Concern grows around US health-care workforce shortage: ‘We don’t have enough doctors’ | CNN



CNN
 — 

There is mounting concern among some US lawmakers about the nation’s ongoing shortage of health-care workers, and the leaders of historically Black medical schools are calling for more funding to train a more diverse workforce.

As of Monday, in areas where a health workforce shortage has been identified, the United States needs more than 17,000 additional primary care practitioners, 12,000 dental health practitioners and 8,200 mental health practitioners, according to data from the Health Resources & Services Administration. Those numbers are based on data that HRSA receives from state offices and health departments.

“We have nowhere near the kind of workforce, health-care workforce, that we need,” Vermont Sen. Bernie Sanders told CNN on Friday. “We don’t have enough doctors. We don’t have enough nurses. We don’t have enough psychologists or counselors for addiction. We don’t have enough pharmacists.”

The heads of historically Black medical schools met with Sanders in a roundtable at the Morehouse School of Medicine in Atlanta on Friday to discuss the nation’s health-care workforce shortage.

The health-care workforce shortage is “more acute” in Black and brown communities; the Black community constitutes 13% of the US population, but only 5.7% of US physicians are Black, said Sanders, chairman of the Senate Committee on Health, Education, Labor, and Pensions.

“What we’re trying to do in this committee – in our Health, Education, Labor Committee – is grow the health-care workforce and put a special emphasis on the needs to grow more Black doctors, nurses, psychologists, et cetera,” Sanders said.

At Friday’s roundtable, the leaders of the Morehouse School of Medicine, Meharry Medical College, Howard University and Charles R. Drew University called for more resources and opportunities to be allocated to their institutions to help grow the nation’s incoming health-care workforce.

“Allocating resources and opportunities matter for us to increase capacity and scholarships and programming to help support these students as they matriculate through,” Dr. Valerie Montgomery Rice, president of the Morehouse School of Medicine, told CNN.

“But also, the other 150-plus medical schools, beyond our four historically Black medical schools, owe it to the country to increase the diversity of the students that they train,” Rice said, adding that having a health-care workforce that reflects the communities served helps reduce the health inequities seen in the United States.

Historically Black medical schools are “the backbone for training Black doctors in this country,” Dr. Hugh Mighty, senior vice president for health affairs at Howard University, said at Friday’s event. “As the problem of Black physician shortages rise, within the general context of the physician workforce shortage, many communities of need will continue to be underserved.”

A new study commissioned by the National Institute on Minority Health and Health Disparities estimates that the economic burden of health inequities in the United States has cost the nation billions of dollars. Such inequities are illustrated in how Black and brown communities tend to have higher rates of serious health outcomes such as maternal deaths, certain chronic diseases and infectious diseases.

The researchers, from Johns Hopkins University and other institutions, analyzed excess medical care expenditures, death records and other US data from 2016 through 2019. They took a close look at health inequities in the cost of medical care, differences in premature deaths and the amount of labor market productivity that has been lost due to health reasons.

The researchers found that, in 2018, the economic burden of health inequities for racial and ethnic minority communities in the United States was up to $451 billion, and the economic burden of health inequities for adults without a four-year college degree was up to $978 billion.

“These findings provide a clear and important message to health care leaders, public health officials, and state and federal policy makers – the economic magnitude of health inequities in the US is startlingly high,” Drs. Rishi Wadhera and Issa Dahabreh, both of Harvard University, wrote in an editorial that accompanied the new study in the journal JAMA.

The Covid-19 pandemic “pulled the curtain back” on health inequities, such as premature death and others, Rice said, and “we saw a disproportionate burden” on some communities.

“We saw a higher death rate in Black and brown communities because of access and fear and a whole bunch of other factors, including what we recognize as racism and unconscious bias,” Rice said.

“We needed more physicians, more health-care providers. So, we already know when we project out to 2050, we have a significant physician shortage based on the fact that we cannot educate and train enough health care professionals fast enough,” she said. “We can’t just rely on physicians. We have to rely on a team approach.”

She added that the nation’s shortage of health-care workers leaves the country ill-prepared to respond to future pandemics.

The United States is projected to face a shortage of up to 124,000 physicians by 2034 as the demand outpaces supply, according to the Association of American Medical Colleges.

The workforce shortage means “we’re really not prepared” for another pandemic, Sanders said.

“We don’t have the public health infrastructure that we need state by state. We surely don’t have the doctors and the nurses that we need,” Sanders said. “So what we are trying to do now is to bring forth legislation, which will create more doctors and more nurses, more dentists, because dental care is a major crisis in America.”

