African American History Program Urges Greater Attention to Health Disparities
By Sharon Ricks
Photos by Ernie Branson
On the Front Page...
Today two healthy babies were born in the most affluent, technologically advanced country on the globe. One is a white female; the other is a black male. They were born in the same city, in the same hospital, and they both have proud, happy parents. But they are different. One will live to see her grandchildren grow up, the other will not.
"Black Americans born today have a life expectancy significantly shorter than that of white Americans," said Dr. Louis W. Sullivan, president of Morehouse School of Medicine, addressing a group of 200 employees at the African American History Program on Feb. 24. "For white females, life expectancy is 79.6 years compared to 74.1 years for black females. That's a 5-year difference. For white males average life expectancy is 73.8 years; for black males it is 66.4 years, a difference of 7.4 years." Sullivan, former secretary of the U.S. Department of Health and Human Services, said the 13-year gap in life expectancy between white females and black males is astonishing. The program, "Continuing the Journey: Biomedical Research and Education," was presented in memory of Dr. Geraldine Pittman Woods for her lifetime achievements in initiating and developing NIH-supported minority research and training programs. Woods was instrumental in the development of the Minority Access to Research Careers and the Minority Biomedical Research Support programs at NIH. She also helped Dr. Ciriaco Gonzales, one of the former directors of MARC and MBRS, to establish the Society for the Advancement of Chicanos and Native Americans in Science.
Panelists included Dr. Lafayette Frederick of Howard University, Dr. Alfred Johnson of NCI, Dr. Patrice Desvigne-Nickens of NHLBI and Nia Banks, an M.D.-Ph.D. candidate at Johns Hopkins University School of Medicine.
Speakers spotlighted the need to recruit and retain culturally competent and sensitive biomedical researchers; increase major grant support among minority institutions and investigators; boost minority participation in clinical trials; enhance NIH projects that address minority health issues; and ensure that bench technologies reach the bedsides of the most needy areas.
"In minority populations," said Desvigne-Nickens, who studies the effects of cardiovascular diseases on women and minorities, "where there are so many competing issues and just putting food on the table can be such a problem, health is not given the type of priority that it is given in populations that have more flexibility in terms of their economic choices. You can't help others, and you can't help yourself without good health."
She said patients must educate themselves. Myths, beliefs and cultural expectations all affect how you view yourself and your health, but more important is knowledge of the information that is available, having the thirst for information about a disease, and being demanding of your physician. She also stressed the need for participation in clinical trials.
Banks offered some issues for doctors to consider. She said there is a "disconnect" between physicians and patients and cited the need for making cultural competence a mandatory part of the curriculum for medical students and physicians-in-training. "Hopkins is the number one hospital in the country, according to U.S. News and World Report," said Banks. "Now I'm not sure of the criteria they used, but if they were to use the disease indices of the East Baltimore community, Hopkins would rapidly lose that position. East Baltimore is a majority black neighborhood. It's a low socioeconomic area. It's an inner city, basically. We have the highest rates of syphilis in the country...an outbreak of chlamydia and gonorrhea...an epidemic of tuberculosis and one of the five highest rates of HIV. This is a neighborhood that I work in every day and that has the number one hospital in the country. That's a travesty, and we need to do something about it."
Panelists discussed a role for NIH in addressing disparities in several areas. With regard to NIH training programs, Dr. Alfred Johnson, a participant in the MBRS program, offered some advice: "Let me break it down. It's simple. I am a product of the MBRS. I was an investment by NIH, and from my point of view, NIH is receiving a much larger give-back than what they put into it to get me, so I think that program works." Johnson said NIH needs to create new programs and initiatives.
Sullivan noted that according to a 1989 article in the Chronicle of Higher Education, only 0.4 percent of all NIH grants went to African American investigators. He said during his medical student years in Boston in the mid-1950's, faculty members who retired from Harvard, Tufts and Boston University often headed west to California and to other states to assist emerging young institutions in the development of their educational and research programs. With faculty additions and sustained grant support from NIH, those fledgling schools have become major contributors to the nation's biomedical research enterprise. Sullivan said he anticipates a similar valuable return to the nation from sustained support for minority health profession schools and minority investigators.
On the issue of health status, Sullivan noted that the areas of health disparity are such that virtually every institute at NIH has a significant contribution to make, and he envisions an NIH-wide effort, not confined to one office or one center.
"With the efforts of Congress to double the NIH budget over a 5-year period, now is the time for NIH to renew attention and commit greater resources to the issue of health disparities," said Sullivan. "It is not only the right thing to do, it is the smart thing to do."
The program was sponsored by 15 institutes and centers.
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