FOR IMMEDIATE RELEASE
Jan 13, 2006
Contact: HHS Press Office
PROTECTING THE HEALTH OF MINORITY COMMUNITIES
Overview: Life expectancy and overall health have improved in recent years for a large number of Americans, due to an increased focus on prevention and dynamic new advances in medical technology. However, not all Americans are benefiting equally. There are continuing disparities in the burden of illness and death experienced by African Americans, American Indians/Alaska Natives, Asian Americans, Hispanic Americans, Native Hawaiians and other Pacific Islanders, as compared to the U.S. population as a whole.
Protecting the health of minority communities is an important objective of HHS Secretary Mike Leavitt's 500-Day Plan, which was issued in January 2005. A key element of the Secretary's strategy for transforming the health care system is support for community-based approaches to closing the health gap, particularly among racial and ethnic minority populations, including American Indians and Alaska Natives. HHS operating and staff divisions are important contributors to Secretary Leavitt's plan, and to department-wide initiatives aimed at reducing minority health disparities.
HHS continues to expand its medical research concerning racial and ethnic minorities. The fiscal year 2005 budget for the National Institute of Health's National Center for Minority Health and Health Disparities is $196 million, an increase of
$5 million from fiscal year 2004.
On January 9-11, 2006, HHS' Office of Minority Health (OMH) will convene the National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health. The Summit will bring together leaders from all levels of government, academia, public health, mental health, minority-serving institutions, and minority communities to advance key issues and opportunities for improving minority health, promote promising and best practices, and mobilize collaborative actions which are critical to improving minority health in the future. Issues to be addressed include health care access, utilization and quality; healthcare and the public health workforce; research, data, and evaluation; health information technology; and culture, language, and health literacy. The Summit, which will mark the 20th year since the establishment of OMH, is intended to promote best practices and collaborative actions that are vital to improving minority health in the future.
Overall the health of the nation has improved. However, not all populations have benefited equally from these gains. Many Americans who are members of racial and ethnic minority groups experience disparities in health outcomes and health care. As a result, African Americans, American Indians/Alaska Natives, Asian Americans, Hispanic Americans, Native Hawaiians and other Pacific Islanders are more likely to have poor health and to die prematurely. A closer look at some of the challenges minority communities face reveals that:
- Heart disease is the leading killer across most racial and ethnic minority communities in the United States, accounting for 28.5 percent of all deaths in 2002. African Americans are 29 percent more likely to die from heart disease than non-Hispanic whites, despite the fact that only 9.6 percent of African Americans have heart disease compared to 12.2 percent of whites. African Americans are 1.5 times as likely as non-Hispanic whites to have high blood pressure. American Indian/Alaska Native adults are 1.3 times as likely as white adults to have high blood pressure.
- Cancer is the second leading cause of death for most racial and ethnic minorities in the United States. For Asians and Pacific Islanders, it is the number one killer. Asian and Pacific Islander women are 2.4 times as likely to have stomach cancer as non-Hispanic white women. Asian American men suffer from stomach cancer 114 percent more often than non-Hispanic white men. Cancer also disproportionately impacts African Americans, who are 19 percent more likely to die from all types of cancer than whites, adjusting for age. Hispanic women are 2.2 times more likely to be diagnosed with cervical cancer than non-Hispanic white women.
- Diabetes affects more than 20 million people above the age of 20 in the United States. An estimated 15.1 percent of American Indians and Alaska Natives have diabetes. They are 2.2 times as likely to have diabetes as non-Hispanic whites. Diabetes is most common among American Indians in the southern United States (26.7 percent) and in southern Arizona (27.6 percent). Diabetes heavily impacts some Latino subgroups as well. Mexican Americans, the largest Latino subgroup, are 1.7 times as likely to have diabetes as non-Hispanic whites. Residents of Puerto Rico are 1.8 times as likely to have diagnosed diabetes as U.S. non-Hispanic whites. African Americans are also 1.8 times as likely to have diabetes as non-Hispanic whites. In Hawaii, Asians, Native Hawaiians, and other Pacific Islanders aged 20 years or older are more than 2 times as likely to have diagnosed diabetes.
