Attitudes about racial/ethnic relations in organizations. Attitudes are thought to affect actions. Therefore, to understand precursors of change, it is useful to gauge attitudes to see how groups differ and what actions each thinks is needed to redress existing inequities. In Tables 34 and 35, we contrast the views of the four groups and consider changes in views expressed by blacks and whites in 1992.

Do minority managers receive greater, the same amount, or less support in healthcare organizations than whites? We asked the groups about the support given to minority managers by their subordinates, supervisors and colleagues. Table 34 shows that in contrast to 1992, when more blacks than whites felt that black managers were supported by their subordinates, today, there are smaller differences between these groups.

On the other hand, the respondents continue to deny, as they did in 1992, the suggestion that minority managers get more support from their supervisors than do whites. Blacks and Hispanics especially denied that such preferential treatment was given compared to whites and Asians.

One specific example of unequal treatment by supervisors showed that the finding observed first in 1992 persists today-- i.e., minorities' evaluations are not as thorough and careful as whites.' This finding held for both men and women. Over half of the blacks today feel supervisors don't evaluate minorities as carefully or thoroughly as whites. Fewer, about 20 percent of Hispanics and Asians, concurred with this view--but only 10 percent of whites felt this was the case.

Lack of inter-racial/ethnic collegiality among managers is again evident in 1997 as it was in 1992. A clear majority of blacks disagreed with whites who thought that white managers share vital growth and career related information with minority managers. Hispanic managers and Asians fell between the two poles established by blacks and whites.

A more general question also focusing on collegial relationships was posed. Respondents were asked if they thought that the quality of relationships between minority and white managers could be improved. Nearly 90 percent of blacks thought so but only about 45 percent of whites agreed. Many other whites were "neutral" in their responses, possibly because they work in organizations with few or no minority managers. Again Hispanic and Asian respondents fell in the midrange between blacks and whites.

Asked if respondents thought the quality of relationships between minorities from different race/ethnic groups could be improved, nearly 90 percent of blacks, and over seventy percent of Asians and Hispanics agreed compared to about 54 percent of whites. Thus, minorities are more ready to acknowledge their relationships with whites and with other minorities could be improved. Again the same caveat cautioned above exists--many white respondents who were neutral may not have experience working with minority managers.

Three attitudinal questions were then posed concerning respondents' views on general career attainment issues. As was the case in 1992, the prevailing view among blacks was that white managers have greater opportunities to advance than minority managers and that there are limited opportunities for minority managers to advance in their careers. White respondents tended to disagree with these views. Hispanic and Asians concurred with the blacks that whites have greater opportunities to advance than minority managers but they were more divided on minorities' having limited opportunities for career advancement.

Finally, both 1992 and 1997 black respondents indicated that minority managers are more often role models in their communities than whites. The majority of Hispanics agreed with the blacks' views but Asians, like the whites expressed ambivalence.

Although minorities said that the quality of their relationships with whites other minorities could be improved, when asked if they would recommend a career in healthcare management to a young person today, about 90 percent of all race/ethnic group members said yes--a similar proportion said this in 1992.

In sum, attitudes about interracial interactions in healthcare management show that these respondents feel subordinates and supervisors give about the same level of support regardless of the manager's race/ethnicity. But minorities say that their evaluations are less thorough or careful than whites'. In evaluating their colleagues, minorities feel that whites fail to share growth and career related information with them. Moreover, minorities stated that the quality of all their collegial interactions --with both other minorities as well as whites could be improved. Blacks and Hispanics especially felt that white managers have greater opportunities to advance than minorities. Nevertheless, despite these expressions of need for improved relationships, about 90 percent of each race/ethnic group would recommend the field to a young person today.

Factors impeding minorities' career attainments. One question asked respondents to write in their views of (1) whether they believe there are inequities in minorities' attaining senior level executive positions today and (2) if so, what factors account for these inequities. Table 35 shows that nearly all the blacks and more than three out of four Hispanics and Asian executives agreed that inequities exist. Fewer whites concurred--two thirds of the women and 51 percent of the men felt there are inequities in minorities' attaining senior level executive positions.