In March, Bill McBride, executive director of the National Governors Association, wrote a letter to Sanders and Louisiana Sen. Bill Cassidy detailing the “root causes” of the health-care workforce shortage and potential ways some states are hoping to tackle the crisis.

“Governors have taken innovative steps to address the healthcare workforce shortage facing their states and territories by boosting recruitment efforts, loosening licensing requirements, expanding training programs and raising providers’ pay,” McBride wrote.

“Shortages in healthcare workers is not a new challenge but has only worsened in the past three years due to the COVID-19 pandemic. Burnout and stress have only exacerbated this issue,” he wrote. “The retirement and aging of an entire generation is front and center of the healthcare workforce shortage, particularly impacting rural communities.”

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Chinese postpartum confinement, called ‘zuo yue zi,’ is gaining Western appeal | CNN


Hong Kong
CNN
 — 

You cannot carry heavy things. You should sleep more. No working. No household chores.

And the list goes on as Carol Chan explained her postpartum instructions for new mom Taylor Richard.

Chan is a “pui yuet,” also called a confinement nanny, who lives with families after a baby is born. She prepares meals and herbal medicines, takes care of the baby and provides guidance on being a new mother.

Richard, a content creator from Canada, traveled to Hong Kong to become a model and fell in love with her husband, Tom, there. They married in November 2018, and Richard gave birth to their son, Levi, in March 2022.

Richard decided to hire Chan, who lived with the family for a month and spent an additional month helping out.

Richard vlogged about her experience with Chan on her YouTube channel, and that video went viral with 2.9 million views. The reaction was mostly admiration and praise from Richard’s primarily Western followers.

The concept of Chinese confinement — “zuo yue zi,” or “sitting the month”— is when a new mother stays at home for one month to allow her body to rest after giving birth.

During that time, the pui yuet makes dishes catering to the mother’s physical needs and helps her with milk production and other concerns. The pui yuet also cares for the mother with massage, body wraps and lessons on how to take care of the new baby.

Richard and Chan declined to share the cost of Chan’s services. Few entities track the pricing of nannies in Hong Kong on a consistent basis because most negotiations are directly between clients and the nannies.

The estimated cost for a pui yuet in Hong Kong ranges from 63,800 Hong Kong dollars (US $8,100) to 268,000 Hong Kong dollars (US $34,100) for 26 to 30 nights for a live-in nanny, according to a 2021 survey by the Consumer Council, a statutory body in Hong Kong dedicated to protecting consumer rights. The council, which surveyed 19 companies or organizations that provide postnatal care, also reported that the cost of a pui yuet working eight hours a day for 26 days ranges from 21,000 Hong Kong dollars (US $2,600) to 34,000 Hong Kong dollars (US $4,300).

This tradition isn’t without criticism, and some have questioned whether the traditional methods of confinement in the Chinese community are too extreme and may be dangerous. In 2015, a new mother in Shanghai following the custom died of heatstroke after wrapping herself in a quilt and turning off the air conditioner, state media reported.

Chan has gotten calls from the US and UK to be a pui yuet after a YouTube video about her went viral.

In recent years, some people have adapted the tradition to more modern ways, taking advantage of available technology. It’s important to turn the air conditioner on when the weather is hot, Chan said, or else you could get sick. The traditional practice had been to avoid anything cold regardless of the weather.

Richard, now 34, said she loved the time she spent with Chan.

“It meant everything! My husband and I both don’t have any family members in Hong Kong, and as new parents we were pretty clueless,” she said via email. “Having someone take care of my body and gently guide me through my transition into motherhood made for a very positive beginning of my baby’s life. I’m forever grateful for Carol!”

Richard was the first Western mother whom Chan cared for in her 12-year career. But since Richard’s YouTube video went viral, Chan said she’s gotten calls from Westerners asking for her services from as far away as the United States and United Kingdom. She’s now headed to Vancouver, British Columbia, in July to work as a pui yuet for a family there for a month.

The kind of care Richard received is expensive, whether the new parents live in Hong Kong or elsewhere. One US location, Boram Postnatal Retreat, opened last year in New York City.

“It was very challenging to get the concept received by others,” cofounder Boram Nam told CNN. “It was a lot about the education process — information is abundant up to until you give birth, and the spotlight completely shifts over to the baby — so we get into that discussion, and people get it.”