- Overweight and obesity are risk factors for many diseases such as heart disease, diabetes, and some cancers. Overweight and obesity are higher among women from racial and ethnic minority populations than among non-Hispanic white women. Mexican American women are 1.2 times more likely than non-Hispanic white women to be obese. Mexican-American men have a higher prevalence of overweight and obesity than non-Hispanic men, while non-Hispanic white men have a greater prevalence than non-Hispanic black men.
- HIV/AIDS has had a devastating impact on minorities in the United States. Racial and ethnic minorities accounted for almost 70 percent of the newly diagnosed cases of HIV and AIDS in 2003. In 2003, 80 percent of babies born with HIV/AIDS belonged to minority groups. AIDS is the leading cause of death in African American women aged 25-34 and the third leading cause of death in African American men in the same age group. African Americans are 10 times more likely to die of AIDS than non-Hispanic whites. HIV/AIDS is spreading at a rapid rate in the Hispanic community. Hispanics accounted for 20 percent of AIDS cases in 2003, despite making up only 12.5 percent of the U.S. population.
- African Americans are almost twice as likely to have a first-time stroke as whites and are almost one and one-half times more likely to die from the condition. American Indian/Alaska Native adults are 60 percent more likely to have a stroke than their white adult counterparts.
- The United States has made substantial improvements in infant mortality, but disparities still exist. In 2002, the infant mortality rate for infants of African American mothers was more than twice the rate for infants of non-Hispanic white mothers (13.8 deaths per 1,000 live births for African Americans vs. 5.8 deaths per 1,000 live births for non-Hispanic whites). In American Indian and Alaska Native populations, the death rate is 48 percent higher than among infants of non-Hispanic white mothers. American Indian/Alaska Natives Sudden Infant Death Syndrome (SIDS) mortality rate is 2.2 times the SIDS mortality rate for non-Hispanic whites. Although the infant mortality rate for Hispanic infants is less than the rate for infants of non-Hispanic white mothers, within the Puerto Rican subgroup, the infant mortality rate was 41 percent higher than infants of non-Hispanic white mothers.
HHS MINORITY HEALTH INITIATIVES
OMH is the federal focal point for improving the health of racial and ethnic minorities and eliminating health disparities through policy and program development. It had a fiscal year 2005 budget of $50.4 million. OMH provides overall public health guidance to the department on issues affecting African Americans, American Indians/Alaska Natives, Asian Americans, Hispanic Americans, Native Hawaiians, and other Pacific Islanders. Operating and staff divisions of the department are major contributors to HHS Secretary Mike Leavitt's 500-Day Plan, which supports community-based approaches to closing the health care gap, particularly among racial and ethnic minority populations, including American Indians and Alaska Natives. Many HHS programs and intra-departmental collaborations support this plan:
Hurricane Katrina Relief: HHS awarded more than $12 million to support minority individuals, families, and children affected by the devastation caused by Hurricane Katrina. The grants support greater access to health and behavioral health care services, assistance through faith-based and community organizations, and enhanced communications through minority media outlets. Projects include support for culturally relevant mental health services, bringing electronic health records to mobile units, efforts by state minority health offices, services to pregnant women and children in affected areas, and aid to evacuees who face cultural and linguistic barriers. For more information, visit www.omhrc.gov .
The President's Health Centers Initiative: HHS' Health Resources and Services Administration (HRSA), through the Consolidated Health Centers Program, manages President Bush's health center expansion initiative, which was launched in 2002. The initiative aims to create or expand 1,200 health center sites and serve an additional 6 million patients annually by the end of 2006. The number of sites would grow to 4,400 by the end of 2006, while the number of health center users would grow from just under 10.3 million in 2001 to more than 16 million by 2006. The President's fiscal year 2006 budget requests a $304 million increase from fiscal year 2005 to fund the Consolidated Health Centers. The Initiative is strengthening the health care safety net for medically underserved families and individuals. In addition, the President has established a new goal of helping poor counties that lack a community health center or rural health clinic. The budget request includes $26 million to fund establishment of 40 new health centers in high poverty counties. Community health centers provide quality, culturally competent health care for families and individuals nationwide regardless of their ability to pay and immigration status. For more information, visit www.hrsa.gov .
