Historical Significance of Minority-Serving Institutions in Physical Therapy Education, The

Journal of Physical Therapy Education, Winter 2003 by Reicherter, E Anne, Wilson, Stanley, Chesbro, Steven, Manuel, Bernadette

Physical therapy education has constantly evolved since the 1920s. Only in the last 28 years, however, have education programs that specifically target minority students been established. Currently, only 7% of physical therapist programs and 6% of physical therapist assistant programs are housed at minority-serving institutions. The value of these institutions can only be fully appreciated if one considers the historical context of educational and societal conditions that have necessitated their existence. The purposes of this commentary are to highlight historical factors that have influenced ethnic and racial representation in the physical therapy profession, to identify the role of the minority institution in physical therapy education, to consider the current climate of diversity in higher education, and to make recommendations that foster continued growth in the number of physical therapists and physical therapist assistants of an ethnic or racial minority available to provide care and education to a diverse nation.

Key Words: Medical education, Minority groups, Physical therapy

INTRODUCTION

The profession of physical therapy in the United States is relatively young compared with other health care professions such as dentistry, medicine, and nursing. Thus, its recognition of the importance of educating members of racial and ethnic minority groups is relatively new. This is not to say that the profession was without minority representation in its early development. However, the purposeful education of members of these groups was not truly addressed until the late 1970s. Though ethnic and racial minorities have made significant contributions to the physical therapy profession as clinicians and educators, there is very little documentation on the history of this group in physical therapy education in the United States. The purposes of this commentary are to provide a historical perspective in which to view the current condition and value of the involvement of racial and ethnic minorities, both as students and as academic faculty, in physical therapy education and to highlight the role of minorityserving institutions (MSIs). With this perspective in mind, some suggestions for strategies to increase the inclusion of racial and ethnic minorities in physical therapy education will be discussed.

SOCIOPOLITICAL INFLUENCES AFFECTING PHYSICAL THERAPY EDUCATION OF MINORITIES

Early in physical therapy education, individuals of a racial or ethnic minority group attended predominantly white institutions (PWIs) because no MSIs had established physical therapy programs (See Figure 1). Prior to the 1960s, due in part to institutional racism, there were fewer opportunities for minority students to participate in higher education than for their white counterparts.1 In the late 1800s and early 1900s, "most southern states and many border states legally prohibited African Americans from attending public institutions of higher education [and] 19 states established dual systems of higher education."2(p10) During this same period, due to segregation and poor access to health care, there was little exposure of minorities to health care professions. Subsequently, the ability of minorities to enter fields such as physical therapy was inhibited.

Efforts to repeal Jim Crow laws began in the United States after World War H and continued through the 1970s.1 These laws, named for a 19th century minstrel show character and in effect since the Civil War, permitted the segregation of public transportation, accommodations, education, and health care delivery. During the post-World War II decade, public pressure prompted several key federal legislative and policy initiatives that drove the desegregation movement. In 1945, the US Surgeon General Thomas Parron asserted that "the national welfare demanded an end to discrimination in medical education."1(p247) However, it was not until the late 1950s that half of the medical schools in the United States were desegregated. Additionally, the Hill-Burton Act of 1946 increased minority patient and health care professional access to newly constructed hospitals that received federal funding.

Though segregation was a national problem, not just a Southern one, Jim Crow laws directly affected those minority students who were attending schools south of the Mason-Dixon Line.1 One African American physical therapist who was an undergraduate student in the early 1950s recollects that she was required to he seated in the Jim Crow section of the train with the other blacks.2 For physical therapy students, this climate also limited the housing available to minority students on clinical affiliations2 and affected the attitudes of some clinical instructors.3 With the passage of the Civil Rights Act of 1964, which banned segregation in public accommodations and removed federal funds from any state or local agency permitting the practice, came increased access to educational and health care opportunities for minorities. The enactment of Medicare legislation in 1965, denying payment to segregated hospitals, further enhanced the cause. Following these initiatives, there was some increase in minorities entering health care professions; however, their numbers continued to be very low. For example, by the 1983-1984 academic year, the enrollment of under-represented minority students such as Native Americans, African Americans, Mexican Americans, and Puerto Ricans in US medical schools had reached 9.7%.4 But the overall dearth of minorities in the profession of physical therapy cannot be blamed solely on institutional racism.