Introduction
The ethnic and racial configuration of the U.S. populations into the future will be diverse and to create a truly sustainable and prosperous nation, diversity and inclusion must be effectively entrenched as a matter of public policy. Diversity has a critical value in the healthcare sector in the United States because it has been a federal policy to expand access and inclusivity particularly in the key public sectors of education and health. Diversity has the positive effect of increasing access to medical care for underserved populations and such populations will see physicians and general practitioners with whom they share culture or ethnicity. Globally, and across the United States, increased international immigration has yielded multiculturalism within every local community and society should adjust, particularly in the fields of medical services to embrace diversity and inclusion to ensure a future of progress (Hokkanen & Löf, 2019). Within a medical facility, increasing the workforce diversity from 10 percent to a possible 30 percent is a critical developmental milestone. The benefits of such a policy are numerous because an inclusive workforce has a higher chance for higher productivity because of the convergence of diverse views, cultural competencies, and greater readiness to render quality care for diverse populations and demographics due to a cultivated culture of tolerance.

Literature Review
The U.S. medical and healthcare system is one of the most competitive in the world and this implies massive engagement among agencies and hospitals to advance research, teaching, and modeling solutions to address complex healthcare challenges. However, lack of diversity has led to persistent challenges in the medical sector because certain social segments have lacked representation among the ranks and cadres of practitioners, which only yields suspicions and negative conspiracy theories. Adequate representation of all categories of social, ethnic and racial groups through inclusion will yield greater access to marginalized sections and greater participation (Rataul, 2016). High cost of training in the medical fields is one of the leading causes of lack of representation of certain social classes and ethnic groups in the medical fields. However, effective inclusion programs can be addressed through a robust mechanism involving public-private partnerships and affirmative action to resolve the existing disparities.
The public health planning functions have devised methods of rationalizing factors that lead to exclusion for critically disadvantaged populations and minorities with the aim of establishing the grounds for equitable access to healthcare. However, a disproportionate process favors white population and excludes a large number of other demographic sets forever persists. The need to take up inclusion and diversity agenda as a matter of managerial and strategic concern for public health suffices. Medical insurance, which is often associated with income levels, age, and the severity of one’s health conditions, have always been adversely tilted for a critical mass of the racial minority peoples of America. A robust inclusion program that carters for such skewed situation is thus a suitable objective because of the growing interest in charity care and other public welfare programs targeting the disadvantaged populations in healthcare access.
According to the critical race theory, all forms of discrimination and subjugation of a people through subtle methods in society create far greater social and economic harm, which affect behavior, distorts the perceptions, and utterly leads to a wasteful social process in community. The necessity for diversity an inclusion cannot be gainsaid because its gains and rewards to community are immense. A tradition of racial and ethnic balkanization and gentrification cannot yield a sustainable and thriving economy in light of the trends characterized with multiculturalism and cosmopolitanism heading to the future. Diversity and inclusion helps bridges the existing gaps of wide disparities and ensures future business prospects and service delivery in the healthcare sector is sustained (Valentine, Wynn & McLean, 2016). It is ironic that the very people who have been ostracized in the mainstream of the healthcare system are the most diseased and the most deserving of medical care as opposed to relatively elite and upper social class cadres in America.
It is projected that within just a few years to come, the United States will experience a major demographic shift in which a great proportion of the population will not be the dominant white population but minorities from many different ethnicities and races across the globe. Census figures from the year 2000 have demonstrated a rapid rise in the minority populations and in California State, African Americans, Hispanics, Asians, and Native Americans have significantly surpassed the white population. The need to cultivate a culturally competent workforce in the healthcare sector is urgent and these workers should be equipped with adequate understanding of how different cultures embrace medical care in many diverse ways. Cultural competence denotes the critical unawareness of varied family structures, belief systems, cultural biases, ethnicities, and social cadre influence how people experience illness, respond to treatment or adhere to medical guidance. Salient differences between people derived from these variables produce diverse outcomes in the medical and healthcare systems and institutions have to take a critical note of their influence to facilitate a workforce that can deal with the effects into the future.
