GOP Senate Leader Seeks Disease Equality
Majority Leader Bill Frist, R-TN, announced last month that
one of the senate GOP's highest priorities this year will
be to get the federal government to spend money on eliminating
health differences between racial groups.
Frist, a medical doctor, said his bill called "Closing
the Health Care Gap Act," is designed to increase "opportunities"
for minorities to enter the health care field, create a permanent
division within the Department of Health and Human Services
called the "Office of Minority Health," and narrow
the gap between disease rates for different groups.
Frist said he didn't really know how much his plan would cost
the federal government, but that the legislation was at the
top of his agenda anyway.
"I can only say that we've seen when we prioritize initiatives
- like Medicare prescription drugs, global HIV/AIDS - we find
the money to fund them, and this is my highest priority,"
Frist argued that his legislation was needed to make sure
that whites, blacks, Hispanics, Asians, and American Indians
all have the same rates of health problems, including being
"We know that African-Americans, Hispanics, and Native
Americans die younger and suffer from heart disease, diabetes,
and HIV/AIDS at higher rates than everyone else. These numbers
are unacceptable," he announced.
The bill is cosponsored by Sen. Thad Cochran, R-MS, who said
the health program must be funded, even if it means reducing
budget outlays for other programs.
"We will identify the programs and provide the maximum
funding available under our budget," he said.
The senators believe it is the responsibility of taxpayers
to make sure that racial groups do not have disproportionate
health problems or get overweight more than other groups.
A "Health Disparities Fact Sheet" distributed by
Frist's office warns: "African-Americans have the highest
rate of high blood pressure of all groups and tend to develop
it younger." The fact sheet notes that "among adults
aged 20 or older, African Americans are twice as likely as
whites to have diabetes, and American Indians and Alaskan
natives are 2.6 times more likely to have diabetes. Hispanics
are 1.9 times more likely to have diabetes."
Among the other disparities that Frist says his bill will
eliminate is the disparity in obesity.
"African Americans (66 percent) and Hispanic adults (62
percent) are twice as likely to be overweight than Asian/Pacific
Islanders (32 percent)," notes the fact sheet. "Among
African Americans, the proportion of women who are obese is
80 percent higher than the proportion of men who are obese.
This gender difference is also seen among Hispanic women and
men, but the percentage of white, non-Hispanic women and men
who are obese is about the same."
How his legislation will equalize the obesity rates of racial
groups is unclear.
A statement from Frist's office says the legislation will
"fund a number of initiatives to improve access to health
care services," including what it calls "Awareness
Grants." Under the program, the federal government will
give money to local community groups that "provide disparity
populations with greater access to and awareness of available
health care services."
The legislation will also "increase the diversity and
cultural sensitivity of the nation's health care workforce"
by making sure fewer whites attend medical schools. Frist's
bill is designed to "increase diversity in the health
professions workforce by providing funds for scholarships"
The bill also provides funding to establish curricula in medical
schools that is described as culturally sensitive. A summary
of the legislation from Frist's office says that "studies
have shown that there often is a lack of cultural awareness
and sensitivity among health professionals." To remedy
that, Frist's bill will "authorize a series of demonstration
projects to test model curricula" to provide "culturally
appropriate care." The purpose is to create what Frist's
office calls "cultural competence," defined as "health
care services and training in the cultural context and language
that is most appropriate for those individuals receiving the
service or training,"
The "Office of Minority Health" to be permanently
established in HHS will "fund a national minority health
resources center to serve as a national resource and referral
service on minority health services."
No such referral service or resource center will be available
for whites under Frist's bill.