Class ceilings: Patient representation on community health center boards

Context: To ensure community responsiveness, federally-qualified community health centers are

legally required to have a patient-majority governing board.

Purpose: To measure the association between trustees' external status characteristics and their

within-board status to assess the likelihood that patient board members are truly representative of

the health center patient population and hold board leadership positions.

Methods: This study uses 2001 health center board data from the federal Uniform Data System

to test linear probability models using ordinary least squares regression analysis.

Results: There are significant differences in the composition of board leadership positions by

trustee gender, patient status, tenure, and occupation.

Conclusion: Leadership positions within health center governing boards tend to be filled by

individuals with high external status characteristics, suggesting that the typical health center

patient is excluded from board leadership and that patient trustees are unlikely to be

representative of the general patient population.