Eliminating Health Disparities: Focal Points for Advocacy and Intervention

We applaud the Journal’s October 2003 focus on eliminating health disparities and the University of Pittsburgh’s National Minority Health Research Summit. Efforts to reduce inequalities need to be derived from multiple sources. Two recent publications about the challenges of achieving equality for American Indians, Alaska Natives, and Latino peoples show the failings of our past approaches.1,2 The National Institutes of Health’s National Center on Minority Health and Health Disparities is paving the way for a more aggressive research agenda in this area.3 Public health professionals need to educate policymakers about the need for support for such research, as well as for programs that translate research into practice, such as the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health (REACH) 2010.4 REACH is funded for fiscal year 2004 at only $37 million —the same amount it received in fiscal year 2003.5 It is clear that government intentions alone will not elevate the health status of America’s marginalized and minority peoples. Voluntary professional associations such as the Sociey for Public Health Education and the American Public Health Association (APHA) must call on their members to connect with all levels of society. A central organization can plan training, promote cultural sensitivity, share information and research, and develop positions that can be used by other groups in their advocacy efforts. APHA is demonstrating its leadership in this area by designating “Eliminating Health Disparities” the theme of National Public Health Week in 2004.6 In 1966, Dorothy Nyswander defined an open society as “one where justice is the same for every [person]; where dissent is taken seriously as an index of something wrong or something needed; where diversity is expected; . . . where the best of health care is available to all; where poverty is a community disgrace not an individual’s weakness; [and] where desires for power over [people] become satisfaction with the use of power for people.”7(p37) In keeping with this vision, in 2000 the Society for Public Health Education (SOPHE) commissioned an Open Society Commission, which resulted in 6 resolutions aimed at eliminating health disparities and calling for widespread socioecological change. Yet stronger organizational commitment from groups such as SOPHE and APHA is crucial to helping diverse practitioners eliminate such continuing practices among health care professionals as racism, stereotyping, bias, discrimination, and cultural and professional incompetence. Let each public health professional rise to the challenges of achieving an open society and reaching our national goal of eliminating health disparities.