characteristics: 2013. Current Population Reports, P70BR-145. Washington (DC): U.S. Census Bureau; 2017.
  • United States Census Bureau. Poverty rates for selected detailed race and hispanic groups by state and place: 2007–2011. United States Census Bureau. Available from: https://www.census.gov/newsroom/press-releases/2013/cb13-29.html. Accessed July 4, 2018.
  • Kumwenda B, Cleland J, Greatrix R, MacKenzie RK, Prescott G. Are efforts to attract graduate applicants to UK medical schools effective in increasing the participation of under-represented socioeconomic groups? A national cohort study. BMJ Open. 2018:8(2):e018946. Published 2018 Feb 14. doi:10.1136/bmjopen-2017-018946
  • GCSA global consensus for social accountability of medical schools: consensus document. December 2010. Available from: http://healthsocialaccountability.sites.olt.ubc.ca/files/2011/06/11-06-07-GCSA-English-pdf-style.pdf. Accessed October 9, 2017.
  • Office for Fair Access, Higher Education Funding Council for England. National Strategy for Access and Student Success in Higher Education. London, UK: Department for Business, Innovation and Skills; 2014. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/299689/bis-14-516-national-strategy-for-access-and-student-success.pdf. Accessed January 10, 2016; Accessed March 10, 2019.
  • Grbic D, Jones DJ, Case ST. The role of social economic status in medical school admissions: validation of a social economic indicator for the use of medical school admissions. Acad Med. 2015;90:953–960. doi:10.1097/ACM.0000000000000653
  • Patten E. Racial, gender wage gaps persist in US despite some progress. Pew Fact Tank. July 1, 2016. Available from: http://www.pewresearch.org/fact-tank/2016/07/01/racial-gender-wage-gaps-persist-in-u-s-despite-some-progress/. Accessed October 13 2018.
  • Do C, Parry J, Mathers J, Richardson M. Monitoring the widening participation initiative for access to medical school: are present measures sufficient? Med Educ. 2006;40(8):750–758. doi:10.1111/j.1365-2929.2006.02511.x
  • Braveman P, Acker J, Arkin E, Bussel J, Wehr K, Proctor D. Early Childhood Is Critical to Health Equity. Princeton (NJ): Robert Wood Johnson Foundation; 2018.
  • Cox D, Lienesch R, Jones RP. Beyond economics: fear of cultural displacement pushed the white working-class to Trump. PRRI/The Atlantic Report. Available from: https://www.prri.org/research/white-working-class-attitudes-economy-trade-immigration-election-donald-trump/. Accessed July 15, 2018.
  • Haider AH. Association of unconscious racial and social class bias with vignette based clinical assessments by medical students. JAMA. 2011;306(9):942–951.
  • MR Rank. One Nation, Underprivileged: Why American Poverty Affects Us All. Oxford University Press; New York, NY,  2004.
  • Rank MR, Hirschl TA, Foster KA. Chasing the American Dream. Oxford University Press; New York, NY, 2014.
  • Van de Poel E, O’Donnell O, Dooslaer E. Are urban children really healthier? Evidence from 47 developing countries. Soc Sci Med. 2007;65(10):1986–2003. doi:10.1016/j.socscimed.2007.06.032
  • Jantti M American exceptionalism in a new light: a comparison of intergenerational earnings mobility in Nordic Countries, the United Kingdom and the United States. Institute for the Study of Labor. IZA Discussion Paper 1938. January 2006. Available from: http://ftp.iza.org/dp1938.pdf. Accessed October 10, 2017.
  • OECD. How Does the United States Compare? A Broken Social Elevator? How to Promote Social Mobility. Paris: OECD Publishing; 2018. doi:10.1787/9789264301085-en
  • Kaushal N, Magnuson K, Waldfogel J. How is family income related to investments in children’s learning? In: Duncan Greg J, Murnane Richard J, editors. Whither Opportunity: Rising Inequality, School, and Children’s Life Chances. New York: Russell Sage Foundation; 2011;187–206.
  • Pfeiffer FT, Killewald A. Generations of advantages: multigenerational correlations in family wealth. Soc Forces. 2018;96(4):1411–1442. doi:10.1093/sf/sox086
  • Collins W, Wanamaker M. Up from Slavery? African-American Intergenerational Economic Mobility since 1880. National Bureau of Economic Research (NBER). May 2017; 23395. Available from: http://www.nber.org/papers/w23395. Accessed December 15, 2017.
