DEPARTMENT OF HEALTH AND HUMAN SERVICES
Meeting of: Secretary's Council on National Health Promotion and Disease
Prevention Objectives for 2010
September 12, 2000, Proceedings
Agenda Item: Partnership to Eliminate Health Disparities
Mohammad Akhter, American Public Health Association
DR. AKHTER: Thank you, Dr. Satcher. Good afternoon, everybody. It's a delight to see you here. Last week, we were in Beijing holding the press conference together, today here. My wife, who was with me, asked
Dr. Satcher, what is the way to fight the jet lag? His answer was, get on a plane and go someplace else. It worked really well for you, Dr. Satcher.
It's such an honor and such a delight for me to be here, to see my friends and some of my senior colleagues with whom I have worked over the years, and to be able to present to the Secretary's Council this initiative that we, as the public health community, have undertaken with the federal government.
It's no secret; we all know that there are disparities in health status. But when we started to look toward the future of our country, our nation, we discovered that the disparities that are here today are going to be become bigger as the country progresses in the next century. The disparities issue has been looked at from time to time only in the African-American or in some smaller arenas. Never has it been looked at in a comprehensive way to see, as a nation, what is it that we really want to do.
So in that regard, when we looked at ourselves as a nation and saw these disparities in the health status of different people, we found it's not an issue only of money. It is not an issue of poverty. We start to look and say, why would a Washington, D.C. physician who practices the same medical practice, OB-GYN, makes the same money, goes to the same hospital, drives the same car, lives in the same sort of house, yet have a year less life expectancy? Here in the nation's capital, the richest nation, the most powerful nation in the world.
But that is the reality all over the place, that the life expectancy, the quality of life differs between different segments of our society. America is the most diverse nation on the face of this earth. There is no other place where someone like me, Mohammad Akhter, can go down there and say I'm an American. This is the only place on earth where anybody can come from anywhere and become an American.
So by 2030, 40 percent of all Americans are going to be of an ethnic descent, going to be Asian-American, Hispanic American, African-American. By 2050, almost half of all Americans are going to be Asian American, African-American, Latino or of other ethnic groups.
With the racial and ethnic differences in the health status, we cannot be strong. In the last century, the strength of the nation depended upon how much money you have, how much technology you have, or how many armed forces you have, tanks, planes and jets. In the next century, the strength of the nation is going to be dependent upon what kind of human capital you have. Do you have the right kind of labor force to be able to compete in the global world?
That is the issue that is before us. It's not a minority health issue. It's not something we want to do from the goodness of our heart, saying this is the right thing to do. That's not a bad idea for you to take it that way, but it's the issue of nation building.
So the American Public Health Association, the largest and the oldest public health association in the world -- we all gathered together and looked at, what is it that we need to do for the next 10 years? We looked at this issue and said, this is the kind of thing that we want to do. How we do this and how we proceed with this agenda is what Dr. Satcher has asked me to come down here and present to you.
What we have done is create a partnership, on one hand, with the Department of Health and Human Services. We announced the partnership last July, when we said, there is a role for the federal government, but they need to have a partner for this kind of an issue from outside. This is not something that a single agency, the government, could do.
To deal with racial and ethnic disparities, you need to deal with education; you need to deal with health; you need to deal with nutrition. Dr. Mason, you probably will appreciate the medical missionary experience that I had in my younger life. When the church sends medical missionaries out, they don't just simply send you out there and say, go provide medical care, because all you're going to do is give somebody some shots or give somebody some pills. You're not going to do very much.
They sent three teams together. They said, here is an education team. Your job is to teach people how to read and write, make people educated, particularly the women. They sent another team. They said, you are the agricultural people. Help people grow food so people have good nutrition. And you are the medical folks. Go tell them how to maintain good health. The three teams working together made the difference in the lives of people whose per capita income was less than one dollar a month.
So looking at that, they're seeing that a multi-sectoral approach is needed to deal with this issue. We then met with the Secretary Donna Shalala to ask her assistance to ask other Secretaries, particularly in Education, Labor, Agriculture, EPA, to join with us in this effort, so it becomes for the first time a multi-sectoral approach within the government itself.
Then we went outside and invited leaders from the faith community, from the education community, from foundations, from businesses, labor unions, and people like Andrew Young, people like the BET Chairman, Johnson, people like the US Airways Chairman, the top of the ladder, and said, would you please come down and let's see if we can work all together.
Collaboration with a single entity is already a reality. We all go out and work with the church community here. Some health departments go out and work with a hospital community over there. Somebody goes out there and works with the education community. Working with the multi-sectoral community is an important aspect, a new concept that we wanted to inject into this equation.
So we have gotten these 25 people who are top leaders in their field and said, how could we all work together and help act as a catalyst, as a facilitator, each party doing our share to improve the outcome in the health status of minority people? So we are at a point now where we have invited these people. They will be meeting on October 6 in the historic Indian Treaty Room in the White House to issue a Call to the Nation, because that's the number one issue from our point of view, that this nation must recognize at the turn of the century that, to continue to maintain the leadership of the world, we need to develop the human capital. We need to deal with these racial and ethnic disparities that go way beyond health. Health alone will not do it. We need to work on education, nutrition, housing, and environment, all these areas, and on how we could start to do this.
So after we issue this call, we want each one of these members of different groups to go back to their own groups -- the business people going back to the business group, the faith community going back to the faith community -- and send the message out all the way down the line that this is an issue where we really need to join hands and need to do things that will promote good health.
The 2010 objectives then become a very good yardstick for us. In one sense, it sets a goal for us: in 10 years we want to eliminate racial disparities, a great goal to have. But on the other hand, it provides us the yardstick to measure our progress as we go year-by-year to see how far we have gotten.
After this call is issued, it will be widely distributed to all communities, all focuses within our country. The idea is to educate the people and then to generate a movement. An issue of this magnitude can't be dealt with by the government people alone. It can't be dealt with by the state people alone. It can't be dealt with by local folks alone. It is when the movement starts, and people of good will from all sectors join hands in saying, this is not the problem of the minorities. This is our problem as a nation, and we need to fix it. Only then will the change start to take place; only then the resources start to come in, and things begin to happen.
Following the call, we intend to have then a plan of action, a national plan of action, a state-level plan of action, and a local-level plan of action, because locally is actually where things will take place. We expect it to take us a year or 18 months to develop such an effort. We want to invite people from all segments of society to participate in this effort. APHA will provide the resources that are necessary and the necessary coordination, while the federal government will continue to provide the programs, the services, the access to care, preventive programs that they already provide, and be our partners in helping us monitor the progress that we have made.
That is our agenda. It might take us more than 10 years, but the organization has made the commitment. This is the only issue that we will work on in that 10 years. When 55,000 public health people make this commitment, not on the basis of any kind of financial incentive, but on the basis that this is the right thing to do, this is an issue of human rights and human dignity and of nation building for the future, we think we are going to make significant progress in this arena and make this thing happen.
I'll be glad to answer any questions you might have. Again, I appreciate the opportunity.