Health Disparities Collaboratives: Two-thirds of the community health centers have been a part of the Health Disparities Collaborative, a multi-year health initiative in partnership with the Institute for Health Care Improvement. The Collaboratives develop, test, and implement evidence-based models of care to improve health outcomes for underserved populations. The Collaboratives focus on asthma, cancer, depression, diabetes, cardiovascular disease, and perinatal/patient safety. Data from calendar year 2004 show almost 3 million African Americans, more than 4 million Hispanics/Latinos, some 302,000 Asians/Pacific Islanders, and more than 137,000 American Indians and Alaska Natives received health care services through the HRSA-funded community health center program. Some 64 percent of persons served by the health centers are from racial or ethnic minority communities. For more information, visit www.hrsa.gov .
Medicare Preventive Services and the New Prescription Drug Benefit: The Medicare Modernization Act has tremendous potential to reduce health disparities among minority seniors. Medicare will now cover preventive services that can detect health problems early, when treatment works best. These new preventive services include screenings for depression, heart disease, cancer, and diabetes -- conditions which disproportionately affect racial and ethnic minorities. In addition, Medicare coverage will now support programs that help smokers quit. This is critical because African American and Hispanic seniors are 64 percent more likely than whites to have diabetes. African Americans are 7 times more likely to have diabetes-related amputations and develop kidney failure than whites with diabetes, and the prevalence of hypertension in African Americans is among the highest in the world. More than one-third of American Indian adults smoke. The new benefits of Medicare also will enable more than 7.8 million minority beneficiaries to have access to a prescription drug benefit for the first time. Nearly 87 percent of African American seniors and 69 percent of Mexican seniors needed a prescription drug within the last month. Medicare will now help pay for the drugs they need. There is also extra help for those that need it most -- patients with limited incomes and resources. For most people with limited means, the extra help means no premiums, no deductibles, no gap in coverage and co-pays of only a few dollars for all prescriptions. Altogether, almost a third of all Medicare beneficiaries and nearly half of minority beneficiaries -- more than 3 million minority beneficiaries -- will qualify for this comprehensive extra help so that they can get the up-to-date drugs they need. To receive these benefits, seniors must enroll by May 15, 2006. For more information, visit www.medicare.gov .
Healthy People 2010: Healthy People 2010 is a comprehensive set of health objectives for the nation, and includes two overarching goals of increasing the quality and years of life, and eliminating health disparities, including differences that occur by race or ethnicity. Go to www.health.gov/healthypeople for more information.
Racial and Ethnic Approaches to Community Health (REACH) 2010: Launched in 1999, REACH 2010 is designed to eliminate disparities in cardiovascular disease, immunizations, breast and cervical cancer screening and management, diabetes, HIV/AIDS, and infant mortality. In FY 2005, the Centers for Disease Control and Prevention (CDC) received $34.5 million for REACH 2010 to support community-based coalitions that have a high potential to implement and evaluate innovative strategies aimed at eliminating local racial/ethnic health disparities, carefully documenting what happens in each local setting and study the similarities and differences among settings, and generate lessons that when applied will increase the effectiveness of future programs aimed at eliminating health disparities nationwide. CDC currently funds 40 projects in 21 states which target African Americans, American Indian/Alaska Natives, Asian Americans, Hispanic Americans, and Pacific Islanders. CDC also conducts the REACH 2010 Risk Factor Survey annually in minority communities in the United States, focusing on Blacks, Hispanics, Asians/Pacific Islanders, and American Indians. For more information on REACH 2010, visit http://www.cdc.gov/nccdphp/publicat.htm#PE.
National Diabetes Education Program (NDEP): The NDEP is a program co-sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (NIH) and the CDC. It is a leading source for information about diabetes care and prevention. The NDEP spreads its messages in English, Spanish and 14 Asian languages. Campaigns for high-risk minority Americans include "Small Steps. Big Rewards. Prevent Type 2 Diabetes.", "Paso a Paso," and "Si Tiene Diabetes, Cuide Su Corazón." NDEP recently launched "Take Care of Your Heart. Manage Your Diabetes." campaigns for American Indians and Alaska Natives and for Asian Americans and Pacific Islanders. For more information, visit www.ndep.nih.gov.
