TB Challenge: Partnering to Eliminate TB in African Americans
Eliminating Racial and Ethnic Health Disparities through
Passion, Perseverance, and Public Health
Carmen J. Head, MPH, CHES, Director, School Health Programs,
Society for Public Health Education
U.S. Public Health Service Syphilis Study at Tuskegee remains the
most infamous biomedical research study conducted in this country.
My grandfather, Fred Tyson, was among the poor uneducated
sharecroppers included as study subjects. The painful, tragic, and
unjust events that took place over the course of this 35 year study
have left an irrevocable mark on clinical research. The study boldly
highlights the history of unequal health practices in this country,
and provides a clear example of how the abuse of power, and race and
economic status can impact health. While we work to address
disparities in health due to race and class, it is also important to
examine the past and to discuss the root causes of health
disparities. Not having a clear under-standing of the past makes
the creation of solutions for a brighter, healthier future unlikely.
This year marks the 10th anniversary of the
Presidential apology made to the study survivors and their families.
As we poignantly reflect upon the history of the study, we must
continue to apply the lessons learned from Tuskegee with shared
determination to identify the best practices and strategies in
eliminating racial and ethnic health disparities. As both a family
member of a syphilis study subject and public health professional, I
am always eager to explore ways for us to transform the bleak legacy
of the Syphilis Study into one that works toward improved health
status for all --particularly the most disadvantaged.
In this short article, I share what I consider
three important “must haves” in any planned approach or strategy to
improving health outcomes for communities of color.
The elimination of racial and ethnic health
disparities in this country calls for a devoted workforce of
professionals from a number of fields that are impassioned about
seeking social justice for the nation's racial and ethnic
minorities. These professionals play a critical role in bringing
about change through: shining the light on a growing need;
identifying unethical practices; collecting health data and trends;
framing and implementing public health policies; and implementing
and evaluating programs aimed at improving health outcomes for all
people. Many existing national, state, and local strategies that
support efforts to eliminate racial and ethnic health disparities
are due primarily to a cadre of concerned health advocates,
researchers, and practitioners. These champions for health equity
many of whom themselves are minorities
strive to make a difference because of an undying passion that
drives them to remain grounded in these efforts.
My choice to pursue public health as a
profession is the direct result of my grandfather's involvement in
the study. My passion for health equality and improved health
status for African Americans, other minorities, and the economically
challenged is a lifetime commitment.
While we are challenged each day in our current
positions with issues or mundane obstacles that may be peripheral to
our common goal of eliminating racial and ethnic health disparities,
let us continue to see the broader picture of improved health for
all communities. As we prepare the future public health workforce
with the resources and skills needed to address health equity, let
us instill in them the importance of working with conviction and
As we know, racial and ethnic disparities in
health and health care are created and sustained by very broad and
complex challenges, which have been in existence for hundreds of
years. Often these complex challenges call for complex
multi-level, multi-lingual, and multi-disciplinary strategies. Over
the past 20 years, racial and ethnic health disparities have
received much needed examination and resources, thanks in part to
earlier reports like the Heckler report, and more recently, the
Sullivan Commission and Unequal Treatment Report. Other research
studies and reports have clearly identified a strong association
between race, poverty, and health. More challenging for me to
determine, however, is how to effectively reform social determinants
such as education, employment, housing, and health care to improve
the health status of minorities. CDC is making progress in
addressing health disparities through projects like the CDC Racial &
Ethnic Approaches to Community Health (REACH) and a project funded
in select states by the CDC Division of Tuberculosis Elimination to
reduce TB rates in the African-American community. However, much
more work needs to be done.
Public health research and practice play
critical roles in working towards the elimination of racial and
ethnic health disparities. Most national public health non-profit
organizations have created resolutions to help guide their research,
policy, and education efforts in addressing health disparities.
Some organizations focus their efforts on encouraging policy makers
to create sound public health policies. Other organizations strive
to strengthen pre-professional public health programs, while still
other non- profits use federal resources to engage communities in
research to create and implement effective programs and services.
The Society for Public Health Education (SOPHE), where I am
currently employed, does all of the above. SOPHE's mission is to
provide leadership to the profession of public health education and
to contribute to the health of all people and the elimination of
disparities through advances in health education theory and
research, excellence in professional preparation and practice, and
advocacy for public policies conducive to health. SOPHE has a
longstanding commitment to racial and ethnic health disparities.
Since 1967, SOPHE has embraced an Open Society that charges the
organization to respect diversity and seek social justice and health
equity for all. Since that time, SOPHE has engaged in multiple
programs on the topic of health disparities and has secured federal
and private funds for health disparities related programming.
In my current position at SOPHE, I manage two
major dissemination activities for SOPHE's Health Education Research
Agenda on Eliminating Racial and Ethnic Health Disparities. The
first initiative involves the dissemination of an electronic
resource that undergraduate and graduate programs in public health
and health education can use in classroom discussion to address
health disparities. Supported by funds from the National Cancer
Institute, the contents of this DVD were created from presentations
at SOPHE's 2005 Inaugural Health Education Research Disparities
Summit entitled Health Disparities and Social Inequities: Framing a
Transdisciplinary Research Agenda in Health Education. The second
initiative, funded by the WK Kellogg Foundation, involves community
dialogues that four local SOPHE chapters have received funding to
convene. These community dialogues will provide National SOPHE
community input for its research agenda.
SOPHE's commitment to advancing health equity
is evidenced through its many other activities and partnerships
sustained throughout the year. In March 2007, SOPHE partnered with
members from the Coalition of National Health Education
Organizations to hold the 10th Annual Health Education Advocacy
Summit. At the summit, participants were trained on key policies and
funding issues for federally funded health disparities initiatives.
From October 31 through November 3, 2007, SOPHE hosted its 58th
annual meeting. This year's meeting, Partnerships to Achieve Health
Equity, took place in Alexandria, VA in collaboration with the CDC
Racial & Ethnic Approaches to Community Health (REACH) project and
Eta Sigma Gamma, a national professional health education honors
society. To find out more information on SOPHE's resources or
meetings, please contact the SOPHE office at 202-408-9804 or visit
the Web site.
Work towards the elimination of racial and
ethnic health disparities will continue in many years to come; Dr.
Martin Luther King once said “Of all the forms of inequality,
injustice in health is the most shocking and inhumane.” As we face a
future nation that will become more racially and ethnically diverse,
the health status of communities of color must be a top priority.
Let us continue to work towards the dream of health equity and
social justice for America and the global community. I would like
to commend the work that CDC's Division of Tuberculosis Elimination
has done and continues to do to address TB health disparities and I
look forward to hearing about CDC's future successes.