  • Wilson WJ. The Truly Disadvantaged. The Inner City, the Underclass, and Public Policy. University of Chicago Press, Chicago, IL. Copyright 1987.
  • Sharkey P. Stuck in Place. Urban neighborhoods and the end of progress toward racial equality. University of Chicago Press, Chicago, IL. Copyright 2013.
  • Reardon SF, Fox L, Townsend J. Neighborhood income composition by household race and income, 1990–2009. Ann Am Acad Political Soc Sci. 2015;660:78–97. doi:10.1177/0002716215576104
  • Sharkey P. Spatial segmentation and the Black middle class. Am J Soc. 2014;119:903–954. doi:10.1086/674561
  • Shapiro Thomas M. Toxic Inequality: How America’s Wealth Gap Destroys Mobility, Deepens the Racial Divide, and Threatens Our Future. New York: Basic Books; 2017.
  • Maroto M. Growing farther apart: racial and ethnic inequality in household wealth across the distribution. Soc Sci. 2016;3:801–824.
  • Yeung WJ, Conley D. Black–white achievement gap and family wealth. Child Develop. 2008;79:303–324. doi:10.1111/j.1467-8624.2007.01127.x
  • Williams–Shanks TR. The impacts of household wealth on child development. J Poverty. 2007;11:93–116. doi:10.1300/J134v11n02_05
  • Papageorge NW, Thom K. Genes, education, and labor market outcomes: evidence from the health and retirement study. NBER Working Paper No. 25114. September 2018. Available from: http://www.nber.org/papers/w25114. Accessed October 7, 2018.
  • Sheridan MA, McLaughlin KA. Neurological models of the impact of adversity on education. Curr Opin Behav Sci. 2016;10:108–113. doi:10.1016/j.cobeha.2016.05.013
  • Mani A, Mullainthan S, Shafir E, Zhao J. Poverty impedes cognitive function. Science. 2013;341:976. doi:10.1126/science.1238041
  • Kochhar R, Fry R. Wealth Inequality Has Widened along Racial, Ethnic Lines since End of Great Recession. Washington (DC): Pew Research Center; 2014.
  • Cook L US education still separate and unequal. US News Data Mine. January 28, 2015. Accessed January 1 2018.
  • Givens M, Gennuso K, Jovaag A, Van Dijk JW. County Health Rankings Key Findings 2018. University of Wisconsin Population Health Institute. Available from: http://www.countyhealthrankings.org/explore-health-rankings/rankings-reports/2018-county-health-rankings-key-findings-report?utm_medium=email&utm_source=govdelivery. Accessed March 28, 2018.
  • Steven K, Dowell J, Jackson C, Guthrie B. Fair access to medicine? Retrospective analysis of UK medical schools application data 2009–2012 using three measures of socioeconomic status. BMC Med Educ. 2016;16:11. doi:10.1186/s12909-016-0536-1
  •   Bloome D, Dyer S, Zhou X. Educational Inequality, Educational Expansion, and Intergenerational Income Persistence in the United States. American Sociological Review. 2018;83(6):1215–1253. doi:10.1177/0003122418809374.
  • Aschbacher PR, Li E, Roth EJ. Is science me? High school students’ identities, participation and aspirations in science, engineering, and medicine. J Res Sci Teach. 2009;47(5):564–582.
  • Mathers J, Parry J. Why are there so few working-class applicants to medical schools? Learning from the success stories. Med Educ. 2009;43(3):219–228. doi:10.1111/j.1365-2923.2008.03274.x
  • Greenhalgh T, Seyan K, Boynton P. ‘Not a university type’: focus group study of social class, ethnic, and sex differences in school pupils’ perceptions about medical school. Br Med J. 2004;328(7455):1541–1544. doi:10.1136/bmj.328.7455.1541
  • Department of Education. The Condition of Education 2016. National Center for Education Statistics, Department of Education. Washington DC 2016. Available from: https://nces.ed.gov/pubs2016/2016144.pdf. Accessed October 21, 2017.
  • Fitzgerald B, Delaney J. Educational opportunity in America: the condition of access. In: Heller DE, editor. Condition of Access: Higher Education for Lower Income Students. Westport (CT): Praeger;2002;3–24.
