Career Attainments by Race/Ethnicity: Position

Results by ACHE’s Executive Office, Research.


In 2022, the American College of Healthcare Executives led the sixth in a series of studies conducted over the past 30 years comparing career attainments of healthcare executives by race/ethnicity. Questionnaires were sent to comparative samples of Asian, Black, Hispanic/Latino and white healthcare executives. Of the 9,416 ACHE members who were successfully sent the survey, 2,527 responded, yielding a 26.8% response rate. These responses were supplemented by a small number of responses from an earlier questionnaire pretest and a sample of executives provided by the National Association of Health Services Executives.

Among the many aspects of career progression examined in the survey was the proportion of executives in the different racial/ethnic groups who had obtained senior leadership positions. The results are shown in the table below. At the time of the survey, 66% of white respondents held positions of vice president and above, while this proportion was 48% for Asian and Hispanic/Latino respondents and 43% for Black respondents. White respondents as a group were markedly older and Asian respondents as a group were markedly younger than members of other racial/ethnic groups. This may explain some of the variation in position attainment, but it does not appear to explain it all.  

The study examined whether variation in respondents’ current positions could be explained by differences in the roles they held when they entered the healthcare leadership field. These results are also shown in the table. Variation in starting position does not appear to fully explain variation in current roles. The proportions of those entering the healthcare leadership field in positions of vice president and above were similar for members of the different racial/ethnic groups; 17% of Asian and Hispanic/Latino respondents, 16% of white respondents and 14% of Black respondents did so. Hispanic/Latino and white respondents were somewhat more likely to enter the field as department heads and somewhat less likely to have started in more junior positions than their Asian or Black counterparts. 

ACHE thanks the executives who responded to this survey for their time, consideration, and service to their profession and to healthcare leadership research. ACHE also wishes to thank the National Association of Health Services Executives, the National Association of Latino Healthcare Executives, the Institute for Diversity and Health Equity and ACHE’s Asian Healthcare Leaders Community Committee for their support of this study.


Current Position

# Asian Black Hispanic/Latino White
CEO 10% 14% 14% 22%
COO/Senior Vice President 19% 14% 20% 21%
Vice President 19% 15% 14% 23%
Department Head 33% 38% 41% 26%
Manager/Supervisor/Program Director 3% 5% 3% 2%
Department Staff 13% 13% 6% 6%
Other 3% 3% 2% 3%
Total* 100% 100% 100% 100%
(N) (271) (503) (256) (1,194)

* Percentage may not sum to 100% due to rounding.


First Healthcare Leadership Position

# Asian Black Hispanic/Latino White
CEO 4% 3% 3% 3%
COO/Senior Vice President 7% 5% 9% 5%
Vice President 6% 6% 5% 8%
Department Head 38% 41% 47% 48%
Manager/Supervisor/Program Director 12% 9% 11% 8%
Department Staff 29% 34% 23% 25%
Other 4% 3% 3% 3%
Total* 100% 100% 100% 100%
(N) (269) (505) (256) (1,188)

* Percentage may not sum to 100% due to rounding.