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REMARKS BY:
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TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES
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DATE:
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April 19, 2004
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Health Disparities Summit
Thank you, David, for that kind introduction. [AstraZeneca
CEO David Brennan]. I’d also like to thank Dr. Gary
Puckrein, Dr. Randall Maxy, Dr. Marilyn Gaston, and everyone else
here for all you do to improve the quality of health care in
America.
My friends, let me be very frank. There are some who thought
I shouldn’t come and speak to you all today, given the
controversy surrounding my Department’s report on racial
disparities.
These people were wrong. There is no place I would rather be
than here with you. Yes, mistakes were made in issuing this
report, but I intervened personally to correct these
mistakes. And I believe wholeheartedly that our Nation
faces few challenges more pressing than ensuring that all Americans
can access quality health care. A big part of this
challenge involves not just reducing, but eliminating disparities
in the quality of care available to communities of color.
Clearly, research and data indicate that health differences exist
among racial and ethnic minority groups. There are gaps in
health outcomes. There are disparities in the incidence of
chronic disease. Across geographic locations, racial and
ethnic minorities are under-represented in health professions such
as nursing. All told, we have some major obstacles to
overcome.
I’m here today to reaffirm my commitment to overcoming these
obstacles. I stand before you as the same man whom you
honored last year with the Booker T. Washington Award. You
gave me this award—in the name of a great American who fought
for equality and opportunity—because of my Department’s
commitment to addressing racial disparities. Today,
this commitment has not wavered. In fact, I believe even more
deeply in the importance and urgency of this cause.
We have made significant progress in reducing disparities.
For example, over the last three years, over 300 community health
centers have participated in the National Diabetes Collaboratives,
which have experienced great success. Approximately 70% of
all those served by health centers are members of a racial or
ethnic minority. On average, patients participating in
these Collaboratives have seen their blood sugar levels go down
dramatically, significantly reducing their risk of eye, kidney, and
nerve complications.
Also, we have increased the number of organ donations among African
Americans and Hispanics. I was actually just inducted into
the Minority Transplant Hall of Fame, in recognition of our efforts
to increase organ donations among minorities. This was my
2nd Hall of Fame, the first was the Motorcycle Hall of
Fame.
About 5.8 million children who otherwise would not have health
coverage were enrolled in the State Children's Health Insurance
Program (SCHIP) at some point during fiscal year 2003 -- a 9
percent increase from the previous year.
But as I said, our goal is not to reduce disparities—it is to
eliminate them. To achieve this objective, we still have some
serious work on our hands.
And my Department is serious about leading this effort. Let
me talk briefly about a few of the many things we are doing to
address racial disparities in health care.
We are supporting research specifically targeted at minority
health. In September, I announced the creation of eight
Centers for Population Health and Health Disparities. They
will perform research to help us understand and reduce differences
in health outcomes, access, and care. We are investing more
than $60 million in these centers over the next five
years—and that’s on top of the $65 million invested in
NIH’s National Center for Minority Health and Health
Disparities. These Centers are using a community-based
research approach to explore the complexity of health disparities
by studying obesity, cardiovascular disease, breast cancer,
prostate cancer, cervical cancer, mental health, and other factors.
We have increased funding to address HIV and AIDS in minority
communities that are disproportionately affected by this
epidemic. The fiscal year 2005 budget includes a $53 million
request to support innovative approaches to HIV and AIDS prevention
and treatment in minority communities. So we are ensuring
that money and expertise are reaching our hardest-hit communities,
in fresh ways.
We are helping low-income seniors through the new Medicare
Modernization Act, which provides almost 8 million minority
Medicare beneficiaries with access to a prescription drug benefit
for the first time ever. For the more than 1.5 million
low-income minority beneficiaries who do not already have drug
coverage, the drug card will give them up to $600 per year to help
them afford their medicines, on top of their discounts off retail
drug prices.
We are encouraging health literacy, education, and preventive
steps, particularly through our “Take A Loved One to the
Doctor Day.” This annual event is a cornerstone of my
Department’s broader “Closing the Health Gap”
education campaign.
In 2003, more than 35 million people heard Take a Loved One to the
Doctor Day messages that were part of our African American radio
campaign, or saw TV coverage of our local events. They heard
the message on more than 200 radio stations, and TV coverage on two
dozen stations and networks. More than 150 local Dr Day
events were held. These are just the ones we know about.
We partnered with Tom Joyner and distributed 75,000 pledge
cards to people who said they would take a loved one to the doctor.
17,000 Spanish-speaking consumers, mainly families, attended our
health fairs in 12 urban and rural markets where we offered free
screenings for diabetes, cholesterol, high blood pressure and
more. 40 community based organizations, healthcare providers
and health departments participated with us to bring home the
message.
We know people were hungry for health information and for our
help. They asked us for help in finding a doctor. They
asked us for help in paying for care. They asked us for
information in languages other than English. They asked us
for help in keeping themselves and their families healthy.
