Historically Black Colleges and Universities as anchor institutions for the rural pharmacy workforce.

BACKGROUND: Rural U.S. communities face persistent pharmacist shortages and pharmacy closures that restrict access to medications, chronic disease management, and other essential care. Pharmacy workforce scholarship has paid little attention to Historically Black Colleges and Universities (HBCUs), although they educate a disproportionate share of Black pharmacists, several are located in or near the rural South, and their missions emphasize service to underserved communities. Rural workforce research rarely examines race, and HBCU health professions research rarely examines rural practice, leaving the rural Black South poorly studied.

OBJECTIVES: To develop the Rooted Pathways framework, which positions HBCUs as anchor institutions for recruiting, educating, and retaining rural pharmacists.

METHODS: The framework integrates scholarship on pharmacy education, rural workforce development, social accountability, and community-engaged education.

RESULTS: Rooted Pathways replaces the extractive pipeline metaphor with a root system in which communities help educate students and graduates contribute to the places that formed them. The framework identifies six pathways: mission-driven recruitment, culturally responsive education, longitudinal community partnership, rural experiential learning, concordant mentorship, and service-oriented professional identity formation. It defines dual concordance as shared rural origin and racial or cultural identity and advances seven testable propositions with institutional, policy, and community moderators.

CONCLUSION: Rooted Pathways provides a basis for institutional investment and a research agenda to generate the longitudinal evidence needed to evaluate HBCUs' role in the rural pharmacy workforce.