RACE AND HEALTH: New Centers to Focus on Disparities

      The Agency for Health Care Policy and Research (AHCPR) announced that it plans to establish four "centers of excellence" over the next five years to identify tools and strategies to eliminate ethnic and racial disparities in the health care system. The effort is part of the HHS Initiative on Eliminating Racial and Ethnic Disparities and the U.S. Surgeon General's Healthy People 2010. The research will focus on infant mortality, cancer screening and management, cardiovascular disease, diabetes mellitus, HIV and immunizations for children and adults, and also will focus on children and elderly who are chronically ill as they "may be particularly vulnerable to the impact of disparities in health care treatment." Surgeon General David Satcher said, "Eliminating disparities in health will require additional research dedicated to a better understanding of the relationships between health status and race and ethnicity." Dr. John Eisenberg, AHCPR administrator, said, "Earlier research sponsored by AHCPR and others has given us a good foundation for taking the next step to eliminating racial disparities. The findings of this new research will help close the gap between what we know ... and what we can do."
      AHCPR has also earmarked $3 million in research funds to focus on access and quality of care issues for racial and ethnic populations. Two of four grants will be funded by Sept. 1, 2000 and the agency has set aside the following: $850,000 for clinical prevention services studies, $500,000 for the study of minority children and $500,000 for the study of chronically ill minority elderly. AHCPR grant applicants are expected to expand upon existing relationships with communities and community organizations, as well as develop new relationships with communities.
      Additionally, AHCPR has completed funding of 11 Medical Treatment Effectiveness Programs (MEDTEP) Research Centers on Minority Populations, "to improve the effectiveness of medical diagnosis and treatment, and disseminate the information to help both minority patients and their health care providers." (AHCPR release, 10/26). In other minority health news:

• African American physicians in the National Medical Association met this weekend to discuss negative effects of bias in the workforce, medical school admissions and curriculum and medical decision making, as well as the need to increase immunization rates among African American adults, mental illness treatment of inmates and the effects of tobacco use in the African American community. After the conference, participants spoke with members of Congress about the "necessity for congressional leaders to enact legislation and provide funding for programs to lessen the health disparity gaps in the African American community" (NMA release, 10/25).
• A new research paper from the Heritage Foundation reveals that Hispanics have the highest rate of uninsurance. About 40% of Hispanics lack health insurance compared to 14% of whites. Author and businessman Roberto Garcia de Posada blames this disparity on the fact that a large number of Hispanics have low incomes and work for small businesses that don't offer insurance. In addition, Garcia notes that Hispanics are denied tax breaks given to those who are insured through their employers, effectively preventing them from buying coverage. He writes, "The best option to expand health insurance for Hispanic workers is to give them direct tax relief, either in the form of tax credits, if they are paying taxes, or vouchers -- in effect, refundable tax credits -- if they do not have taxable income" (Heritage Foundation release, 9/28).
• The city of Boston received a $300,000 grant from the CDC to implement REACH, a study of racial disparities in breast and cervical cancer. Minority women in Boston between the ages of 35 and 44 are three times more likely to die of cervical cancer than are Caucasian women of the same age. Mayor Thomas Menino said, "It's time to find out why these numbers are so high." With the grant, outreach workers will go out into communities to research why the disparities exist. Menino added, "We already know that issues like cultural beliefs, health insurance and location of health centers play a role in the cancer rate. It's our goal for REACH Boston to identify specific factors that keep minority women from receiving the care they need" (Conroy, Boston Herald, 10/26).
• HHS Secretary announced yesterday the start of a new component of the "Back to Sleep" campaign against Sudden Infant Death Syndrome (SIDS) that will focus on developing a community-based approach to target the African American population. Led by the National Institute of Child and Human Development, of the NIH, the campaign will be carried out by a new partnership with the National Black Child Development Institute, the Health Resources and Services Administration, the American Academy of Pediatrics, as well as the SIDS Alliance and the Association of SIDS and Infant Mortality Programs. Although minority outreach has been a component of the "Back to Sleep" program from its inception, African American infants are 2.2 times more likely to die from SIDS than white infants. HHS Secretary Shalala said, "[W]e must continue to work together to be sure that these effective strategies are reaching every community" (NICHHS release, 10/27).