Why hospital boards need more diversity

The Black Directors Health Equity Agenda promotes diversity as a way to solve lasting problems in healthcare.

Deborah Phillips, executive director of the Black Directors Health Equity Agenda, says hospitals need more diversity on their boards if they want to improve patient care and close disparities in outcomes.

Black Americans are more likely to be diagnosed with cancer at later stages and are more likely to die, according to the Centers for Disease Control and Prevention. Black women are more likely to die of maternal causes than other women, federal statistics show.

Deborah Phillips, executive director of the Black Directors Health Equity Agenda, says hospitals and health systems must work on closing those disparities. She tells Chief Healthcare Executive® that hospital and health system boards need more Black directors to effectively tackle those issues.

“Having a diverse board brings lived experiences to the table to address issues and concerns,” she says.

A nonprofit group, the Black Directors Health Equity Agenda was founded in 2020 on the premise that there aren’t enough Black members serving on hospital boards. Her group teamed with the American Hospital Association and The Health Management Academy on a report examining diversity on the boards of hospitals and health systems.

The report shows progress, although the data indicates the gains aren’t quite overwhelming.

On health system boards, Black members accounted for 15% of members in 2022, up from 7% in 2014. But among freestanding hospital boards, the percentage of Black members rose just a percentage point from 2014 to 2022, moving from 4% to 5%.

Hispanic members made up 3% of the boards of freestanding hospitals in 2022, the same as in 2014, and Hispanic directors held 6% of the seats of system boards in 2022, up from 3% in 2014.

Looking at the data, Phillips says, “When you think about it in the grand scheme, that means that there's a lot more work to do.”

• Read more: For hospitals, improving diversity is good for business

‘A rising tide’

The Black Directors Health Equity Agenda is focused on improving access, affordability, treatment and outcomes, she says.

Phillips makes the point that improving health outcomes for Black patients and other disadvantaged groups will lead to better care for all patients.

“We operate from a mantra that a rising tide raises all boats,” she says. “And so if you're looking at that, you do want the diversity of thought, of opinion, of care, and more importantly, looking at the data to see what it's telling you, around what you need to do.”

Phillips says the group is launching a task force on hospital board diversity, and the group will begin work in the new year. The effort is being bolstered by a grant from Kaiser Permanente, she says.

The Black Directors Health Equity Agenda is also looking to develop a playbook aimed at diversity in public hospitals and community health centers, Phillips says.

Facing a DEI backlash

Phillips acknowledges criticism of diversity initiatives and “anti-DEI” sentiments that have emerged over the past few years.

“One of the things that we've chosen intentionally at this point is not to get hung up on name language and nomenclature, because when you do, then that's why people want to attack ‘DEI’ or ‘woke.’ If you notice, most of the things you see from us talk about diversity, the benefits of diversity, the lived experiences of the people, and the value that they bring,” Phillips says.

“I'm not going to sit here and have a whole bunch of conversation about DEI,” she adds. “We know that we intentionally name the Black Director's Health Equity Agenda, and its focus, because we know intrinsically, if we're doing our work, not only will the Black community benefit, but the entire American community and health will benefit, because of the areas of focus that we planted.”

Over the last two years, Phillips says she’s talked to healthcare executives and board members who are focused on improving health equity. Even amidst some growing criticism of DEI efforts, Phillips says she sees hospital leaders and board members focused on closing disparities in care and outcomes.

She says healthcare leaders are also mindful of their message and how they communicate about their goals.

But she says, “I would say the urgency is still there.”

Focus on the data

Phillips repeatedly stresses organizations need to gather data on outcomes and treatment, to understand where there are disparities in care. She adds that it’s difficult to argue against numbers.

“I should say it makes all the business sense in the world,” Phillips says. “On the other hand, if the mission of the organization is healing patient outcomes and delivery, you have no choice but to pay attention to the data. And the data is going to tell you some things that you need to do.”

Early in her career, Phillips says a leader taught her a valuable lesson: “People will respect what you inspect.”

For hospitals that are aiming to improve outcomes and close disparities, the data offers a baseline to develop strategies, she says.

Hospitals and health systems need to be willing to look closely at the data, even if it reveals deficiencies that have to be addressed.

“Assessments are not bad things,” Phillips says. “Those are really things that are points on the curve to let you know where you are, where are you making progress, and where you need to invest or change in order to improve.”

• Read more: Why health equity efforts need accountability