Leadership in Healthcare Service Delivery and Workforce Management
Healthcare is a complex service-delivery environment, which involves public policy deliberations and massive national budgetary allocations as well as critical concerns of welfare and fraternity concerns. Leadership in the sector and organizational policy orientations have to exhibit not only the quest for profitability but also the preponderance with humanistic concerns and ethical style of management. The quest for diversity and inclusion stems from the primary concerns with human social welfare that views healthcare as a basic human right. Such conceptions have brought forth the necessity to make healthcare not only affordable to the underserved populations but also the need to regulate the sector in manners that improves access to quality care and many other progressive views (Hokkanen & Löf, 2019). Viewed through the global scope of healthcare development concerns, inclusion facilitates the necessary grounds for advancing research and yielding solutions to diverse communities in need of specialized care. Moreover, in an environment that is increasingly risk ridden, for both practitioners and patients, collaboration is inevitable. The healthcare leadership seeks to institute a globally interconnected process that can meet the varied needs of highly differentiated populations.
The Scope of Progressive Diversity in Healthcare
Over the past two decades since the turn of the millennium, the United States has witnessed massive influx of immigrants. Among the younger populations, the United States has attracted a massive influx of international students and technical experts in many diverse fields. Age diversity is thus a vital consideration within today’s and futuristic workplaces across many cities because of sweeping demographic changes across the globe. Moreover, ethnic, tribal, and racial diversity is another important consideration because every local community within the United States exhibits diversity (Jones & Wilsdon, 2018). Diversity of sexual orientation is another critical consideration because many people express diverse sexual orientations. Gender and other aspects of diverse lifestyles constitute healthcare sensitive concerns, which can only be addressed when the caregivers have a social and cultural sensitivity about such diversity concerns. Differences in age, sex, and gender influence health seeking inclinations and behaviors far beyond the ordinary socioeconomic characteristics traditionally thought to the exclusive determinants. Progressive healthcare institutions need diversity within their workforce to keep the pace of change and disruption within the sector and to remain competitive.
Diversity concerns in the healthcare sector have grown exponentially and social class diversity is a critical factor for the effective management of any strategic operations within healthcare institutions. Income levels and educational attainment are critical to the effective management of healthcare systems because they imply different lifestyles, health seeking behaviors and personal care dispositions, which influence health outcomes (Mousa, Massoud & Ayoubi, 2020). Cultural and religious inclinations can equally affect lifestyle choices and dispositions in health and longevity thereby affecting individual healthcare needs and household healthcare needs. Diversity is a practical need in the healthcare sector because it promotes trust and confidence, particularly among the traditionally underrepresented groups of minorities who often have ambivalent views and deeply laid suspicions about the moral rectitude and altruism in the basis of existing practices in the medical sector. Most of the suspicions are validated and justified based on a tradition of racial prejudice, ethnic animosity, and institutionalized cruelty. Nonetheless, the need to institutionalize rectitude is a present urgency.
Challenges and Opportunities Associated with Diversity
Diversity can be a suitable policy objective when it serves the overall good of the healthcare organization. However, as a matter of policy, the federal government in the U.S. tends to favor diversity as a matter of principle because of the gains it holds for the economy. In many instances, the recruitment of new staff in the healthcare systems have considered foreigners co-opted into the United States through immigration programs to fill existing gaps (Figueroa et al., 2019). Such recruitment drives may present complexity because such foreign-trained personnel may lack the appropriate cultural competence to appreciate the reality of diversity and its overbearing burden in a foreign country. Moreover, training and deploying foreign-trained workers in a different country present many questions about competency and work readiness, which are often not effectively addressed (Oyewunmi, 2018). The bid to have inclusive organizations has attracted all manner of initiatives to employ foreign-trained professionals who may have varied challenges. Language barrier is a single important concern that would greatly jeopardize inclusion efforts in many institutions.
