Racial disparity found in health care executive advancement

Health Care Financing Review, Spring, 1993

A disparity exists between the career attainments of black and white health care executives, according to the results of a study jointly announced by the American College of Healthcare Executives (ACHE) and the National Association of Health Services Executives (NAHSE). Concerns arising from these findings prompted the two associations to offer recommendations to specifically address this situation.

The study, believed to be the first of its kind, compared the career attainments of black and white health care executives and found that even though the two groups had few demographic differences--such as age and educational background--their actual professional growth revealed some clear contrasts. Fewer black health care executives hold chief executive officer (CEO) positions or positions reporting to the CEO, and fewer black executives are in general management, with more in specialized management areas such as human resources or finance. Salaries also differed substantially, with black executives earning a median total compensation of $53,000 in 1990, compared with $67,000 for white executives.

"While this study suggests that blacks have, regretfully, not yet achieved the same positions and salaries in health care management as their white counterparts," said Thomas C. Dolan, Ph.D., the president and CEO of ACHE, a Chicago-based organization representing more than 25,000 health care executives, "we are confident that by understanding the basis for these discrepancies, our profession will be better equipped to help correct the situation."

One explanation for these differences can be found in the current working arrangements of the two groups. A substantial number of the black respondents (34 percent) reported being employed in organizations with predominantly black employees and that offer service to the black community. Similarly, a comparison of hiring activities at the respondents' organizations showed that those organizations employing black persons involve them in recruitment less often--a factor thought to limit the black executives' visibility both inside and outside the organization.

The black managers also expressed less satisfaction in every category--salary, promotions, recognition, professional membership dues paid, support for continuing education, and physical facilities--when asked about the fairness of their treatment by their employing organizations.

Racial discrimination appears to play a role in career disparity between black and white executives, although the two groups have somewhat different opinions on the magnitude of this barrier. More than 60 percent of the black health care executives surveyed perceive that their careers have been negatively affected by racial discrimination, compared with less than 5 percent of the white health care executives.

The black executives surveyed were close to unanimous agreement (96 percent) in perceiving white executives to have greater opportunities to advance in health care management, while most of the white executives (57 percent) were either neutral about or disagreed with this perception. The black managers were also more likely than white managers (74 percent compared with 19 percent) to see black persons having only limited opportunities in health care. Finally, nearly 70 percent of the black respondents and only 10 percent of the white respondents agreed with the statement, "Blacks usually have to be more qualified than others to get ahead in any organization."

Based on the findings of this study, ACHE and NAHSE have jointly released recommendations to all types of health care organizations and professional associations, to help redress the issues that have contributed to the disparity in the career attainments of black and white health care executives.

For more information, contact Lynn Kahn of ACHE at (312) 943-0544.