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

Many factors contribute to persistent intractable disparities in health care, but the geographic separation of health care executives and patient communities has not been explored. From Congresspeople to police officers, individuals engaged in public service often face criticism for not living in the neighborhoods where they work. These critiques stem from the belief that to engage meaningfully with a community, one has to understand its experiences and share its interests-and geographic proximity offers one opportunity to bridge such divides. This article seeks to determine whether the senior executive leadership of American hospitals live in the same communities as their patient populations.

From August 2020 to January 2021, the research team identified the leadership of the "largest" and "best" hospitals in the United States (n=68). Public directories were used to locate residential addresses. Newly released U.S. Census data provided proportions of individuals identifying as black/African American and Hispanic/Latinx in each zip code. Respective demographic proportions of hospital communities and hospital leadership residence were compared.

Hospitals shared the same zip codes with only three health system leaders (4.41%), seven hospital leaders (10.45%), and six deans (10.91%) of respective institutions. Hospital leadership lived in zip codes with a significantly lower proportion of black/African American (p<0.0009) and Hispanic/Latinx (p<0.0036) residents than their hospital communities.

This article reveals significant differences between where health care leaders live and where they work. Future research should investigate the impact of residential disparities and the consequences of potential remedies on health equity.