Now is the time to answer the call
J. Nadine Gracia, MD, MSCE | 4/24/2015, 6:15 a.m.
At a commemorative event two years ago, I heard a historian say that history is not a steady stream of events, but rather a series of punctuation points, like ripples from stones tossed into water. I believe that we are at the cusp of just such a punctuation point today as we commemorate National Minority Health Month and the 30th anniversary of the landmark Report of the Secretary’s Task Force on Black and Minority Health (also known as the Heckler Report). The Heckler Report marked the first time the U.S. government convened a group of health experts to conduct a comprehensive study of the health status of minorities. This legacy health equity tome elevated minority health onto a national stage and continues to serve as a driving force for the monumental changes in research, policies, programs and legislation to end health disparities in America.
Over the past 30 years, the influence of the Heckler Report has advanced our nation’s progress toward health equity through new techniques in data collection; dedicated institutes, centers, offices, and commissions of minority health across the country; innovative community-level interventions and transformative legislative measures. These advances reflect the vision of former U.S. Department of Health and Human Services (HHS) Secretary Margaret M. Heckler who, in 1985, determined that we must act swiftly to address the excess deaths among racial and ethnic minorities and the health inequity that plagued our country. In her words, health disparities were “an affront both to our ideals and to the ongoing genius of American medicine.”
Secretary Heckler, members of the Task Force that was convened to develop the report and other visionaries had an unwavering commitment and a heart of service to enact change. And with that commitment came a tremendous opportunity. The Heckler Report created an opportunity to engage the nation in thoughtful discussions about the health needs of minority communities. Individuals from across the nation – public health professionals and health care providers to advocacy groups, researchers to academic institutions and policymakers – began to ponder solutions to a dilemma that required immediate scrutiny.
As a result, milestones began to line the path toward health equity: the Jackson Heart Study explored reasons for certain cardiovascular health disparities; the Healthy Start program brought infant mortality prevention efforts to underserved communities; the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care gave guidance on how health care organizations can provide respectful and responsive services to diverse communities; and an HHS mandate reaffirmed the commitment to the appropriate inclusion of data on minority groups in HHS research, services and related activities.
And, nearly a generation after the Heckler Report, the pivotal Affordable Care Act and its key tenet of quality, affordable and accessible health care is touching the lives of Americans every day. When President Obama signed this powerful legislation into law five years ago, it opened up a remarkable window of opportunity in the movement to reduce health disparities and achieve health equity. The Affordable Care Act is expanding access to coverage with approximately 16.4 million uninsured people having gained health coverage since March 2010. The law is also expanding access to primary health care through investments in community health centers; increasing the diversity of the nation’s health workforce; strengthening the federal minority health infrastructure to reduce health disparities by establishing Offices of Minority Health within six HHS agencies and elevating the National Center on Minority Health and Health Disparities to a NIH Institute; ensuring individuals are protected from discrimination in health care; and improving data collection and research on health disparities.