National Breast and Cervical Cancer Detection Program: CDC administers the $161 million National Breast and Cervical Cancer Early Detection Program (NBCCEDP) for state- and territory-based projects and Tribal governments. Established in 1991, the program is currently implemented in 50 states, 4 U.S. territories, the District of Columbia, and 13 American Indian/Alaska Native organizations. This program helps low-income, uninsured, and underserved women gain access to life-saving screening programs for early detection of breast and cervical cancers. The CDC has joined with a variety of national organizations and other partners to help strengthen and maintain the infrastructure needed to implement the NBCCEDP. The NBCCEDP has provided more than 4 million breast and cervical cancer screening and diagnostic tests to almost 1.75 million low-income, uninsured women. From 1991 through 2002, 1,175,759 women received 2,038,118 mammograms and 1,329,523 women received 2,305,936 Pap tests through the NBCCEDP. Because of these screenings, 9,956 cases of breast cancer, 12,187 cases of precancerous cervical lesions, and 832 cases of invasive cervical cancer were diagnosed. From 1999 through 2004, nearly 55% of the women who received breast cancer screenings 48% of women who received cervical cancer screenings through NBCCEDP were racial and ethnic minorities. For more information, visit http://www.cdc.gov/cancer/nbccedp/ .
Closing the Health Gap: Launched in 2001, Closing the Health Gap now comprises four minority health campaigns coordinated by OMH in partnership with HHS agencies. Take a Loved One for a Checkup Day encourages individuals to take charge of their health by visiting a health professional, making an appointment, attending a health event in the community or helping a friend, neighbor or family member do the same. Checkup Day events and messages have run in partnership with the ABC Radio Networks, the Tom Joyner Morning Show, and African American and other community groups around the U.S. Take a Loved One for a Checkup in American Indian Communities involves tribal colleges and universities in health events that bring people to screenings and health services. Celebra La Vida Con Salud promotes prevention and celebrates health by drawing upon family and community strengths to make good health practices a part of daily living, with health fairs in key Hispanic markets, and call-in health shows on Spanish-language radio. Know What to Do for Life aims to help reduce the infant mortality rate among African Americans by reducing the risks of Sudden Infant Death Syndrome (SIDS), preterm birth, and low birth weight. For more information, visit www.healthgap.omhrc.gov.
"¡Soy Unica! ¡Soy Latina!": The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed a bilingual initiative for Hispanic girls ages 9-14, and their mothers and other caregivers. "¡Soy Unica! ¡Soy Latina!" is designed to help them build and enhance their own self-esteem, mental health, decision-making and assertiveness skills, and to prevent the harmful consequences of alcohol, tobacco and illicit drugs. The "¡Soy Unica! ¡Soy Latina!" project encourages cultural pride by emphasizing the strengths inherent in the Hispanic culture initiative materials include posters, activity books, brochures and a Web site. For more information, visit, www.soyunica.gov.
The Community Initiatives to Eliminate Stroke Program (CITIES): This OMH-led effort is a demonstration program intended to test interventions that could increase minority community awareness and knowledge of hypertension and stroke, enhance early detection of high blood pressure and stroke with early referral to care, increase the community's adoption and use of lifestyle behaviors known to promote prevention and control of hypertension and stroke, reduce the death rate by stroke in targeted communities, and enhance blood pressure control rates. The three grantees are the Medical University of South Carolina, Charlestown; Forsyth Medical Center Foundation, Winston-Salem, NC; and the University of Alabama at Birmingham.
HHS AGENCIES TARGET HIV/AIDS IN MINORITY COMMUNITIES
Ryan White Comprehensive AIDS Resources Emergency (CARE) Act: The HHS fiscal year 2006 budget request for the Ryan White programs is $2.1 billion and includes special programs to reduce the disproportionate impact of HIV/AIDS in minority communities. These programs build on the department's core mission to protect and improve the health of vulnerable populations. Administered by HRSA, the Ryan White programs address the unmet health needs of persons living with HIV disease by funding primary health care and support services that enhance access to and retention in care. The 2005 Ryan White appropriation of $2.0 billion helped provide services to racial and ethnic minorities through local community health centers. For more information, visit www.hab.hrsa.gov.
