Voices from the pipeline: high school completion among rural Latinos

Journal of Cultural Diversity, Summer, 2003 by Mary D. Lagerwey, Elizabeth Phillips, Kathi Fuller

Abstract. Although significant strides have been made in increasing the numbers and proportions of minorities in nursing, at 2.0% of the RN population (MinorityNurse.com, 2001), Latinos continue to lag far behind other minorities (Buerhaus & Auerback, 1999). As the fastest growing minority group in the United States--an increase from 9% of the population in 1990 to 11.9% in 2000 and projections of 14.6% by 2001 and 17% by 2020 (U. S. Census, 2001)--Latinos' under-representation in all fields of health care is expected to continue unless concerted efforts are taken to recruit and educate more students.

This paper presents an analysis of narratives of high school completion as articulated by Latino adolescents in group interviews. Narrative inquiry of the focus group data found three major categories of supports and challenges: peers, family, and schools. The paper concludes with a discussion of how these findings can be used to develop community based interventions to increase high school completion and thus increase the pool of applicants for nursing and other health careers.

Key Words: Rural Latinos

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STATEMENT OF THE PROBLEM: SIGNIFICANCE AND BACKGROUND

One of the most urgent concerns facing health care professions in the United States is the current and growing nursing shortage. It has become a top priority of nursing organizations, management, and the health care industry, including The American Nurses Association, The American Hospital Association, and health care insurers. The nursing shortage has made headlines in the popular media, with extensive coverage given by newspapers, magazines, and television. In the midst of the concerns, calls to action, and programs to recruit and retain more nurses, needs for increasing both the numbers and proportions of minority nurses must not be overlooked. In fact, the National League for Nurses, the National Advisory Council on Nurse Education and Practice (NACNEP), and the Health Resources and Services Administration (HRSA)'s Division of Nursing have placed increasing the number of minority nurses central to efforts to address critical nursing shortages (MinorityNurse.com, April 2001). Furthermore, nursing shortages, rates of many diseases, and poorer health outcomes are especially acute in areas of high minority populations.

Although significant strides have been made in increasing the numbers and proportions of minorities in nursing, at 1.6% of the RN population in 1996 and 2.0% of the RN population in 2000 (MinorityNurse.com, 2001), Latinos' representation within nursing continues to lag far behind that of other minorities (NSSRN, 2001). A recent analysis of the national Sample Surveys of the Population of Registered Nurses showed that while the numbers of non-Hispanic Blacks, Asian/Pacific Islanders, and American Indian/Alaskan Natives has nearly tripled over the past 20 years, the numbers of Hispanics has only doubled, and all minorities are still significantly underrepresented in nursing (Buerhaus & Auerback, 1999).

As the fastest growing minority group in the United States--an increase from 9% of the population in 1990 to 11.9% in 2000 (U.S. Census, 2001) and projections of 14.6% by 2001 and 17% by 2020 (U. S. Census, 2001)--Latinos' under-representation in all fields of health care is expected to continue unless concerted efforts are taken to recruit and educate more students. Citing overwhelming evidence showing that "people respond better to health care providers who share their cultural background" (Trossman, 1998, p. 4), the American Nurses Association has set a goal of an RN workforce that reflects the country's population.

At community levels, solutions to nursing shortages have been typically short-term. Measures such as sign-on bonuses merely redistribute nurses and do nothing to increase the supply (Taft, 2001). Most federal efforts to increase the number of minority health professionals have focused on college-level students. There is, however, a growing awareness that the under-representation of minorities in health careers is, in part, a result of the disproportionately small numbers of minorities graduating from high school. Latino youth drop out of high school at rates far exceeding any other ethnic or racial group in the United States except for American Indians (Rivera, 1993; Christenson, Sinclair, Thurlow & Evelo, 1995; Hess & D'Amato, 1996). According to the New York Times (Canedy, 2001) High school drop out rate for Latinos nationwide is over 31% for males and 26% for females. This contrasts with 7.9% and 6.9% respectively for Whites, and 13% and 12.1% for Blacks (Stern, 1996).

Reasons given for this disparity include geographic mobility (Morse & Hammer, 1998; Rumberger & Larson, 1998), lack of value placed on education by peers (Valenzuela, 1999), poverty and language barriers (Morse & Hammer, 1998), lack of family involvement in children s education, feelings of alienation and rejection from school, and low career expectations (Hess & D Amato, 1996; Rumberger & Larson, 1998). Other barriers include low educational attainment of parents, migration, gang affiliation, high teen pregnancy rates, poor health and gang violence (Bonilla, 1997; Rodriguez, 1992 and Trueba & Delgado-Gaitan, 1988). How these factors play out in particular communities is less clear.