GOP Senate Leader Seeks Disease Equality

enate 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," he said.

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 overweight.
"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" to minorities.

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.