  • Mortenson TG. Students from low-income families and higher educational opportunity. Postsecondary Ed Opp. 1998;78:1–2.
  • Keller KRI. How can educational policy improve income distribution? An empirical analysis of education stages and measures on income inequality. J Develop Areas. 2010;43(2):51–77. doi:10.1353/jda.0.0052
  • Beveridge, Sir William. Social Insurance and Allied Services. Paper Presented to UK Parliament, London, UK, November 1942.
  • McLanahan S, W Jacobsen. Diverging Destinies Revisited. Pp 3-24 in Amato, Booth, McHale, and VanHook (eds.). Families in an Era of Increasing Inequality: Diverging Destinies. New York, NY: Springer.
  • Kneebone E, Reeves RV. The Intersection of Race, Place, and Multidimensional Poverty. The Brookings Institute; April 2016. Available from: https://www.brookings.edu/research/the-intersection-of-race-place-and-multidimensional-poverty/. Accessed July 27, 2017.
  • Reeves R, Rodriguez E, Kneebone E. Five Evils: Multidimensional Poverty and Race in America. the Brookings Institution; Washington DC, April 2016.
  • Edwards A. Crisis, chronic, and churning: an analysis of varying poverty experiences. SEHSD Working Paper Number 2015–06. U.S. Census Bureau. Available from: https://www.census.gov/content/dam/Census/library/working-papers/2015/demo/SEHSD-WP2015-06.pdf. Accessed March 15, 2018.
  • Douglass J, Thomson G. Poor and rich: student economic stratification and academic performance in a Public Research University System. High Ed Q. 2012;66(1):65–89. doi:10.1111/j.1468-2273.2011.00511.x
  • Laderman S. SHEF: FY 2017 – State Higher Education Finance Report April 2018. Higher Education Today April 23, 2018. Available from: https://www.higheredtoday.org/2018/04/23/annual-state-higher-education-finance-report-fy-2017-released. Accessed June 20, 2019.
  • Gose B. The chorus grows louder for class-based affirmative action. Chron High Ed. 2005;51(25):B5–B6.
  • Pell Institute. Indicators of Opportunity in Higher Education. Washington (DC): Pell Institute; 2004.
  • Goldrick-Rab S, Richardson J, Hernandez A. Hungry and Homeless in College: Results from a National Study of Basic Needs Insecurity in Higher Education. Wisconsin HOPE Lab; March 2017. Available from: wihopelab.com/publications/hungry-and-homeless-in-college-report.pdf. Accessed June 29, 2018.
  • Martinez SM, Maynard K, Ritchie LD. Global food initiative: food and housing security at the University of California. December 2017. Available from: https://www.ucop.edu/global-food-initiative/_files/food-housing-security-exec-summary.pdf. Accessed May 19, 2018.
  • Taliaferro W, Duke-Benfield AE. The case for redesigning state financial aid to better serve nontraditional adult students. Center for Law and Social Policy. 2016. Available from: https://www.clasp.org/sites/default/files/public/resources-and-publications/publication-1/Redesigning-State-Financial-Aid-to-Better-Serve-Nontraditional-Adult-Students.pdf. Accessed November 22, 2018.
  • DiMartino LA. The “free college” illusion: how state tuition support programs are widening the opportunity gap. Georgetown J Poverty Law and Policy. 2018;25(2):257–302.
  • The Sullivan Commission. Missing persons: minorities in health professions. A report of the Sullivan commission on diversity in the healthcare workforce. The Sullivan Commission. 2004. Available from: http://www.thesullivanalliance.org/cue/research/publications.html. Accessed October 23, 2018. 
  • American Medical Student Association. Medical student debt. Available from: https://www.amsa.org/advocacy/action-committees/twp/medical-student-debt/. Accessed June 17, 2018.
  • Cain L. Medscape physician wealth and debt report 2018. Available from: https://www.medscape.com/slideshow/2018-physician-wealth-debt-report-6009863#9. Accessed June 18, 2018.
  • Hiltonsmith R. At what cost?: how student debt reduces lifetime wealth. Demos. 2013. Available from: http://www.demos.org/sites/default/files/imce/AtWhatCostFinal.pdf. Accessed July 10, 2018.
  • Huelsman M. The debt divide: the racial and class bias behind the “new normal” of student borrowing. Demos. 2015. Accessed July 10, 2018.