Effective anthropological evaluations need to be undertaken to determine the best modalities of executing inclusion programs because diverse categories of people express largely divergent intestates and characterizes of needs and pursuits. However, many human resource professionals do not consider underlying cultural and social differences with a great keenness when addressing inclusion programs. Moreover, sexual orientation has emerged as a critical concern among many groups across the globe and inclusion should address the interests of such categories due to the visibility across the globe. Organizational culture and leadership programs have to adjust to the existing realities of the present time and the future to make a significantly meaningful deliberation on the agenda. Moreover, the inclusion program has to also account for leadership and promotion system, which helps an organization become significantly established for a particular market niche.
Diversity has the salient benefit of improving the benefits the U.S. could derive from health research agenda, the cultivation of a highly culturally competent workforce and the improvement of access to high quality healthcare for traditionally underrepresented social classes. Diversity agenda could also rapidly improve and expand the pool of trained executives who can drive the policy objectives of a truly diverse and competent medical fraternity not only for the United States, but also a world of interconnected institutions in medical services. The only way to revamp the situation of underrepresentation of minorities in the critical fields of medical service is to overhaul the educational pipeline, which has traditionally segregated the other racial groups and made the medical profession predominantly white and male. Affirmative action concerns in policy deliberations about recruitment of minority groups into the medical fraternity has yielded and should be considered the prime approach for inclusion rather than the process in which foreign trained individuals are co-opted into service in the United States. Following the 1978 case of the Regents of the University of California v. Bakke, in which the racial concern was demystified, incremental numbers of minority students have gained access to the Universities for the medical courses.
Recommendations for a Workforce Diversity and Inclusion Policy
Institutional level policies and strategies should align with state-level and national policy deliberations particularly for the sensitive sectors like healthcare. The healthcare system in the United States involves multi-agency systems of collaboration and convergence, which demand that each institution has to embrace the wider scope of policy deliberations and local institutional guidelines. Diversity promoted a feeling of global connectedness, which helps foster a unique approach to work and cultural competency among workers (Sheikh et al., 2017). Diverse workforce also cultivates a spirit of tolerance among workers and helps fosters good relations with clients. Within the healthcare systems, diversity can be a suitable program, which could augment better leadership practices, best management talents from diverse backgrounds and better problem solving.
Cultural diversity is a management challenge that all health institutions have to address effectively as a strategic concern because it influences the clientele characteristics and profitability or economic viability of institutions. Racial and ethnic values are important determents for the health seeking behaviors and choices, which organizations have to consider in an ever increasingly competitive economic environment. A workforce characterized by diversity and inclusivity has the capacity to break the barriers that many distinct social or racial categories may consider in their choices of healthcare institutions. Although diversity and inclusion may compound diverse concerns like ownership characteristics and consequent management concerns, diverse knowledge systems, and cadres, the most important aspect of diversity is that it should cultivate excellence and a spirit of collective clamor for competitiveness and excellent service delivery.
Diversity should be instituted through a clear understanding of the trends and shifts in the epidemiological, demographic, and societal changes reordering many sections of the healthcare sector. Rapid technological advancement and scientific disruption, new environmental realities spelling medical risks, political and economic changes, as well as social advancement across many societies have created a uniquely complex global agenda for medical services. The increased role of varied stakeholders underscores the necessity to inject altruism in the management of exigencies, which in effect justify the need for a diverse and inclusive workforce. Both public and private sector players have demonstrated a great intensity of involvement and the regulatory authorities and their policy deliberations have increased exponentially affecting all health institutions across the globe under the new incidence of collaborative global health governance.
Health leadership seeks to institute collaborative approaches in mitigating the health concerns among low-income communities and marginalized populations globally. At the international level, Sustainable Development Goals (SDGs) which spelled the needs for the ratification of Universal Health Coverage (UHC) continue to prompt leaders to invent new modalities of advancing inclusion and diversity as priority policy positions. In the same spirit, individual healthcare institutions have to embrace both national and international policy directives and priorities to remain competitive and relevant in the rapidly changing environment of healthcare service delivery.
