Just in time for National Minority Health Month, Centers for Disease Control and Prevention researchers are reporting “promising strategies” for reducing racial and ethnic health disparities in several areas.
Evidence-based interventions at the local and national levels that address disparate behaviors, access to healthcare, and the social determinants of health are showing favorable signs toward reducing inequalities in HIV infection rates, immunization coverage, motor vehicle injuries and deaths, and smoking, according to a new report by the CDC's Office of Minority Health and Health Equity.
"Reducing and eliminating health disparities is central to achieving the highest level of health for all people," said CDC Director Dr. Tom Frieden in a statement. "We can close the gap when it comes to health disparities if we monitor the problem effectively and ensure that there is equal access to all proven interventions."
The report highlighted several health interventions that have proven effective or have shown promise in reducing health disparities.
The Vaccines for Children (VFC) Program, the largest legally mandated program managed by CDC, provides vaccines at no cost to eligible children who might otherwise not be inoculated because of an inability to pay. Since the program was introduced, racial/ethnic disparities in childhood immunization coverage for measles-mumps-rubella and poliovirus vaccines have disappeared and disparities in immunization rates for the recommended four doses of diphtheria-tetanus-pertussis vaccines have been reduced.
Many Men, Many Voices (3MV), an HIV/STD (sexually transmitted disease) prevention intervention developed by and for Black men who have sex with men (MSM), has yielded decreased rates of HIV infection and increased access to preventive services and treatment among MSM of color.
The program uses small group sessions to increase knowledge and change attitudes and behaviors related to HIV/STD risk among Black MSM, the most vulnerable group to infection. A randomized clinical trial demonstrated that 3MV reduced participants' high-risk sexual activity and increased rates of HIV testing. The program has been implemented in 37 states, the District of Columbia and Puerto Rico and has been adapted to serve other MSM of color.
Kali Lindsey, deputy director of public policy at amfAR, The Foundation for AIDS Research, lauded the 3MV program, saying it works because it provides contextualized, science-based information that allows men to make better choices. The only shortcoming of the intervention, however, is thin dissemination because of the time commitment required and the cost of maintaining the program.
“The best solution is to embed these useful lessons into other interventions that are already established in communities,” he said. “It is incumbent on us to mainstream [3MV] and make it available to all communities at risk so it has a broader impact.”
Evidence-based interventions are also producing progress in reducing disparities in vehicular accidents and deaths. For American Indians/Alaska Natives, rates of vehicular deaths are two to four times higher than for other races/ethnicities. Evidence-based road safety interventions were implemented among four tribes, resulting in increased use of seat belts and child safety seats, increased enforcement of alcohol-impaired driving laws, and decreased motor vehicle crashes involving injuries or deaths.
Effective communication—through billboards, radio and television media campaigns, and school and community education programs—was a major component of these successful public health programs.
"These interventions demonstrate progress toward health equity,” said Leandris C. Liburd, CDC associate director for Minority Health and Health Equity, in a statement. “They show the elimination of health disparities as an achievable goal and encourage further implementation of evidence-based initiatives and interventions addressing health disparities and inequities."
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