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

Statement of the Issue

Racially/ethnically diverse employees represent a growing percentage of all healthcare employees, but they hold only a small percentage of top healthcare management positions.

This disparity persists despite recent successes in attracting racially/ethnically diverse students to graduate study in health administration. For example, by the 2000-2001 academic year, the proportion of racially/ethnically diverse individuals enrolled in and graduating from master’s programs in health administration had nearly doubled compared to their representation in the 1992-1993 academic year. By 2003-2004, the proportion of racially/ethnically diverse individuals graduating from master’s programs amounted to nearly 30 percent of the total. However, success in recruitment must be considered only a partial triumph as underrepresentation in healthcare management positions persists. Studies conducted jointly by the American College of Healthcare Executives (ACHE), the Institute for Diversity in Health Management, the National Association of Health Services Executives, the Association of Hispanic Healthcare Executives, and the Executive Leadership Development Program of the Indian Health Service show that proportionately fewer racially/ethnically diverse individuals attain high-level executive positions compared to whites. Racially/ethnically diverse women who do attain executive positions earn lower salaries, and they appear to be overrepresented in management positions in institutions serving a disproportionate share of the indigent population.

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 senior management will involve a commitment to the awareness of diversity issues, hiring practices that attract diverse staff, development and mentoring in educational programs and organizations, and organization wide diversity training.

The American College of Healthcare Executives 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 on these issues.

All stakeholders should renew and strengthen their commitment to redressing the 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

• Institute 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.

• Advocate racial and ethnic diversity in the appointment of job search committee members and promote the provision of an ethnically diverse slate of candidates for senior management positions.

• Recruit racially/ethnically diverse individuals at every level, 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.

Promotion

• At every opportunity advocate the goal of achieving full representation of racially/ethnically diverse individuals 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.

• 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.

• 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, that champion racially/ethnically diverse executives through internships and other programming.

• 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.

• Identify potential candidates to support and encourage retention and advancement of racially/ethnically diverse individuals.

• Provide diversity training at every level of the organization, including the board, to promote and encourage understanding.

• Urge racially/ethnically diverse healthcare executives who are not affiliates to join ACHE; extend invitations to events such as executive breakfasts, educational programs, clusters and Regent’s Advisory Council meetings.

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

• Earn an advanced degree in healthcare management or business.

• Seek positions in organizations in order to build their careers.

• Choose positions that offer new experiences and expand their skills sets and management abilities.

• Interact with colleagues and become 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 7, 2005.

Data describing the demographic characteristics of individuals enrolled in and graduating from master’s programs in health administration were obtained from studies conducted by the Association of University Programs in Health Administration.