“Of all the forms of inequality, injustice in health care is the most shocking and inhumane,” said Dr. Martin Luther King Jr. in a speech to the Medical Committee for Human Rights back in 1966. And yet, decades later, that injustice thrives – Blacks and other minorities continue to lack, disproportionately, access to health care and to suffer and die from a gamut of diseases.

“Our preexisting condition remains race and ethnicity,” said Fredette West, chair of the Racial and Ethnic Health Disparities Coalition. A six-year cancer survivor, West said many more minority women who suffered breast cancer did not make it. “And, sad to say, in a lot of instances, even though the death certificate may have read ‘breast cancer,’ the underlying cause for many of them was race-based and ethnic-based health disparities – medical injustices – that should not be in this great country of ours.”

That’s why West and other medical equality advocates welcomed the Obama administration’s announcement last week of a “first-of-its-kind” national plan to reduce – and eventually eliminate – those disparities. “Thank you, Lord,” was West’s reaction as she spoke at the press conference called to announce the initiatives.

Effective immediately within all Department of Health and Human Services offices, the HHS Action Plan will seek to increase the number of minority physicians; tap “promotoras,” community health workers to guide Spanish-speaking residents in seeking health services and provide dental care to poor children, among other steps.

“This action plan … is the most comprehensive federal effort ever to address racial/ethnic disparities,” said Dr. Howard Koh, assistant secretary of Health and Human Services. Emphasizing its importance and the need for across-the-board support, he later added, “We know that the health of the individual is almost inseparable from the health of the larger community we know that the health of the community determines the overall health of our nation.”

As a physician and the son of immigrants, Dr. Koh said he’s seen far too many, whose poor health was linked to social or economic disadvantage. And so the plan acknowledges “that health depends on much more than what happens in the doctor’s office,” he said. “It’s impacted by where people live, labor, learn, play and pray.”

A major player in the disparity of health care outcomes is the unequal access to health insurance. According to HHS, minorities account for more than half of the 50 million uninsured in the United States.

The Affordable Care Act, President Obama’s 1-year-old health care overhaul, addresses some of those gaps. But, the plan also acknowledges the more complex factors that feed those disparities. The five major goals of the HHS Action Plan are to:

– Transform health care by expanding health insurance and increasing access to care through development of new service delivery sites among other actions.
– Strengthen the HHS workforce by creating a new pipeline program to recruit more minorities into public health and biomedical sciences careers, providing more translators and interpreters for non-English-speaking patients, and supporting more training of community health workers.
– Advance the health, safety and well-being of all Americans by implementing the CDC’s new Community Transformation Grants, and additional targeted efforts to achieve improvements in cardiovascular disease, childhood obesity, tobacco-related diseases, maternal and child health, flu and asthma.
– Advance scientific knowledge and innovation by implementing a new health data collection and analysis strategy authorized by the Affordable Care Act, and increasing patient-centered outcomes research.
– Increase the efficiency, transparency and accountability of HHS programs by making health disparities assessments part of all HHS decision-making and doing yearly evaluations of the progress toward reducing health disparities.  

The plan was developed over a few years with the input of about 4,500 individuals including community stakeholders. A separate document offers several strategies to guide community efforts.

Officials said the Affordable Care Act is the vehicle for moving much of this disparities reduction plan forward. “We want to make sure that our commitment does not depend upon one president or one secretary, that this is a permanent commitment to deal with these problems,” said Sen. Benjamin Cardin, D-Md., who many thanked for his key role in ensuring health disparity provisions were included in the health care legislation.

That will demand everyone’s efforts, especially in light of the ongoing budget battles, said Congresswoman Barbara Lee, D-Calif., a longtime minority health advocate and a member of the House appropriations subcommittee that determines health funding.

“We’re under siege right now … and we have to make sure these (initiatives) are fully funded,” she said of current Republican attempts to dramatically slash the budget. “We cannot allow this current debate on the deficit to be used as an excuse not to fund what we have to fund to close these ethnic and racial disparities that now is law. We can’t go to sleep; we must be vigilant.”

For more information about the plans and the National Partnership for Action, visit: http://www.hhs.gov/news/press/2011pres/04/04hdplan04082011.html

For more information about health disparities and the Affordable Care Act, visit: http://www.hhs.gov/news/press/2011pres/04/hdstrategy04082011.html

Zenitha Prince

Special to the AFRO