Diversity In Nursing And Healthcare: A Look At The Numbers

Patients do better when their providers look like them. Research links greater diversity among healthcare professionals to higher patient experience scores and better outcomes. Yet people of color remain underrepresented in the field, and nursing is no exception.

This piece analyzes Current Population Survey data from the Bureau of Labor Statistics for 2003 through 2022, covering three license types: licensed practical nurses (LPNs), registered nurses (RNs), and nurse practitioners (NPs). Three findings stand out. Racial diversity among nurses in 2022 was higher than it had been in 19 years. That diversity grew faster in nursing than in healthcare overall. And practicing LPNs and RNs who continue their education are the clearest path to a more representative workforce.

As of the most recent data, 32% of all healthcare practitioners identify as Black, Asian, or Hispanic/Latino/a, even though those groups make up roughly 39% of the U.S. population. Among nurses across the three license types, 33% identify from these groups.

Nursing compared to healthcare overall

Racial diversity in nursing has outpaced the broader healthcare industry in most years since 2003. The only exceptions were 2004 and 2005, both years that saw a drop in LPNs across all groups.

From 2003 to 2022, representation of nurses of color rose 10 percentage points, compared with 9.5 points for healthcare as a whole. Registered nurses, more than three million strong, make up the largest share of healthcare workers at 34%, so a more diverse nursing workforce pulls the whole field in the same direction. The gains are real, and the gap is still open.

Representation in nursing

Racial and ethnic representation in nursing has climbed slowly and steadily for two decades and has never been higher. In 2003, 23% of LPNs, RNs, and NPs were Black, Asian, or Hispanic/Latino/a. By 2022 that figure reached 33%.

Black representation among LPNs has topped 20% for two decades, well above the Black share of the U.S. population (about 13.6% per the 2020 census). In 2022, 29.1% of LPNs were Black. Among RNs, 31.5% identified as Black, Asian, or Hispanic that year. Representation is lowest among NPs, where 22.8% identified as people of color.

The studies on culturally concordant care focus mostly on physicians and providers like NPs sharing a patient's race or ethnicity. They find that when patient and provider share a background, the patient is more likely to disclose sensitive information, follow the treatment plan, and see better outcomes, largely because the provider can build a more culturally competent plan.

Black representation

Black nurses have made up the largest share of LPNs, RNs, and NPs among underrepresented groups every year since 2003, consistently above 10% across all three levels. Asian and Hispanic/Latino/a representation has stayed below 10% over the same span. Black representation has been highest among LPNs throughout.

In 2022, Black representation among RNs hit its peak at 14.5%, just above the 13.6% Black share of the population. Black LPNs made up 29.1% of that workforce.

Asian representation

Asian nurses make up a smaller share than Black or Hispanic nurses. Across all three license types, Black nurses outnumber Asian nurses nearly two to one. Asian representation peaked in 2018 at 8.4% of nurses across all levels and held roughly steady through 2022, above the 6.3% Asian share of the U.S. population. Relatively strong representation among Asian LPNs and NPs drives the overall figure.

Hispanic or Latino/a representation

Hispanic and Latino/a representation across the three levels trended gradually upward most years from 2003 to 2022, driven mainly by slow growth in registered nursing. Representation among LPNs and NPs has been less consistent. Hispanic representation among LPNs dropped from 13.9% to 10.1% in 2016, and both LPN and NP figures slipped again from 2021 to 2022.

The group peaked in 2021 at 9.3% of nurses across all three types, then fell to 8.6% in 2022. It remains unclear what drove the decline. Either way, Hispanic and Latino/a people are underrepresented in nursing relative to their roughly 19% share of the U.S. population.

How to increase representation

The biggest gap sits at the top of the pipeline. Representation among NPs and nurse educators runs at least 10 percentage points below the combined LPN, RN, and NP figure. In 2021, only 19.2% of nurse educators came from underrepresented groups; in 2022, 22.8% of NPs did. That matters because NPs and educators shape care and the workforce for underserved communities. NPs who share a patient's cultural background tend to communicate more effectively and bring a fuller understanding of the patient's history, which can improve outcomes and satisfaction.

Focusing recruitment on practicing LPNs and RNs who want to continue into registered nursing, advanced practice, or nursing education is the most direct lever. The American Association of Colleges of Nursing pushes the same goals: more diverse faculty, more funding for nursing education, and more mentorship.

Professional organizations

When only a third of nurses come from underrepresented groups, building representation is hard to do alone. Organizations like the National Black Nurses Association (NBNA), the National Association of Hispanic Nurses (NAHN), and the Asian American Pacific Islander Nurses Association (AAPINA) exist for exactly this. They offer networking, mentorship, and financial assistance to help nurses of color start and advance their careers.

The NBNA's mentorship program runs three tiers: beginner for students and new nurses, intermediate for nurses moving into a graduate program or management, and advanced for those pursuing doctoral degrees or leadership roles like chief nursing officer. The NAHN runs its own mentorship program, open after you sign up as a mentee. All three host networking events even where one-on-one mentorship is not available.

Paying for school

Nursing school runs anywhere from $8,000 to $120,000 depending on whether you earn a two-year ADN or a four-year BSN, attend public or private, and live on or off campus. Grants and scholarships, which you do not repay, can close much of that gap, and some target underrepresented or first-generation nursing students specifically.

Career options

To enter nursing, you can earn an ADN or BSN and become an RN. If four years of full-time study is not realistic, start with a one-year LPN program or a two-year ADN, then earn a BSN later through an RN-to-BSN or bridge program once you have the time and money. Current nurses can take the next step by becoming a charge nurse, precepting students, or joining hospital committees. If you want to advance while staying in clinical practice, consider an NP or another advanced practice role. About 70% of NPs deliver primary care, so specializing there lets you directly improve outcomes in your community.

To move off the clinical side, nursing leadership and nurse educator roles let you train the next generation, including students from underserved communities. These roles require a graduate degree (an MSN or doctorate) and several years of experience. More diversity in faculty tends to draw more underrepresented students into the profession.

Methodology and limitations

The representation figures were calculated from the BLS Current Population Survey, 2003 through 2022, for LPNs, RNs, and NPs. Each group's percentage was multiplied by the total number of nurses in that license type per year to estimate counts, then combined across license types to find overall representation.

A few limits apply. The 2010 census changed occupation classifications, so pre-2011 data is not directly comparable to later years; before 2011, BLS counted NPs as RNs. The trend held steady across the change, so earlier data is included. The data covers Black, Asian, and Hispanic individuals only, omitting multiracial and Indigenous nurses. People who identify as Hispanic or Latino/a may be of any race. Certified nurse anesthetists and certified nurse midwives are excluded because BLS does not track demographics for roles under 50,000 workers. BLS also notes that 2020 data is not strictly comparable to other years.