The table also categorizes respondents' factors that they believe give rise to inequities. For example, blacks more than other groups cited racism or prejudice and lack of affirmative action and other organizational initiatives. Both black and Asian males cited a lack of mentors, lack of opportunities to network and the presence of a white old boys network. Thus apart from global racism, blacks especially see structural features in the workplace that stymie their achieving high level positions. Apart from the lack of affirmative action initiatives, they recognize that personal assistance in the form of mentors, and networking opportunities would do much to give them a foothold in management's upper ranks.

Interestingly about a fifth of white females cited the old boy network as the causal factor for inequities as well. White females also suggested that inequities arise due to lack of education or experience among the minorities. Other factors were cited by Hispanic and Asian executives--notably, language, and cultural differences.

Overall, minorities claim that they are treated unfairly due to structural factors in the system--embedded racism, lack of organizational commitment to affirmative action and both a paucity of mentors and the influence of an "old boys" clique. In the following discussion, we examine what steps respondents think managers and government can take to ameliorate the unfair treatment of members of minority race/ethnic groups in healthcare management.

Managers' role in fostering positive race/ethnic relations. Should managers influence their staff's views on race/ethnicity issues? A majority of respondents, stated managers should, in their view, influence the attitudes of employees in race/ethnic relations. About two thirds or more of all race/ethnic groups agreed--even higher proportions of blacks concurred this was part of the healthcare manager's role (Table 36).

A majority of all race/ethnic groups thought that managers should take public positions on equal employment opportunities and affirmative action. But though nearly 60 percent of whites agreed with this role, over a fifth disagreed. It is interesting that black managers in 1997 responded similarly to the 1992 respondents. In contrast, agreement by whites declined about 12 percent among the women and by 16 percent among the men. Part of this decline may be a general societal backlash against affirmative action policies.

We then asked if racial/ethnic quotas should be established and implemented by healthcare organizations to ensure equal employment opportunities. Establishing quotas was subscribed to by nearly half of the black females and 36 percent of black males. But as was true 5 years ago, as many black males oppose the idea as endorse it. The plurality of Hispanics and the majority of Asians and whites oppose establishing quotas.

The role of government in promoting equity. Two final questions asked respondents about the role of government in promoting equity between racial/ethnic groups. The first, asked for opinions on government needing to create incentives for the healthcare industry to engage in equal employment practices. About two thirds of the blacks, half of the Hispanics and just over a third of Asians thought this was a good idea. But only 11 percent of whites agreed--and indeed, 70 percent of the whites disagreed. Again these findings reflect the dissimilar attitudes held by blacks and whites uncovered 5 years ago.

The last question concerned increasing financial support (both government and private) for minority students who want to be healthcare managers. The pattern of responses already observed was repeated again; blacks were most supportive, followed by Hispanics, then Asians and whites generally disavowed such a support. The contrast between blacks and whites confirmed findings observed in 1992.

Overall, respondents agreed that managers should, as part of their role responsibilities, influence their staff's views on racial/ethnic relations; the majority also believe there is a role for managers to speak out and take public positions on equal employment opportunities and affirmative action. But respondents were very divided on whether racial/ethnic quotas should be established. Most supportive were black women--nearly half of them endorsed the idea. But black men and Hispanic women split on the issue. The majority of Asians and whites oppose the idea.

Government, in the view of blacks and Hispanics, is needed to create incentives for the healthcare industry to engage in equal employment positions. Most whites disagreed while Asians were ambivalent as a group. Blacks and Hispanics and a plurality of Asians support the notion of government and private sources providing more financial support for minority students who wish to become healthcare managers. Less than half of the whites support the idea but only about a quarter oppose it.

In all these policy related questions, a few ideas emerge that constitute common ground: management's role is to influence staff attitudes and to speak out about equal employment and affirmative action in public debates. But race/ethnic divisions persist on the role of healthcare organizations' establishing quotas, and on whether the government should incentivize the process of achieving equal employment practices.

A non-response analysis is presented in Table 37. It shows that respondents were not significantly different from non-respondents in age, highest degree attained, field of highest degree, position level attained or employing organization. The non-response analysis was of necessity, confined to the ACHE sample which included members of all race/ethnic groups.