Leadership Forum examines health disparities

“When you hear that there is a disparity between minorities and the rest of the population, believe it,” says John Ruffin, the first associate director of research on minority health, of the National Institutes of Health (NIH). In his address to the Leadership Forum of the Commonwealth Fund/Harvard University Fellows (CFHUF) in minority health policy on Oct. 3, Ruffin explained that, despite voluminous data, it was a challenge to convince people who can make a difference that disparities in health and training are real.

“We are all on the same ‘wavelength’ today, however,” Ruffin said, reporting encouragement from the “top down,” as President Clinton has made eliminating health disparities a priority and each agency, inside and outside of NIH, is playing a key role in the national debate. Citing the pressing need “to build a consensus,” Ruffin convened a 53-member advisory minority fact-finding team, co-chaired by David Satcher, now U.S. Surgeon General, and Norman Francis, president of Xavier University of Louisiana. Members of the team included Health and Human Services Secretary Donna Shalala, former Congresswomen Barbara Jordan, and Theodore Cooper, former director of NIH. The central question for this group was: “What should we be doing that we are not doing now?”

In answer to this question, posed during a series of national workshops involving more than 1,000 community members, the team drafted 13 recommendations aimed at improving minority health, and increasing participation of minorities in all levels of research and training. These recommendations became the guidelines and cornerstone of the programs of the Minority Health Initiative.

Ruffin reported that “the train has left the station and all 13 recommendations have been implemented in some form.”

A sampling of these recommendations:

_ “Build partnerships between minority academic health centers and majority health centers.” Working with the Cancer Institute, they fund research that couples the best of each, for three years, in a highly successful effort that has become a model across all the institutes.

_ “Build a bridge” between two- and four-year college programs and another between master and Ph.D programs to specifically address training. These programs have been successful in attracting more minority scientists who were not making the transition to a four-year program because of economic realities and those enrolled in historically black colleges or universities who could now simultaneously enroll in a Ph.D. program in a major research institute.

_ “Legislate a model to encourage minority students to recognize that science is global.” This was accomplished by a series of strategic funding mechanisms, from regional to international settings.