Cofounder Boram Nam opened Boram Postnatal Retreat last year in New York for new mothers.

But her program comes with a hefty price tag, starting at three nights for $2700.

“This is the price we do need to charge for the level of service that we provide within the guidelines of what postpartum care looks like in the US,” said Nam, adding that she hopes eventually to get services covered by insurance. “We want to make sure this can be accessible by others, by more women, a more diverse group of people.”

Mandy Major, owner of Major Care, a virtual postpartum doula service based in the US, has noticed a lack of postpartum education in her country.

“We have a lack of systematic postpartum here within our health care system,” Major said. “We have a go-go, hyper-productive, hyper-independent culture, but we also don’t have paid leave.”

Richard’s mostly Western followers on YouTube noted that pressure, commenting on the luxury of taking a month off to spend time recovering and connecting with their babies.

“As an American woman who has given birth 4 times and been booted immediately out of the hospital expected to figure it all out on my own, I can undoubtedly say had this been an option, it may have changed my whole mothering experiences!!” one person said.

“I returned to work 2 weeks postpartum in America,” another mother wrote. “I never felt that I was able to fully bond with my child.”

The month of confinement came to an end for Richard last April. In Richard’s YouTube video, Chan holds Levi one last time and passes him back to his mother as she put her shoes on to leave.

Richard’s eyes begin to fill with tears, surprising herself at her emotional reaction.

“I feel like I’m losing a family member,” she says as the door slowly closes behind Chan, according to the video.

Even after the confinement experience, Chan remains close with Richard’s family, stopping by for lunch occasionally and still giving baby advice.

“If I have another baby, I would love to have it in Canada with my family, but I want Carol to come with me if I do!” Richard said in a video chat later, smiling. “I can’t imagine going through this again without her.”

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The haunting Masters meltdown that changed Rory McIlroy’s career | CNN



CNN
 — 

Slumped on his club, head buried in his arm, Rory McIlroy looked on the verge of tears.

The then-21-year-old had just watched his ball sink into the waters of Rae’s Creek at Augusta National and with it, his dream of winning The Masters, a dream that had looked so tantalizingly close mere hours earlier.

As a four-time major winner and one of the most decorated names in the sport’s history, few players would turn down the chance to swap places with McIlroy heading into Augusta this week.

Yet on Sunday afternoon of April 10, 2011, not a golfer in the world would have wished to be in the Northern Irishman’s shoes.

A fresh-faced, mop-headed McIlroy had touched down in Georgia for the first major of the season with a reputation as the leading light of the next generation of stars.

An excellent 2010 had marked his best season since turning pro three years earlier, highlighted by a first PGA Tour win at the Quail Hollow Championship and a crucial contribution to Team Europe’s triumph at the Ryder Cup.

Yet despite a pair of impressive top-three finishes at the Open and PGA Championship respectively, a disappointing missed cut at The Masters – his first at a major – served as ominous foreshadowing.

McIlroy shot 74 and 77 to fall four strokes short of the cut line at seven-over par, a performance that concerned him enough to take a brief sabbatical from competition.

But one year on in 2011, any lingering Masters demons looked to have been exorcised as McIlroy flew round the Augusta fairways.

Having opened with a bogey-free seven-under 65 – the first time he had ever shot in the 60s at the major – McIlroy pulled ahead from Spanish first round co-leader Alvaro Quirós with a second round 69.

It sent him into the weekend holding a two-shot cushion over Australia’s Jason Day, with Tiger Woods a further stroke behind and back in the hunt for a 15th major after a surging second round 66.

And yet the 21-year-old leader looked perfectly at ease with having a target on his back. Even after a tentative start to the third round, McIlroy rallied with three birdies across the closing six holes to stretch his lead to four strokes heading into Sunday.

McIlroy drives from the 16th tee during his second round.

The youngster was out on his own ahead of a bunched chasing pack comprising Day, Ángel Cabrera, K.J. Choi and Charl Schwartzel. After 54 holes, McIlroy had shot just three bogeys.

“It’s a great position to be in … I’m finally feeling comfortable on this golf course,” McIlroy told reporters.

“I’m not getting ahead of myself, I know how leads can dwindle away very quickly. I have to go out there, not take anything for granted and go out and play as hard as I’ve played the last three days. If I can do that, hopefully things will go my way.

“We’ll see what happens tomorrow because four shots on this golf course isn’t that much.”

McIlroy finished his third round with a four shot lead.

