Seattle resident Jameel Bhojani, 27, was inspired to become a nurse after watching his uncle die of liver failure in a Tanzanian hospital. “At the end of his life, it was nice to see the nurses interact with him in such a manner that he forgot about illness and pain,” he says. “I thought to myself, ‘I want to be the person who does that.’ ”

Today, Bhojani works as a nurse in the Seattle area, offering compassionate care to a diverse population in a Neurology-Nephrology hospital department, which addresses brain and kidney issues, respectively. He also volunteers with a professional nursing organization to provide free, basic health screenings — such as blood pressure and glucose readings — at community centers.

As a multilingual, Tanzanian-born man with Indian heritage, Bhojani’s skills, experience and background are in demand in nursing — and underrepresented. According to the Washington State Budget and Policy Center, almost one-third of Washington’s population are people of color. Still, only 17% of Washington registered nurses identify with diverse ethnic or racial groups.

Yet a diverse nursing corps may offer solutions to health disparities, reduce costs, increase patient satisfaction and even efficiency — but only if more are recruited.

The health disparity problem

A health disparity is “a type of difference in health that is closely linked with social or economic disadvantage,” according to the Centers for Disease Control.

Factors might include ethnicity, gender, religion, income, sexual orientation, mental health, or having a disability.

Overall, ethnic minorities bear the worst burden of these disparities, often living in areas underserved by the health care system. They’re less likely to be insured, lack access to care, and experience worse health outcomes from preventable and treatable conditions. For example, in the U.S., black women are up to four times more likely to die from pregnancy complications than white women.

In addition, unconscious or explicit provider bias can lead to procedures or treatments that are different or incorrect, compared to other populations.

For disadvantaged patients, navigating the health care system can be difficult, resulting in mistrust and discomfort with asking questions or sharing concerns. For example, older adults who are lesbian, gay, bisexual, transgender and queer (LGBTQ) may avoid health care situations due to fear of discrimination, which then leads to worse health outcomes.

Nurses are uniquely positioned to help distrustful patients. Bhojani says the nurse-patient relationship both generates and requires a special type of trust. While physicians might spend a few minutes with a patient, nurses have spent the most time with them. A patient who initially rejects an MRI or procedure may be more accepting when supported by a nurse.

Health equity and patient satisfaction

A diverse nursing workforce has been found to improve health outcomes, patient satisfaction, service use and success in following a treatment plan. Overall, diverse nursing staff can improve patient health care quality and access, which leads to a decrease in health disparities and the achievement of health equity.

“It’s important to have a workforce or health care team that’s diverse,” Bhojani says. In Bhojani’s nursing unit, a variety of languages are spoken, a benefit when communicating with patients, improving communication and increasing efficiency.


“All kinds of people walk through the hospital doors, and it can be very hard to connect with somebody’s language, culture or way of life, if you can’t relate to it,” he says.

“If we have nurses representative of our population, they can provide care that’s culturally sensitive,” says Sofia Aragon, executive director of Washington Center for Nursing.

As an example, one study found that hospitalized Asian patients were more satisfied when met with culturally competent physicians and nurses, information about treatments and procedures and Asian foods.

“For day-to-day care, diversity increases trust between patient and nurse, if a nurse brings knowledge of cultural context,” Aragon says. She points out that a Vietnamese, Ukrainian-born or veteran nurse may better understand the unique medical needs, asks and perceptions from similar patients; and all nurses benefit from a greater awareness of how biases, whether personal or those of a patient, can affect quality of care.

More male nurses are needed, along with nurses from Asian Pacific, African-American, LGBTQ backgrounds, Aragon says, along with nurses in rural areas or who are veterans.

There are broader policy implications, too. By leading advanced or college-level research into health disparities, minority nurses are helping to address and eliminate systemic issues.

And nearly $230 billion could be saved if health disparities were eliminated, according to the National Institutes of Health.

Higher education link

Working in the nursing field requires a degree from an accredited school. Among them: Highline College offers an associate degree in registered nursing, University of Washington and Seattle Pacific University offer a bachelor’s in nursing, while graduate nursing programs are available at UW and Seattle University. Few students are from underrepresented groups.

Last year, Bhojani graduated from Seattle Pacific University with a bachelor’s in nursing. He was one of only three men in his graduating group of 60. There weren’t any male nursing professors when he attended.

Research shows that underrepresented nursing students often feel excluded and isolated, and struggle to find mentors, diverse students and diverse faculty

Attracting nursing students from underrepresented communities requires approaches such as community outreach, recruiting diverse faculty, providing financial aid and lowering college costs. Scholarships help students attend nursing school, while mentoring programs support underrepresented nursing students as they transition from nursing school to practicing nursing, Aragon says.

Clubs and organizations can help reduce isolation. For example, UW offers chapters of the National Association of Hispanic Nurses, LGBQTTSIA+, a health equity circle and a diversity awareness group for underrepresented students at the UW School of Nursing.

“Students want to see themselves in the nursing faculty, and see more models of diverse nurses in hospitals,” Aragon says — successful role models, improving community health, one patient at a time.

The Washington Center for Nursing supports a healthier Washington by building a diverse, highly qualified nursing workforce.