Diversity among health care leaders in Canada: a cross-sectional study of perceived gender and race
We initially included 3333 hospital or health ministry executives from 135 institutions across Canada (Appendix 1, Supplementary Figure 1). Photographs were identified for 3056 (91.6%) of these executives, which constituted the sample used for this analysis. Overall inter-rater reliability was high, with a 96.4% match rate for perceived race (Cohen κ = 0.81) and a 98.9% match rate for perceived gender (Cohen κ = 0.98) (Appendix 1, Supplementary Table 3). Inter-rater reliability varied between perceived racial categories of health care leaders (κ range 0.30–0.88).Concordance on perceived gender was achieved for 3022 individuals (98.9%). Reviewers perceived gender as “woman” for 37 (47.4%) of 78 leaders at the ministry level, 36 (50.0%) of 72 leaders in provinces with centralized hospital systems (Alberta, Saskatchewan, Prince Edward Island, Nova Scotia) and 120 (56.1%) of 214 leaders in provinces with regional hospital systems (BC, New Brunswick, Newfoundland and Labrador) (Table 1). In Manitoba, Ontario and Quebec, where leadership exists at the individual hospital level, 1326 (49.9%) of 2658 executives were perceived as women (Table 1).