The truth can hurt, and McIlroy was about to prove his assessment of Augusta to be true in the most excruciating way imaginable.

His fourth bogey of the week arrived immediately. Having admitted to expecting some nerves at the first tee, McIlroy sparked a booming opening drive down the fairway, only to miss his putt from five feet.

Three consecutive pars steadied the ship, but Schwartzel had the wind in his sails. A blistering birdie, par, eagle start had seen him draw level at the summit after his third hole.

A subsequent bogey from the South African slowed his charge, as McIlroy clung onto a one-shot lead at the turn from Schwartzel, Cabrera, Choi, and a rampaging Woods, who shot five birdies and an eagle across the front nine to send Augusta into a frenzy.

Despite his dwindling advantage and the raucous Tiger-mania din ahead of him, McIlroy had responded well to another bogey at the 5th hole, draining a brilliant 20-foot putt at the 7th to restore his lead.

The fist pump that followed marked the high-water point of McIlroy’s round, as a sliding start accelerated into full-blown free-fall at the par-four 10th hole.

His tee shot went careening into a tree, ricocheting to settle between the white cabins that separate the main course from the adjacent par-three course. It offered viewers a glimpse at a part of Augusta rarely seen on broadcast, followed by pictures of McIlroy anxiously peering out from behind a tree to track his follow-up shot.

McIlroy watches his shot after his initial drive from the 10th tee put him close to Augusta's cabins.

Though his initial escape was successful, yet another collision with a tree and a two-putt on the green saw a stunned McIlroy eventually tap in for a triple bogey. Having led the field one hole and seven shots earlier, he arrived at the 11th tee in seventh.

By the time his tee drive at the 13th plopped into the creek, all thoughts of who might be the recipient of the green jacket had long-since switched away from the anguished youngster. It had taken him seven putts to navigate the previous two greens, as a bogey and a double bogey dropped him to five-under – the score he had held after just 11 holes of the tournament.

Mercifully, the last five holes passed without major incident. A missed putt for birdie from five feet at the final hole summed up McIlroy’s day, though he was given a rousing reception as he left the green.

Mere minutes earlier, the same crowd had erupted as Schwartzel sunk his fourth consecutive birdie to seal his first major title. After starting the day four shots adrift of McIlroy, the South African finished 10 shots ahead of him, and two ahead of second-placed Australian duo Jason Day and Adam Scott.

McIlroy’s eight-over 80 marked the highest score of the round. Having headlined the leaderboard for most of the week, he finished tied-15th.

McIroy was applauded off the 18th green by the Augusta crowd after finishing his final round.

Tears would flow during a phone call with his parents the following morning, but at his press conference, McIlroy was upbeat.

“I’m very disappointed at the minute, and I’m sure I will be for the next few days, but I’ll get over it,” he said.

“I was leading this golf tournament with nine holes to go, and I just unraveled … It’s a Sunday at a major, what it can do.

“This is my first experience at it, and hopefully the next time I’m in this position I’ll be able to handle it a little better. I didn’t handle it particularly well today obviously, but it was a character-building day … I’ll come out stronger for it.”

Once again, McIlroy would be proven right.

Just eight weeks later in June, McIlroy rampaged to an eight-shot victory at the US Open. Records tumbled in his wake at Congressional, as he shot a tournament record 16-under 268 to become the youngest major winner since Tiger Woods at The Masters in 1997.

McIlroy celebrated a historic triumph at the US Open just two months after his Masters nightmare.

The historic victory kickstarted a golden era for McIlroy. After coasting to another eight-shot win at the PGA Championship in 2012, McIlroy became only the third golfer since 1934 to win three majors by the age of 25 with triumph at the 2014 Open Championship.

Before the year was out, he would add his fourth major title with another PGA Championship win.

And much of it was owed to that fateful afternoon at Augusta. In an interview with the BBC in 2015, McIlroy dubbed it “the most important day” of his career.

“If I had not had the whole unravelling, if I had just made a couple of bogeys coming down the stretch and lost by one, I would not have learned as much.

“Luckily, it did not take me long to get into a position like that again when I was leading a major and I was able to get over the line quite comfortably. It was a huge learning curve for me and I needed it, and thankfully I have been able to move on to bigger and better things.

“Looking back on what happened in 2011, it doesn’t seem as bad when you have four majors on your mantelpiece.”

A two-stroke victory at Royal Liverpool saw McIlroy clinch the Open Championship in 2014.

McIlroy’s contentment came with a caveat: it would be “unthinkable” if he did not win The Masters in his career.