So we intend to do it again, and make it bigger and better each
year.
We are expanding the good work of community health centers, which
play a key role in addressing racial disparities. These
centers are uniquely positioned to serve the patients who need our
help the most, particularly underserved racial and ethnic
minorities. They provide quality, compassionate care,
regardless of patients’ ability to pay.
Early in his Administration, President Bush outlined a five-year
initiative to create 1,200 new or expanded health center sites that
could increase the number of people served from about 10 million to
16 million in 2006. I’m happy to report that we are
half way toward meeting these ambitious goals, thanks to a $500
million increase in funding over the last five years.
More than 600 new or expanded sites are up and running, and health
centers across the country have added over a million new patients
for the second year in a row.
We are screening more minority women for cancer through our
National Breast Cancer and Cervical Cancer Early Detection
Program. This program has provided more than 3.5 million
screening tests for breast and cervical cancer to nearly 1.5
million low-income women. So we are helping to ensure that
underserved women have access to screening services that can detect
cancer early and reduce illness and death.
We are launching a new Stroke Belt Initiative, to reduce
hypertension rates in the southeastern United States, where
minorities are disproportionately affected by strokes.
Hypertension is the most powerful risk factor for stroke.
And I want to thank Dr. Larry Fields and Dr. Garth Graham, my White
House Fellow, who have both done a great job moving this Stroke
Belt Initiative forward. In addition, Garth has been working
on issues related to Minority Men's Health, which I know many
of you are interested in as well. In fact, we will invite
many of you to participate in a roundtable we are putting together
on minority men's health.
We are working to break down barriers that prevent people from
buying health insurance and to help the uninsured—this is a
major hurdle to reducing racial disparities. Over the past
three years, we have approved Medicaid waivers and state plan
amendments to allow state governments to expand access to health
coverage for more than 2. 6 million people and to expand the range
of benefits offered to 6.7 million other Americans.
I’ve just mentioned 10 different action areas where our
Department is doing important work to address disparities,
investing millions of dollars. I could list many more.
On a broader level, we have organized a new Health Disparities
Council that is working to develop a specific action plan to
eliminate disparities. This plan—which will be
finalized within the next few months—will bring all of our
goals and programs together under one overarching initiative, with
actionable steps and measurable results. It will focus
our efforts and allow us to speak with one voice as we work to
increase research, improve education and outreach, diversify the
health workforce, and implement cross-cutting services to help
minority patients.
So you see: At HHS, our record is clear. Our record is
strong. We are taking important steps to solve the problem of
racial disparities. Yet we also recognize that this is not a
problem that will be solved by HHS alone. Nor is it a problem
that will be solved within an election cycle. These
disparities are rooted in history, poverty and culture. They
represent a complex social ill, and there is no silver bullet or
simple cure for this complicated problem. Still, like our
personal health, we can take small steps that will yield great
progress. And each small step takes us in the right
direction.
Reducing racial disparities requires long-term dedication at all
levels of government, through all segments of society. It
requires commitment, cooperation and coordination between
government, the health care industry, and community
leaders.
And all of you here play a big role in this fight. One of the
most important things that you, as doctors, can do, is to encourage
disease prevention and health literacy. I believe that people
of every ethnic group can lead healthy lives, but they have to know
the facts of prevention. They have to learn how to lead
healthy lifestyles. We are doing our part to educate minority
groups, and we need you to help us in this important
work.
As I close, let’s look at the big picture. Prejudice is
a reality in America. It hurts many of our
citizens. And it holds back our society from achieving
the ideal of equality expressed at our founding. As a nation,
as a government, as individuals, we must be vigilant in responding
to prejudice wherever we find it.
When it comes to health equality, a great challenge remains.
And again, the challenge is not reducing health
disparities—we’re already doing that—it’s
eliminating health disparities.
As long as I’m at HHS, rest assured that we will always be
willing to talk and to listen to you. We may not always
see eye to eye on the correct solutions to this dilemma. But
I pledge to keep my door open to you at all times.
In return, I ask of you one thing: Don’t just come to
me with problems. Don’t just come to me with
complaints. Come to me with solutions. Do that, and I
commit to you that you will have an unwavering partner in the fight
to eliminate health disparities in every corner of America.
I believe that this great and prosperous land can become a single
nation of justice and opportunity. As President Bush
has said, “We will not, and we must not, rest until
every person of every race believes in the promise of America
because they see it with their own eyes and feel it in their own
lives.”
It’s my job to ensure that people see and feel the promise of
this country when they receive top-notch care from the
doctor—when they find a friend at a community health
center—when their children learn the fundamentals of exercise
and nutrition. And ultimately, when they see the benefits of
better health in their own lives.
My friends, let us achieve this goal together. Thank you.
Last Revised: April 19, 2004
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