  • Goldrick-Rab S, Kelchen R, Harris DN, Benson J. Reducing income inequality in educational attainment: experimental evidence on the impact of financial aid on college completion. Am J Soc. 2016;121(6):1762–1817. doi:10.1086/685442
  • Bettinger E. Need-based aid and college persistence: the effects of the ohio college opportunity grant. Ed Eval Pol Anal. 2015;37(1S):102S–119S. Available from:: http://journals.sagepub.com/doi/pdf/10.3102/0162373715576072
  • Rabinowitz HK, Diamond JJ. The impact of multiple predictors of generalist physicians’ care of underserved populations. Am J Pub Health. 2000;90(8):1225–1228. doi:10.2105/AJPH.90.8.1225
  • Cleland J, Dowell J, McLachlan J, Nicholson S, Patterson F. Identifying Best Practice in the Selection of Medical Students. London: General Medical Council; 2012.
  • Larkins S, Johnston K, Hogenbirk JC, et al. Practice intentions at entry to and exit from medical schools aspiring to social accountability: findings from the Training for Health Equity Network Graduate Outcome Study. BMC Med Educ. 2018;18(1):261. Published 2018 Nov 13. doi:10.1186/s12909-018-1360-6
  • Anderson I, Robson B, Connolly M. Indigenous and tribal peoples’ health (The Lancet-Lowitja Institute of Global Collaboration): a population study. Lancet. 2016;388(10040):131–57.75. doi:10.1016/S0140-6736(16)00345-7
  • Haider AH. Unconscious race and social class bias among acute care surgical clinicians and clinical treatment decisions. JAMA Surg. 2015;150(5):457–464. doi:10.1001/jamasurg.2014.4038
  • Whitla DK, Orfield G, Silen W, Teperow C, Howard C, Reede J. Educational benefits of diversity in medical school: a survey of students. Acad Med. 2003;78(5):460–466. doi:10.1097/00001888-200305000-00007
  • Morrison E, Grbic D. Dimensions of diversity and perceptions of having learned from individuals from different backgrounds: the particular importance of racial diversity. Acad Med. 2015;90(7):937–945. doi:10.1097/ACM.0000000000000675
  • Williams RL, Romney C, Cano M, et al. Racial, gender and socioeconomic status bias in senior medical student clinical decision-making: a national survey. J Gen Int Med. 2015;30(6):758–767. doi:10.1007/s11606-014-3168-3
  • Lang KR, Dupree KY, Kon AA, Dudzinski DM. Calling out implicit bias as a harm in pediatric care. Camb Q Healthc Ethics. 2016;25(3):540–552. doi:10.1017/S0963180116000190
  • Stone J, Moskowitz GB. Non-conscious bias in medical decision making: what can be done to reduce it? Med Educ. 2011;45:768–776. doi:10.1111/j.1365-2923.2011.04026.x
  • Capers Q, Clinchot D, McDougle L, Greenwald AG. Implicit racial bias in medical school admissions. Acad Med. 2017;92(3):365–369. doi:10.1097/ACM.0000000000001388
  • Chapman EN, Kaatz A, Carnes MJ. Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities. Gen Intern Med. 2013;28(11):1504–1510. doi:10.1007/s11606-013-2441-1
  • American Board of Internal Medicine Foundation, American College of Physicians – American Society of Internal Medicine Foundation, and European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136:243–246. doi:10.7326/0003-4819-136-3-200202050-00012
  • Vela MB, Chin MH, Press VG. Advocacy training as a complement to instruction about health disparities. Acad Med. 2016;91(4):449. doi:10.1097/ACM.0000000000001109
  • Association of American Medical Colleges. Underrepresented in medicine definition. Available from: https://www.aamc.org/initiatives/urm/. Accessed 10 March 2019.
  • Lowrance AM The disadvantaged status in the American Medical College Application Service: medical students reflect on their experiences [Dissertations]. 2017: 417. Available from: http://digscholarship.unco.edu/dissertations/417. Accessed October 24, 2018.
  • Mann H. Report No. 12 of the Massachusetts School Board 1848. In: Cremin LA, editor. The Republic and the School: Horace Mann on the Education of Free Men. Vols. 79–80. 1957:84–97. Teachers College Press.New York, NY. 1957.
  • Collected essays on public health and epidemiology/Rudolf Virchow. LJ Rather Ed. Canton, MA. Science History Publications. 1985.