Yet as he prepares for his 15th appearance at Augusta National this week, a green jacket remains an elusive missing item from his wardrobe.

Despite seven top-10 finishes in his past 10 Masters outings, the trophy remains the only thing separating McIlroy from joining the ranks of golf immortals to have completed golf’s career grand slam of all four majors in the modern era: Gene Sarazen, Ben Hogan, Gary Player, Jack Nicklaus, and Tiger Woods.

The Masters is the only major title to elude McIlroy.

A runner-up finish to Scottie Scheffler last year marked McIlroy’s best finish at Augusta, yet arguably 2011 remains the closest he has ever been to victory. A slow start in 2022 meant McIlroy had begun Sunday’s deciding round 10 shots adrift of the American, who teed off for his final hole with a five-shot lead despite McIlroy’s brilliant 64 finish.

At 33 years old, time is still on his side. Though 2022 extended his major drought to eight years, it featured arguably his best golf since that golden season in 2014.

And as McIlroy knows better than most, things can change quickly at Augusta National.

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Lovie Smith said the NFL had ‘a problem’ about Black coaches. A year later he was fired and the league is being criticized yet again about its lack of diversity | CNN



CNN
 — 

When Lovie Smith was hired by the Houston Texans in February 2022 as the team’s new head coach, he said the NFL had “a problem” with hiring Black coaches and diversity.

“I realize the amount of Black head coaches there are in the National Football League,” Smith told reporters just under a year ago.

“There’s Mike Tomlin and I think there’s me, I don’t know of many more. So there’s a problem, and it’s obvious for us. And after there’s a problem, what are you going to do about it?”

Smith was fired Monday at the end of his one and only season at the helm of the Texans, finishing with a record of 3-13-1.

Smith is the second Black coach in two years to be relieved of his duties by the Texans, which fired David Culley at the end of the 2021 season.

Smith’s time in charge wasn’t full of wins and high points – though his parting gift to the organization was a last-minute Hail Mary victory over the Indianapolis Colts, which saw them relinquish the No. 1 pick in the 2023 NFL draft to the Chicago Bears. But his Texans team showed togetherness and competence, traits often desired by outfits undergoing a rebuild.

Houston general manager Nick Caserio said Smith’s firing was the best decision for the team right now.

“On behalf of the entire organization, I would like to thank Lovie Smith for everything he has contributed to our team over the last two seasons as a coach and a leader,” Caserio said in a statement.

“I’m constantly evaluating our football operation and believe this is the best decision for us at this time. It is my responsibility to build a comprehensive and competitive program that can sustain success over a long period of time. We aren’t there right now, however, with the support of the McNair family and the resources available to us, I’m confident in the direction of our football program moving forward.”

But the firing of the 64-year-old coach, the Texans organization as a whole, and the measures implemented by the league to promote diversity have been heavily criticized by former players and TV pundits.

“The Houston Texans have fired Lovie Smith after 1 year. Using 2 Black Head Coaches to tank and then firing them after 1 year shouldn’t sit right with anyone,” former NFL quarterback Robert Griffin III tweeted Sunday, when news of Smith’s firing broke.

On ESPN, Stephen A. Smith and NFL Hall of Famer Michael Irvin also condemned the decision. Smith called the Texans organization an “atrocity.”

“They are an embarrassment. And as far as I’m concerned, if you’re an African American, and you aspire to be a head coach in the National Football League, there are 31 teams you should hope for. You should hope beyond God that the Houston Texans never call you,” Smith said.

Irvin said Black coaches are being used as “scapegoats” by the Texans.

“It’s a mess in Houston and they bring these guys in and they use them as scapegoats. And this is what African American coaches have been yelling about for a while and it’s blatant, right in our face,” he said.

When CNN contacted the Texans for comment, the team highlighted the moment at Monday’s news conference when Caserio was asked why any Black coach would consider working for the team, and his response was that individual candidates would have to make their own choices.

Smith on the sidelines during a game against the Indianapolis Colts.

“In the end it’s not about race. It’s about finding quality coaches,” the general manager said. “There’s a lot of quality coaches. David (Culley) is a quality coach. Lovie (Smith) is a quality coach.

“In the end, each coach has their own beliefs. Each coach has their own philosophy. Each coach has their comfort level about what we’re doing. That’s all I can do is just be honest and forthright, which I’ve done from the day that I took this job, and I’m going to continue to do that and try to find a coach that we feel makes the most sense for this organization. That’s the simplest way I can answer it, and that’s my commitment.

