Clinton Offers Plan to Close Racial Health Gap

President Clinton has launched a $400-million initiative to eliminate gaps between the health of non-Latino whites and minorities by the year 2010, declaring that such disparities “are unacceptable in a country that values equality and equal opportunity for all.”

Outlining the plan in his Saturday radio address, Clinton said: “Nowhere are the divisions of race and ethnicity more sharply drawn than in the health of our people.”

Various studies have identified several ailments that hit minorities harder than they do non-Latino whites, and Clinton’s initiative aims to eliminate these disparities by targeting six areas: infant mortality, diabetes, cancer screening and management, heart disease, AIDS and immunization.

The $400 million would be spent over five years to collect data, evaluate existing federal programs and help communities develop new strategies to improve minority health.

The public health initiative is to be led by Dr. David Satcher, who was confirmed as surgeon general earlier this month. Satcher has devoted much of his medical career to improving the health of minorities.

Clinton linked the announcement to the February celebration of Black History Month. Donna Shalala, secretary of Health and Human Services, described the proposal as the “health piece” of the initiative Clinton launched last year to improve racial relations in America.

The minority health initiative represents the latest in a series of efforts by the Clinton administration to make incremental improvements in the nation’s health care system--a strategic shift from Clinton’s comprehensive health care reform initiative, which was soundly rejected by Congress in 1994.

“We can’t wait for everybody in this country to get good health insurance,” Shalala said at a press briefing. “When you really want to close a health care gap and you do not have a single health care system, you go to every part of the country and have everybody pull in the same direction.”

Clinton said the minority health effort was needed despite recent gains in general public health, including a significant drop in infant mortality and an overall increase in immunization.

“We must not be blind to the alarming fact that too many Americans do not share in the fruits of our progress,” Clinton said.

To drive home the need for the initiative, the White House cited these comparisons between minorities and non-Latino whites:

* African American men are twice as likely to suffer from heart disease. Also, infant mortality rates are 2 1/2 times higher for blacks, who also suffer from diabetes at rates 70% higher than non-Latino whites. And black men younger than 65 are twice as likely to suffer from prostate cancer.

* The stomach cancer rate for Latinos is two to three times higher, and they suffer from diabetes at a rate twice the national average.

* Vietnamese women contract cervical cancer at nearly five times the rate of non-Latino whites. Chinese Americans are more than four times as likely to get liver cancer; and Hepatitis B is much more common among Asian Americans than among the rest of the population.

* Native Americans suffer from diabetes at a rate almost three times the national average, and their infant mortality rate is 1 1/2 times higher than it is for non-Latino whites.

Among the reasons for those disparities, Clinton said, is that minorities are less likely to get regular medical checkups, be immunized or be routinely tested for cancer.

“Perhaps inadequate education, disproportionate poverty, discrimination in the delivery of health services, cultural differences are all contributing factors” to these “disturbing gaps,” Clinton said.

Of the money Clinton has proposed for the program, $80 million has been requested for the first year as part of the fiscal 1999 federal budget he submitted to Congress this month.

About $30 million of this initial funding would go to 30 communities to help them focus on one or two minority health problems and develop model strategies addressing them. The communities have yet to be identified.

Though some are likely to criticize the proposed federal spending as too little, Shalala said the program will seek private-sector contributions that would boost the five-year total to more than $1 billion.

A coalition of 136 philanthropic organizations has agreed to participate in the program and will serve with the White House as co-host of a spring conference on the problem.

As an example of the kind of help the private sector might provide, Shalala cited McDonalds’ past program of printing immunization information on its food tray liners.