NURSES OF AFRICAN DESCENT AND CAREER ADVANCEMENT YVONNE WESLEY, RN, PHD, FAAN* AND MAY T. DOBAL, PHD, RN The purpose of this article is to evaluate a leadership institute designed to promote career advancement and leadership in administration, education, and research among nurses of African descent. Government reports indicate that Black Americans receive lower quality health care than other racial groups even when insurance and income are equal. Moreover, the literature suggests that less than 10% of practicing professional nurses in America are Black—and of these, less than 1% are in senior executive leadership positions. However, the literature lacks detailed discussion of the effectiveness of leadership programs. This article provides an in-depth look at a leadership institute for Black nurses and outlines the impact of the program. (Index words: Leadership; Mentoring; Nurses; African Americans; Blacks; Career Advancement; Program Evaluation) J Prof Nurs 25:122–126, 2009. © 2009 Elsevier Inc. All rights reserved. D ISPARITIES IN HEALTH outcomes are a well- known national problem. Specifically, people of African descent have poorer health outcomes than other racial and ethnic groups. Unfortunately, Black Ameri- cans 1 receive lower quality health care than other groups even when insurance and income are equal, according to government reports. The Institute of Medicine (IOM) report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, highlights the need to increase the proportion of underrepresented minorities among health professionals. In response to empirical findings of unequal treatment, the report recommends that “affirma- tive action and other efforts are needed to increase the proportion of underrepresented U.S. racial and ethnic minorities among health professionals” (p. 186). How- ever, just increasing the number of Black nurses is not sufficient to reverse the unequal burden of disease. It is essential that we have greater participation in health care decision making. We need to develop a pipeline so that Black nurses can mentor and be mentored at all levels in health care organizations, academic institutions, and community organizations. The report also notes that a comprehensive strategy to eliminate racial disparities in health care includes the rationale that it makes good business sense to attract workers who reflect the target population and have multiple perspectives incorporated in health care decision making. Moreover, the American Public Health Association (APHA) recommends aggressive action to address dis- parities that include developing diverse health providers as well as a diverse public health workforce. Although nurses are central to health care and represent a larger portion of the health workforce, there is limited representation at senior and executive management levels. Based on the demographics of the nursing profession and nursing leadership, there are scant numbers of Black nursing leaders who are in positions to (a) participate in decision making at the highest levels, (b) minimize/ eliminate racial and ethnic disparities in health care, or (c) change policy (Satcher & Pamies, 2006). Nationally, the population is becoming more diverse, and most health care organizations treat racially, ethnically, and culturally diverse clients. Although nurses of African descent are represented at staff and middle management levels, they are underrepresented at upper and top management levels. Consequently, there are few people of African descent in decision-making positions and inade- quate congruence between those in decision-making positions and those being treated. This lack of congruence limits the organization's responsiveness to the needs of those being served (Greene, 2007). This is most apparent in the area of health disparities and acts as a barrier to reducing or eliminating health disparities based on race. Clearly, the elimination of health disparities is complex and expands far beyond any one-shot remedy. Many approaches have been suggested including recommenda- *Independent Health Consultant. Address correspondence to Dr. Wesley: 46 East Cherry Street, Rahway, NJ 07065, USA. E-mail: ywesley@earthlink.net 8755-7223/$ - see front matter 1 In the United States, nurses of African descent are generally referred to as African American, African Caribbean, or African immigrants. We acknowledge the African Diaspora and the diversity among people of African descent. Therefore, in this article, nurses of African descent will be referred to as Black. Journal of Professional Nursing, Vol 25, No 2 (March–April), 2009: pp 122–126 122 A 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.profnurs.2008.08.005