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U.S. Department of Health and Human Services

  

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TB Notes 4, 2003

Consultation with African-American Organizations

The Advisory Council for the Elimination of Tuberculosis (ACET) and CDC cosponsored a consultation with national nongovernmental, African-American organizations and agencies whose programs could have an impact on TB control efforts in the African-American population. This was an initial step in addressing the disparity between the TB case rates of African Americans and other US-born racial/ethnic groups in the Southeastern United States. The consultation was intended to raise awareness about the disparity, solicit support for eliminating TB in US-born African Americans, and develop recommendations for accelerating the decline in TB rates among US-born African Americans in the Southeastern states.

The consultation, entitled “TB in America: Disparities in the Southeast,” was held on May 13 and 14, 2003, at the Sheraton Colony Square Hotel in Atlanta. Approximately 40 people attended this consultation (not including observers from CDC). The participants comprised a diverse group that included academicians, health care providers, public health leaders, policy- and decision-makers, religious and community leaders, state and local health department representatives, and others who represent a broad spectrum of views.

Organizations Attending the ACET Consultation

Alpha Kappa Alpha Sorority, Inc.
AME Church
American Medical Association
American Public Health Association
Bureau of Communicable Disease Control, Texas DOH
CDC
Chicago Department of Public Health
City of Atlanta Mayor’s Office
Denver Public Health Department
Division of Immigration Health Services, US Public Health Service
Federal Bureau of Prisons
Georgia Department of Human Resources
Georgia Division of Public Health
Georgia State Senate
Howard University
HRSA/Bureau of Primary Health Care
Institute for Families in Society
Jackson (Mississippi) Medical Mall Foundation
Marion County (Indiana) Health Dept
Dept of Internal Medicine, Meharry Medical College
Metro Public Health Department of Nashville, Tennessee
N.W. Public Health District I, Mississippi
NAACP
National Association of Black Social Workers
National Association of Community Health Centers
National Baptist Convention of America, Inc.
National Black Methodists for Church Renewal
NJMS National Tuberculosis Center
Office of Minority Health (DHHS)
Omega Psi Phi Fraternity, Inc.
San Francisco TB Control, SF General Hospital
South Carolina Department of Health
Substance Abuse and Mental Health Services Admin
University of Alabama-Birmingham
University of South Carolina

The first day of this consultation provided participants with an overview of the TB problem and more specific information about TB in African Americans. On the second day, participants were assigned to smaller breakout groups and asked to develop specific recommendations for accelerating the decline in TB rates among US-born African Americans in the Southeastern states.

During the breakout sessions, the participants were asked a number of predetermined questions that covered several major topics, including level of community TB knowledge, how to increase awareness of the TB problem, how to mobilize community resources, and how to enhance relationships between TB control programs and African-American communities in order to improve TB elimination activities.

The discussion groups identified a number of unmet needs and provided important comments and specific recommendations for activities to raise awareness and stimulate actions to address and reduce TB in racial/ethnic minorities. The following is a summary of the needs and recommendations:

Needs

  • Reframing TB disparities will be important in creating political will.
  • Media and available technology need to be used for the dissemination of information (realizing that some in the target population may not use cell phones and computers).
  • Communities and health departments must “come together” to provide holistic care that addresses more than TB care.
  • The private provider–public health disconnect must be addressed.
  • Internal community issues that perpetuate and magnify communicable diseases must be addressed locally.
  • “Southeast” should be defined as the geographic area where disparities are greatest and where there are enduring historical influences of racism, discrimination, and exploitation.
  • Strategies need to reflect knowledge of the environment in which the TB patients live.
  • Successful models (e.g., Mississippi) in the South exist and key elements/best practices of those programs need to be disseminated.
  • The African-American community needs to hear that TB is curable and preventable, and not an inherited condition.
  • The African-American community needs easier-to-understand educational material.
  • Advocates for TB elimination need one-page fact sheets describing the TB problem at the state and/or local level for presenters of TB information and advocates to hand out to community and political leaders.
  • CDC needs to do more evaluation of existing TB programs in predominantly African-American communities.
  • Notable figures are needed to advocate for TB elimination and reduce the associated stigma.
  • The community needs to become more outraged about the TB problem, stop being so accepting.
  • The consultants perceived a need to raise awareness among both medical and legislative leaders regarding the TB problem and the disparity among African Americans.
  • A national advocacy group is needed to develop relationships with a variety of groups.
  • More publications on the disparity issue in the Southeast are needed to help spread the word.

Recommendations

  • Send TB experts to communities and community organizations to speak about the problem and what we can do about it.
  • Use a number of venues to get the message out, including public service announcements, billboards, former patients, the National Minority Health Education Network, media resources that have a largely African-American audience, direct person-to-person (even door-to-door) education, and local gathering points (churches, shelters, emergency rooms, liquor stores).
  • Seek out and partner with the private sector, CBOs, and other organizations that serve the African-American community.
  • Involve public school systems and form partnerships with historically black institutions of higher learning.
  • Health departments should strive to ensure that the racial/ethnic composition of their staff is similar to that in the communities being served.
  • Place TB on the Secretary’s Health Disparities Report, and on the agenda of the American Public Health Association conference.
  • CDC should improve or establish relationships with a variety of organizations such as the National Medical Association, the Black Women’s Project, and African-American fraternities and sororities.
  • Improve the relationships between the health departments and African-American communities. TB programs must acquire a better understanding of black culture, maintain a level of respect for the individual, evaluate and improve community access to TB services, and create more community coalitions.

Since the consultation was held, work has continued on a number of follow-up tasks. The first task was to develop and distribute an executive summary that participants could use in their reports back to their organizations. In addition, a final participant list was sent to all attendees to facilitate communication between them. On June 5, 2003, the results of the consultation were presented to the full ACET committee. The next step was to advise ACET on potential follow-up activities based on the recommendations made at the consultation. An initial meeting has been held and recommendations are currently being finalized.

In addition to these activities, many consultation participants have been working on their own to inform others of the disparity in TB rates. They have also asked CDC officials to report on the disparity at their national and regional conferences. The National Coalition for the Elimination of Tuberculosis (NCET) has invited participants to join them. The consultants agreed to draft and co-sign a letter to Secretary Tommy Thompson expressing their concern over racial health disparities in TB among Americans.

—Reported by H. Dave Crowder, MPH
Div of TB Elimination

 


Released October 2008
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