“That’s what I’m hired to do, and that’s what I’m in the position to do. At some point, if somebody feels that that’s not the right decision for this organization, then I have to respect that, and I have to accept it.”

CNN has reached out to Lovie Smith for comment.

At the beginning of the 2022 season, NFL.com reported Smith was one one of just six minority head coaches in the NFL, a low number in a league where nearly 70% of the players are Black.

Since Art Shell was hired by the Los Angeles Raiders in 1989 as the first Black head coach in modern history, there have been 191 people hired as head coaches, but just 24 have been Black.

However, the NFL has taken steps to increase diversity in the coaching ranks.

Notably, in 2003, the NFL introduced the Rooney Rule to improve hiring practices in a bid to “increase the number of minorities hired in head coach, general manager, and executive positions.”

But the Rooney Rule hasn’t been an unqualified success.

In 2003, the Detroit Lions were fined $200,000 for not interviewing any minority coaches before hiring Steve Mariucci as their new head coach.

In response to criticism, the NFL announced it was setting up a diversity advisory committee of outside experts to review its hiring practices last March. Teams would also be required to hire minority coaches as offensive assistants.

Despite changes to the rule being implemented in recent years to strengthen it, a 2022 lawsuit alleges that some teams have implemented “sham” interviews to fulfill the league’s diversity requirements.

Last February, former Miami Dolphins head coach Brian Flores filed a federal civil lawsuit against the NFL, the New York Giants, the Denver Broncos and the Miami Dolphins organizations alleging racial discrimination.

Flores looks on during his time as the head coach of the Miami Dolphins during a game against the New York Jets.

Flores, who is Black, said in his lawsuit that the Giants interviewed him for their vacant head coaching job under disingenuous circumstances.

Two months after submitting the initial lawsuit, Flores added the Texans to it, alleging the organization declined to hire him this offseason as head coach “due to his decision to file this action and speak publicly about systemic discrimination in the NFL.”

In response to the lawsuit, the Texans said their “search for our head coach was very thorough and inclusive.”

The NFL called Flores’ allegations meritless.

“The NFL and our clubs are deeply committed to ensuring equitable employment practices and continue to make progress in providing equitable opportunities throughout our organizations,” the league said in response to the lawsuit.

“Diversity is core to everything we do, and there are few issues on which our clubs and our internal leadership team spend more time. We will defend against these claims, which are without merit.”

But 12 months after firing their last Black head coach, the Texans have fired another one.

“How do you hire two African Americans, leave them one year and then get rid them?” questioned NFL Hall of Famer Irvin.

“You know the mess that Houston is,” Irvin added. “We get the worst jobs and we don’t get the opportunity to fix the worst jobs, just like this.

“I don’t know any great White coach that would take the (Texans) job unless you give them some guarantees. ‘You’re going to have to guarantee me four years to turn this place around.’ But the African American coaches can’t come in with that power because Lovie wouldn’t have got another job.

“This was his last chance to get back into the NFL and you have to take what’s on the table to try to change that.”

Irvin speaks on media row ahead of Super Bowl LVI on February 10, 2022 in Los Angeles.

The Texans are now searching for a new head coach under general manager Caserio. The new appointment will be Caserio’s third coach in the role: It is almost unprecedented for a general manager to get the opportunity to hire a third head coach with the same team.

Texans chairman and CEO Cal McNair said he would take on a more active role in the hiring process. The next head coach will be the organization’s fourth in three years.

According to the NFL, the Texans have requested to speak to five candidates already about filling Smith’s position, a list that includes two Black coaches.

After Smith was hired in March 2021, McNair said: “I’ve never seen a more thorough, inclusive, and in-depth process than what Nick (Caserio) just went through with our coaching search.”

At that introductory news conference, Smith spoke candidly about how to bring greater diversity to the NFL coaching ranks.

“People in positions of authority throughout – head coaches, general managers – you’ve got to be deliberate about trying to get more Black athletes in some of the quality control positions just throughout your program. If you get that, they can move up, that’s one way to get more.”

Smith continued: “It’s not just an interview, if you’re interviewing a Black guy. It’s about having a whole lot of guys to choose from that look like me. And it’s just not about talk. You look at my staff, that’s what I believe in. And letting those guys show you who they are. That’s how we can increase it, then it’s left up to people to choose. We all have an opportunity to choose, and that’s how I think we’ll get it done.”



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