CDC's Minority HIV/AIDS Research Initiative: In fiscal year 2005, the CDC devoted $2.9 million to the Minority HIV/AIDS Research Initiative (MARI), a capacity-building initiative to fund investigators to conduct studies that address gaps in HIV/AIDS research in Latino/Hispanic populations. The program identifies and addresses critical gaps in HIV/AIDS research in Latino/Hispanic populations by strengthening the capacity of researchers from the population, increasing the number of racial and ethnic minority researchers who are capable of independently conducting HIV/AIDS research, and facilitating the development of studies that address specific gaps in HIV/AIDS research in Latino/Hispanic populations. For more information, visit www.cdc.gov .
Substance Abuse and HIV Prevention Planning: SAMHSA's Minority Substance Abuse and HIV Prevention Planning Program responds to the health emergency in African American, Hispanic/Latino, American Indian/Alaska Native, and Asian American/Pacific Islander communities. Funds under this planning grant initiative are available to establish the infrastructure and leadership necessary to provide effective substance abuse prevention and HIV prevention and other related services to minority communities. Fiscal year 2005 funds support efforts and activities that will build awareness and consensus, and develop action plans for services to help ensure access to effective interventions. Approximately $7.5 million was awarded to support grants ranging from $90,000 to $125,000. For more information, visit www.samhsa.gov .
Substance Abuse, HIV, & Hepatitis Prevention: SAMHSA's Substance Abuse (SA), HIV, & Hepatitis Prevention for Minority Populations and Minority Reentry Populations in Communities of Color Initiative supports grantees in building a solid foundation for delivering and sustaining effective substance abuse prevention and related services. The program aims to engage community-level domestic public and private non-profit entities to prevent and reduce the onset of SA, and transmission of HIV and hepatitis among minority populations and minority reentry populations in communities of color disproportionately affected these diseases. This initiative funded 81 grants for $20.6 million in fiscal year 2005. For more information, visit www.samhsa.gov .
The Leadership Campaign on AIDS: The Office of HIV/AIDS Policy created The Leadership Campaign on AIDS (OHAP/TLCA) in 1999 as part of the Minority HIV/AIDS Initiative. OHAP/TLCA supports external and internal partners by offering technical assistance for organizational development, resource development, communications and media outreach, website development, graphic design, logistical support, program development, and evaluation support. Pursuing an innovative outreach strategy, OHAP/TLCA works with civic, public health, and faith leaders who have not previously been involved in the fight against HIV/AIDS to educate, motivate, and mobilize leaders in minority communities across America to get involved in the fight against HIV/AIDS. For more information, visit http://www.osophs.dhhs.gov/aids/tlcapage1.html.
HHS Intra-agency Initiatives: The HHS Minority HIV/AIDS initiative, funded at a level of $398.7 million in fiscal year 2005, has doubled since it was first developed in 1999. The initiative includes $52.4 million in fiscal 2005 to fund new projects at NIH, OMH, CDC, HRSA, SAMHSA, OHAP, and other agencies through the Minority HIV/AIDS Initiative Fund. One multi-agency collaboration supported by the fund and led by the OMH seeks to assist the U.S. associated Pacific Island jurisdictions in building a Pacific Health Resource Center, foster the growth of community based organizations, assist local government in organizing prevention campaigns and support the development of educational materials on AIDS as well as associated diseases such as tuberculosis. www.omhrc.gov .
MINORITY HEALTH RESEARCH
National Center for Minority Health and Health Disparities: NIH is the federal focal point for medical and behavioral research for the nation. The fiscal year 2006 budget request for NIH is $28.7 billion, which would more than double NIH funding since 1998. NIH's National Center on Minority Health and Health Disparities (NCMHD) promotes minority health and leads, coordinates, supports, and assesses the NIH effort to reduce and ultimately eliminate health disparities. In this effort, NCMHD conducts and supports basic, clinical, social, and behavioral research, promotes research infrastructure and training, fosters emerging programs, disseminates information, and reaches out to minority and other health disparity communities. The fiscal year 2006 budget request for NCMHD of $197 million would reflect an increase of $1 million from the 2005 appropriation. To find out more about NCMHD, go to www.ncmhd.nih.gov .
