Do Hospital Leaders Live in the Communities They Serve? A Comparative Analysis

Area of Science:

• Health Services Research
• Health Equity
• Socioeconomic Determinants of Health

Background:

• Persistent health care disparities remain a significant challenge.
• The geographic proximity of public service leaders to their communities is often seen as crucial for understanding and engagement.
• The residential patterns of senior hospital executives relative to their patient populations have not been previously studied.

Purpose of the Study:

• To investigate whether senior executive leadership of American hospitals reside in the same communities served by their patient populations.
• To explore the potential link between geographic separation and health care disparities.

Main Methods:

• Identified leadership from 68 of the largest and best U.S. hospitals (August 2020-January 2021).
• Located residential addresses using public directories.
• Compared demographic proportions (Black/African American, Hispanic/Latinx) of hospital communities and leadership residences using U.S. Census data.

Main Results:

• Only a small percentage of health system leaders (4.41%), hospital leaders (10.45%), and deans (10.91%) shared zip codes with their institutions.
• Hospital leadership resided in zip codes with significantly lower proportions of Black/African American residents (p<0.0009) and Hispanic/Latinx residents (p<0.0036) compared to their patient communities.

Conclusions:

• Significant residential disparities exist between health care leaders and the communities they serve.
• These findings highlight a potential contributing factor to health care inequities.
• Further research is needed to understand the impact of these residential differences and to explore potential interventions.