The Rise of the Hospital Chief Equity Officer-A National Survey of Early Experiences and Attributes.

Abstract

Background: Many hospitals have created the position of equity officer (EQO) in efforts to reduce disparities and address social determinants of health.

Objective: To describe EQOs' experiences and needs, and the environment in which they operate.

Design and participants: A national, cross-sectional survey of EQOs in US community hospitals in 2023. Hospitals determined not to have an EQO were excluded, leaving an estimated 1228 eligible EQOs.

Main measures: Characteristics of the respondents and their positions, perceptions of preparedness, critical attributes for success, and obstacles.

Key results: We obtained 363 survey responses (response rate 29.6%). About one-third of respondents had been in their position for less than 1 year (35.8%), and 46.1% reported directly to the CEO. Only 8.3% had their entire full-time equivalent effort dedicated to equity work. Respondents scored positively on about half of the criteria considered important for a robust equity environment. Only 14.4% reported their hospital had an adequate, dedicated equity budget. Persons of color were significantly more likely to work in places where equity was included in the strategic plan, but also faced more environment-related obstacles. Overall, many EQOs felt less than well prepared to fulfill certain key functions of their position, such as developing community health programs (47.2%) or changing the culture of their hospital (46.9%). More than 90% of respondents identified good community relations (93.7%) and access to their hospital or health system's equity data (92.2%) as critically or very important attributes of their position. The most common obstacle to achieving their equity goals was lack of sufficient equity staff (81.5%). Differences by hospital type also were noted.

Conclusions: The position of EQO is relatively new and the majority in these positions commit only a small amount of their effort to health equity issues. EQOs will need appropriate and adequate resources going forward to achieve their goals.