Centers for Disease Control and Prevention: CDC has released DATA2010, an interactive database system developed by staff of the Division of Health Promotion Statistics at the National Center for Health Statistics. DATA2010 is updated quarterly to include new data years, and possibly revisions to baseline data. This database system contains 467 objectives that identify specific measures to monitor health in the first decade of the 21st Century. Data for the population-based objectives may be presented separately for select populations, such as racial, gender, educational attainment, or income groups. The objectives are organized into 28 focus areas, each representing an important public health area. For more information, visit http://wonder.cdc.gov/DATA2010/ABOUT.HTM.
National Center for Bioethics in Research and Health Care: CDC awarded nearly $2 million in fiscal year 2005 to the Tuskegee University National Center for Bioethics in Research and Health Care to support its efforts to increase the equitable and ethical delivery of health services and the ethical conduct of scientific research for disadvantaged communities and vulnerable populations, while increasing the level of their trust in the nation's healthcare infrastructure. The center works with local, regional, national, and international communities to address ethical and human value issues in science, technology, and health as they impact people of color. Established in 1999, the Bioethics Center is the nation's first initiative dedicated to the inclusion of African Americans and other communities of color in response to issues of human values in science, technology and society. The Center has projects and collaborations with organizations and academic institutions around the world. For more information, visit www.tuskegee.edu/bioethics.
Agency for Healthcare Research and Quality (AHRQ): Since 2003, AHRQ has produced an annual report, the National Healthcare Disparities Report (NHDR), to track prevailing disparities in health care delivery as it relates to racial factors and socioeconomic factors in priority populations. The report measures quality and disparities in four key areas of health care: effectiveness, patient safety, timeliness, and patient centeredness. Most of these indicators measure the application of specific treatments and procedures that have been shown to produce best results for patients. The reports also present data on access to services for clinical conditions including cancer, diabetes, end-stage renal disease, heart disease and respiratory diseases; and for nursing home and home health care. The first NHDR, released in 2003, was a comprehensive national overview of disparities in health care among racial, ethnic, and socioeconomic groups in the general U.S. population and within priority populations. The second NHDR initiated a second critical goal of the report series-tracking the Nation's progress towards the elimination of health care disparities. The third NHDR meets these goals more completely and rigorously. New databases and measures have been added to provide a more comprehensive assessment of disparities in the Nation with the goal of leading to improvements over time. For more information: visit: http://www.qualitytools.ahrq.gov/.
ADDITIONAL MINORITY HEALTH RESOURCES:
Office of Minority Health Resource Center (OMHRC): OMH established the Resource Center in 1987 to meet minority community needs for reliable, accurate, timely, and culturally competent health information. OMHRC maintains an extensive library on minority health issues and serves health professionals and consumers with publications, funding searches, reference information, referrals, access to a network of volunteer resource persons, and technical assistance and capacity development services for community organizations. The resource center also maintains an active conference/exhibit program with national and regional minority and public health organizations. Services are offered without charge by telephoning 1-800-444-6472 or visiting www.omhrc.gov .
MEDLINEplus: NIH's National Library of Medicine's MEDLINEplus provides authoritative, full-text health education and medical resources. The site has recently developed population-specific health pages for African Americans, American Indians/ Alaska Natives, Asian Americans/ Pacific Islanders, Hispanics/ Latinos, teens, and seniors. Medlineplus also offers a Spanish-language companion health Web site. The site is available at http://www.medlineplus.gov .
healthfinder Just for You: On September 28, 2001, HHS unveiled healthfinder en Español, a Spanish-language Web site that helps consumers track down reliable information quickly and easily on the Internet. healthfinder en Español brings together health information on over 300 topics, including those health issues of greatest concern to those of Hispanic heritage. To view the site, go to www.healthfinder.gov/espanol.
Office for Civil Rights (OCR): On August 8, 2003, OCR issued written policy guidance to clarify reasonable policies, procedures, and other steps that health and social service providers can take to ensure meaningful access to their programs by persons with limited English proficiency (LEP). OCR has produced a video and a brochure on the rights of LEP persons, in collaboration with the U.S. Departments of Justice and Agriculture. For more information, visit www.hhs.gov/ocr/lep. OCR is also a leader in the Federal Interagency Working Group on Limited English Proficiency that has created the administration-wide Web site, www.lep.gov.
Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.
Last Revised: March 10, 2006