A Model Five-Year Workforce Diversity and Inclusion Program
A five-tear program of diversity and inclusion may involve considerable planning, and budgetary allocations to be directed mainly as recruitment drives and training for inclusion. The entire program should be divided in phases and critical appraisal done at each stage to ensure the right mix of desirable diversity characteristics is achieved. Moreover, job placement and leadership training as well as talent development have to be taken into account as critical concerns in any recruitment drives within the medical sector. The diversity and inclusion program should begin by the assessment and auditing the existing characteristic of the workforce and the specific needs for diversity. The essence of diversity and inclusion is to achieve a certain characteristic and optimal composition of diversity that achieves a stated goal and need within a given institution. Once the specific needs for diversity and inclusion are clear, the selection and deployment of staffs can be regulated and executed effectively.
The robust and ambitious program to advance the inclusion program from 10% to 30% in five years represent a modest ambition which the organization should attain without the need for serious reorganization and change in leadership structures. An accounting process involving the balanced scorecard approach should be tied to the inclusion program so that the direct relations between diversity and institutional performance can be audited and measured progressively. It is also useful to remodel the organizational structure, organizational culture, and leadership styles to embrace the new model based on agile and smart styles and approaches. Diversity and inclusion institutes a cultural change, which has to be ingrained in the organizational process effectively to cultivate excellence. The healthcare sector has attained considerable complexity in many respects and diversity can be a solution to some of the effects of chaos disrupting the sector globally.
Human resource practices of attaining inclusion and diversity within the organization present challenges of training and talent acquisition because when the goal is to attain diversity, sometime qualifications and competence has to be compromised. However, the effective approach in deriving suitable diversity is to create sectors and departments where talent and employee competence does not produce a critical effect on the organizational performance as a short-term strategy. The organization ought to seek employees in the lower ranks from the diverse ethnic and social cadres that are underrepresented and then progressively and steadily seek higher cadre employees to fill senior positions that fall vacant. In that manner, short-term goals and long-term objectives converge in the favor of the organization.
Conclusion
Diversity and inclusion program is a necessary initiative within individual healthcare facilities as a matter of management strategy. The future of healthcare in the United States will undeniably incorporate a multi-agency and multi-stakeholder approach embodying public-private partnership. The emergence of charity care and associated public welfare support programs will increasingly play a critical role in bridging existing gaps in access to healthcare. The recruitment process to have a diverse workforce has to embrace both short-term and long-term outlooks and the convergence in mediating overt outcomes of rapid unsolicited effects of changes in culture. Diversity programs present opportunities and challenges, which have to be managed effectively for any organization to obtain optimal gains from the program. A rapid deployment of diverse people with diverse languages, cultures, attitudes, and social orientations may topple the internal cultural and organizational controls that safeguard organizational leadership and progress. A comprehensive and robust healthcare system has to embrace diversity to be suitably stationed in meeting the challenges of the present times and the future, which will witness increased complexity, chaos, and uncertainty.

References
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Hokkanen, P., & Löf, M. (2019). The multiplicity of work communities in social and healthcare services: Evidence from diversity attitude.
Jones, R., & Wilsdon, J. R. (2018). The biomedical bubble: Why UK research and innovation needs a greater diversity of priorities, politics, places and people.
Mousa, M., Massoud, H. K., & Ayoubi, R. M. (2020). Gender, diversity management perceptions, workplace happiness and organisational citizenship behaviour. Employee Relations: The International Journal.
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Sheikh, K., Josyula, L. K., Zhang, X., Bigdeli, M., & Ahmed, S. M. (2017). Governing the mixed health workforce: learning from Asian experiences. BMJ Global Health, 2(2).
Valentine, P., Wynn, J., & McLean, D. (2016). Improving diversity in the health professions. North Carolina Medical Journal, 77(2), 137-140.