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“Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.”
—Dr. Martin Luther King, Jr.
Despite the overall improved health of Americans collectively, racial and ethnic disparities continue to exist. This health burden is most evident among minorities suffering from preventable diseases. African Americans, American Indians and Alaska Natives, Hispanics, and Native Hawaiians and Pacific Island ers have higher rates of modifiable risk factors—such as hypertension, high blood cholesterol levels, diabetes, tobacco use, physical inactivity, and obesity—than their white counterparts.
Health policy leaders increasingly recognize the importance of controlling these risk factors through interventions that alter behaviors or one’s lifestyle. Former Surgeon General David M. Satcher argues that “while access to and quality of health care are paramount to eliminating racial and ethnic health disparities, their roles are not as significant as lifestyle and environment.” However, behavioral changes are difficult to make—inertia is strong, and changing behaviors requires major changes in thinking, action, and lifestyle.
One solution is community programs that work directly to modify risky health behaviors. For example, the Center for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health (REACH 2010) and the Department of Health and Human Services’ Office of Minority Health’s two grant programs—Community Programs to Improve Minority Health and the State Partnership Grant Program to Improve Minority Health—have effectively reduced racial and ethnic disparities in targeted subpopulations. The idea is to change the actions of people rather than to act on individuals passively.
Empirical evidence of community-level interventions shows that efforts to organize communities, educate them through mass and direct education, provide screenings for risk factors, and change their environment through local programs and policies can alter risky health behaviors. Yet, the success of many of these interventions is dependent on the Congressional appropriations process.
Specific policy suggestions include:
Increase and Leverage Funding for Community Programs:
- Increase funding for the REACH 2010 program and the Community Programs to Improve Minority Health Grant Program at a level that would allow current programs to continue to operate and additional programs to be developed.
- Leverage funding for community organizations to work together to tailor health programs to meet the specific cultural needs of the targeted racial or ethnic subpopulation.
Increase Infrastructure Capacity:
- Restore funding to the Department of Health and Human Services’ Office of Minority Health to previous years’ allotments, with an inflationary increase.
- Allocate necessary funding for each state, territory, and district to have an Office of Minority Health.
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