Increasing and Sustaining Racial/Ethnic Diversity in Healthcare Management

July 1990
May 1995 (revised)
December 1998 (revised)
March 2002 (revised)
November 2005 (revised)
November 2010 (revised)

Statement of the Issue

One of the hallmarks of a democratic society is providing equal opportunity for all citizens regardless of race or ethnicity. In the healthcare sector, racially/ethnically diverse employees represent a growing percentage of all healthcare employees, but they hold only a modest percentage of top healthcare management positions. For example, according to the American Hospital Association, in 2010, 94 percent of all hospital CEOs were white1 (non Hispanic or Latino) while 65 percent of the population is white2 (non Hispanic or Latino), according to the most recent U.S. Census Bureau data.

This disparity persists despite two decades of success in attracting racially/ethnically diverse students to graduate study in health administration. For example, according to the Association of University Programs in Health Administration in 1990-1991, 14 percent of graduate students in healthcare management programs were racial/ethnic minorities. By the 2000-2001 academic year, the proportion rose to 30 percent and by 2009-2010, fully 42 percent of graduate students are minorities.3

In addition to these positive trends, a 2008 study4 conducted jointly by the American College of Healthcare Executives (ACHE), the Asian Health Care Leaders Association, the Institute for Diversity in Health Management, the National Association of Health Services Executives, and the National Forum for Latino Healthcare Executives showed that among females, Latinos exceeded others in attaining senior-level positions. In regard to compensation levels, controlling for education and experience, black women earned similar incomes as white women. But Asian and Latino women earned about ten percent less than their white counterparts.

In the same study, the data for males shows that minority healthcare executives continue to earn less than their white counterparts. White males exceeded minorities in having attained senior-level positions in healthcare organizations and earned more than other racial/ethnic groups, when controlling for experience and education.

Our country's increasingly diverse communities result in a more diverse patient population. Studies suggest that diversity in healthcare management can enhance quality of care, quality of life in the workplace, community relations and the ability to affect community health status. Achieving diversity in management will involve a commitment at all professional levels (including early entrants, middle managers, and senior executives) within the organization through the awareness of diversity issues, hiring practices that attract diverse staff, development and mentoring in educational programs and organizations, and organization wide diversity training.

Policy Position

ACHE embraces diversity within the healthcare management field and recognizes that issue as both an ethical and business imperative. ACHE urges all healthcare executives, board members, educators and policymakers to actively strive to increase diversity within healthcare management ranks, especially in regard to race and ethnic background. ACHE actively strives to increase representation of racially/ethnically diverse individuals in healthcare management and works to create a supportive, collegial environment that encourages their membership and advancement within ACHE itself. ACHE, as a founding member, also is committed to collaborating with the Institute for Diversity in Health Management and other such groups on these issues.

All stakeholders should renew and strengthen their commitment to redressing any imbalance in representation of racially/ethnically diverse individuals in leadership to enhance our profession now and in the future.

ACHE encourages all healthcare executives to play a significant role in addressing this issue by actively pursuing the following:

Recruitment

  • Promote healthcare careers to diverse populations via school programs and community organizations. Encourage students to shadow healthcare executives and explore careers in healthcare.
  • Develop strong outreach mechanisms to attract promising racially/ethnically diverse candidates to healthcare management careers with special emphasis on increasing recruitment efforts at colleges and universities with predominately racially/ethnically diverse student enrollments.
  • Offer internships, residencies and fellowships to racially/ethnically diverse students and provide mentoring to help prepare them for success in the job market.
  • Advocate racial/ethnic diversity in the appointment of job search committee members and promote the provision of a diverse slate of candidates for senior management positions.
  • Recruit racially/ethnically diverse individuals at every level, being transparent about hiring criteria, so as to increase current representation in management, but also to develop a pool of qualified candidates for the future.
  • Recruit candidates external to the healthcare field to broaden the pool of racially/ethnically diverse candidates.
  • Direct executive recruiters to identify and present racially/ethnically diverse candidates for management positions. Have them share criteria they use to recommend candidates for senior-level positions.