  • American Board of Internal Medicine Foundation, American College of Physicians – American Society of Internal Medicine Foundation, and European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern. Ann Intern Med. 2002;136(3):243–6.
  • Flexner A. Medical education in the United States and Canada: a report to the carnegie foundation for the advancement of teaching (PDF). Bulletin No. 4. New York City: The Carnegie Foundation for the Advancement of Teaching;1910: 346. OCLC 9795002. Accessed June 8, 2018.
  • Pennamon T. Report card: states fail high achieving low income students. Diversity Iss High Ed. 2018;35(6):10–11.
  • Hoxby C, Avery C. The missing “one offs”. The hidden supply of high achieving low income students. Brookings Pap Econ Act. 2013;1:1–50. doi:10.1353/eca.2013.0000
  • Haveman R, Smeeding T. The role of higher education in social mobility. Fut Child. 2006;16(2):125–150. doi:10.1353/foc.2006.0015
  • Gardner L. How to identify and invest in high achieving low income students. Chron Higher Educ. 2018;64(23):1.
  • Matsumoto M, Takeuchi K, Tanaka J. Follow-up study of the regional quota system of Japanese medical schools and prefecture scholarship programmes: a study protocol. BMJ Open. 2016;6(4):e011165. doi:10.1136/bmjopen-2016-011165
  • McKimm J, Wilkinson T, Poole P, Bagg W. The current state of undergraduate medical education in New Zealand. Med Teach. 2010;32(6):456–460. doi:10.3109/0142159X.2010.486427
  • Curtis E, Wikaire E, Jiang Y, et al. Examining the predictors of academic outcomes for indigenous Māori, Pacific and rural students admitted into medicine via two equity pathways: a retrospective observational study at the University of Auckland, Aotearoa New Zealand. BMJ Open. 2017;7(8):e017276. doi:10.1136/bmjopen-2017-017276
  • Larkin S, Michielsen K, Iputo J, et al. Impact of selection strategies on representation of underserved populations and intention to practise: international findings. Med Educ. 2015;49(1):60–72. doi:10.1111/medu.12518
  • Alexander K, Palma TF, Nicholson S, Cleland J. ‘Why not you?’ Discourses of widening access on UK medical school websites. Med Educ. 2017;51:598–611. doi:10.1111/medu.132642
  • Razack S, Maguire M, Hodges B, Steinert Y. What might we be saying to potential applicants to medical school? Discourses of excellence, equity, and diversity on the web sites of Canada’s 17 medical schools. Acad Med. 2012;87(10):1323–1329. doi:10.1097/ACM.0b013e318267663a
  • de Visser M, Fluit C, Cohen-Schotanus J, Laan R. The effects of a non-cognitive versus cognitive admission procedure within cohorts in one medical school. Adv Health Sci Educ Theory Pract. 2018;23(1):187–200.
  • Bowman NA. How much diversity is enough? The curvilinear relationship between college diversity interactions and first-year student outcomes. Res High Educ. 2013;54(8):874–894. doi:10.1007/s11162-013-9300-0
  • Brosnan C, Southgate E, Outram S, et al. Experience of medical students who are first in family to attend University. Med Educ. 2016;50:842–851. doi:10.1111/medu.12995
  • Ferguson E, Lievens F. Future directions in personality, occupational and medical selection: myths, misunderstandings, measurement, and suggestions. Adv Health Sci Educ Theory Pract. 2017;22(2):387–399. doi:10.1007/s10459-016-9751-0
  • Strasser R, Neusy A-J. Context counts: training health workers in and for rural and remote areas. Bull World Health Organ. 2010;88:777–782. doi:10.2471/BLT.09.072462
  • Ellaway RH, Malhi RL, Woloschuk W, de Groot JM, Doig CJ, Myhre D. An Axiologic Analysis of one medical school’s admissions process: exploring individual values and value systems. Acad Med. 2019; published ahead of print. doi:10.1097/ACM.0000000000002698109
  • Griffin B, Hu W. The interaction of socio-economic status and gender in widening participation in medicine. Med Educ. 2015;49:103–113. doi:10.1111/medu.12480
  • McLachlan JC. Outreach is better than selection for increasing diversity. Med Educ. 2005;39:872–875. doi:10.1111/j.1365-2929.2005.02339.x