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From the Boardroom to Better Health: How Black Leadership Can Power Health Outcomes

Diversity on healthcare boards of directors will help drive the United States toward health equity.

Deborah Phillips

Executive Director, Black Directors Health Equity Agenda

America’s healthcare system has set out to deliver better health outcomes, starting with crucial changes in the boardroom. A new set of leaders, reflecting the United States’s diversity, are joining with healthcare boards of directors to make access to healthcare fairer and more equitable, inclusive, and empowering. In preparing boards for success, we can profoundly transform the health and prosperity of the communities they represent.

Black health presents board directors with one of their biggest challenges — Black families endure disproportionately severe and higher rates of asthma, diabetes, and many other illnesses than the population at large — often developing multiple chronic conditions. The average lifespan of Black people is nearly 5 years shorter than that of white people. As the governing body responsible for setting strategic goals and priorities for organizations, board directors in healthcare recognize their opportunity to reverse or reduce these health disparities.

The Black Directors Health Equity Agenda (BDHEA) brings Black board directors and executives from across the health ecosystem together to support continuous, effective effort and action on eliminating disparities amongst Black communities. To achieve a better future for the healthcare industry and the American public, the BDHEA has been working with corporate and nonprofit boards across the healthcare ecosystem to highlight the importance of advancing health equity in the boardroom to close the health disparity gap. According to a recent report published by the Deloitte Center for Health Solutions, achieving racial parity on health outcomes would benefit all Americans and add $2.8 trillion to the U.S. economy by 2040.

Governance plays a critical health equity role

Boards of directors have unique powers to address unequal access to healthcare services, disparities in health education, and lack of representation in clinical trials. Health organizations’ trustees drive policies and budgets, paving the way for transformative change. Directors set an organization’s priorities, focus areas, and goals. A board with members from different racial, ethnic, gender, and professional backgrounds is better equipped to understand and address the unique healthcare needs of diverse populations, leading to more inclusive and effective healthcare strategies and improved financial performance.

The latest American Hospital Association (AHA) survey found that health system boards have doubled the proportion of Black trustees to 15% since 2014 — progress that has not been mirrored on the boards of health system subsidiaries or single-hospital organizations. BDHEA was organized in 2020 to support Black board members in encouraging courageous boardroom conversations and data-driven decisions toward achieving health equity, and its members are now working to identify new strategies to increase the demand for Black board directors.

When underserved populations seek and receive care earlier, their conditions are often simpler and less costly to manage. Simply bringing the number of Black people diagnosed with high blood pressure down to the majority benchmark could save about $7.2 billion a year in outpatient treatment, inpatient treatment, medication, and other costs, according to Deloitte’s research for BDHEA. As healthcare boards move to contain costs, directors must strategically consider health equity as a route to lower the expense of chronic care.

Black governance drives better health outcomes

Despite the AHA’s finding of increased Black representation — detailed in a report with BDHEA and The Health Management Academy — it is still the case that 4 out of 5 hospital trustees are white. Many healthcare organizations have no Black board members to advocate for solutions. Black directors bring to governance their lived experiences and an understanding of the social barriers that contribute to poor health outcomes.

Boards of directors represent their patients and communities’ interests within their organization. A culture of boardroom candor ensures that difficult discussions about race, equity, and systemic bias are not only possible but encouraged. Working with healthcare executives and community leaders, Black directors can leverage data, foster inclusion, and drive meaningful, community-centered change.

The BDHEA has produced multiple playbooks as part of its health equity toolkit to support board directors in activating health equity strategies in the boardroom. BDHEA’s health equity toolkit aims to guide healthcare boards toward impactful decision-making. To further the mission of the BDHEA, a $1.5 million grant from Kaiser Permanente’s fund at the East Bay Community Foundation will help create a new health equity playbook to improve community governance of public hospitals and community health centers and support the BDHEA Board Diversification & Inclusion Taskforce to increase the representation of Black people on healthcare boards. Black representation on boards encourages innovative thinking, business transformation, and policy reform to advance health equity for Black Americans, and equal and fair healthcare for all. This is how systemic change works. Communities that strive for greater equity in healthcare boardrooms will make a real difference in health equity outcomes.

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