Promotion

  • At every opportunity advocate the goal of achieving full representation of racially/ethnically diverse individuals at entry-, mid- and senior-levels in healthcare management.
  • Institute policies that (1) prevent discrimination on the basis of race/ethnicity, (2) increase diversity in the recruitment and hiring of candidates, and (3) create an environment that encourages retention and promotion of qualified racially/ethnically diverse employees. Ensure that policies are well known and understood and measure and reward changes resulting from these policies.
  • Consider utilizing pro-diversity initiatives to reduce social isolation through programs such as the following: appoint a manager responsible for diversity; appoint a diversity committee; adopt a diversity action plan; evaluate managers based on their diversity effectiveness; and promote social gatherings and mentoring programs.
  • Publicize career advancement opportunities, such as continuing education, professional development organizations, networking events and vacancies inside the organization, in a manner that appeals to everyone, especially racially/ethnically diverse individuals.
  • Encourage retention and advancement of racially/ethnically diverse individuals. Identify potential candidates to support and create clear pathways for advancement from entry- to mid-level positions and from mid- to senior-level positions.
  • Develop and disseminate specific criteria for advancement in management that would allow all individuals to have an equal opportunity for senior-level positions. Such criteria could be useful to racially/ethnically diverse individuals who wish to prepare themselves for senior-level positions.
  • Conduct regular reviews of organizational compensation programs to ensure salaries are equitable and nondiscriminatory.

Support

  • Work with organizations representing racially/ethnically diverse individuals within their communities to create sources for scholarships and fellowships.
  • Advocate for governmental and private philanthropic programs that increase funding to underwrite advanced education, information dissemination and employment opportunities for racially/ethnically diverse individuals.
  • Support organizations, such as the Institute for Diversity in Health Management, the Asian Health Care Leaders Association, the National Association of Health Services Executives and the National Forum for Latino Healthcare Executives that champion diverse executives through internships and other programming. Enable employed diverse executives to participate in the programs and be part of the volunteer leadership of such organizations.
  • Support and assist the development of mentoring programs within healthcare organizations specifically focused on developing long-term relationships between senior healthcare managers and racially/ethnically diverse candidates.
  • Provide scholarship support for employed diverse executives to participate in leadership development programs.
  • Urge racially/ethnically diverse healthcare executives who are not members to join ACHE and become active at both the local (via chapters) and national levels. Extend invitations to hosted events such as executive breakfasts, chapter networking events and educational programs.

In addition, ACHE encourages racially/ethnically diverse healthcare executives to actively pursue the following:

  • Earn an advanced degree in healthcare management or business.
  • Seek internships, fellowships and administrative development opportunities that lead to permanent positions and form a foundation for building their careers.
  • Seek positions in organizations that offer effective pro-diversity initiatives in order to build their careers.
  • Choose positions that offer new experiences and expand their skillsets and management abilities.
  • Interact with colleagues and actively pursue professional development by becoming involved in professional associations.
  • Seek out mentors and serve as mentors to other professionals.

ACHE advocates a variety of approaches to improve the representation and equitable treatment of racial and ethnic diversity in healthcare management.

Approved by the Board of Governors of the American College of Healthcare Executives on November 8, 2010.

References

1American Hospital Association, Division of Membership database. Accessed January 2010

2U.S. Census Bureau, “Selected Social Characteristics in the United States.” Accessed September 30, 2010

3Association of University Programs in Health Administration 2008-09 Academic Program Survey

4American College of Healthcare Executives, “2008 Racial/Ethnic Comparison of Career Attainments in Healthcare Management”

Related Resources

American College of Healthcare Executives Diversity Resources

Asian Health Care Leaders Association

Institute for Diversity in Health Management

National Association of Health Services Executives

National Forum for Latino Healthcare Executives