ACP: Governmental Affairs and Public Policy - Letter to the Center for Disease Control and Prevention expressing concerns for the CDC "Future Initiative" and the effect it may have on minority health issues

Advocacy

Letter to the Center for Disease Control and Prevention expressing concerns for the CDC "Future Initiative" and the effect it may have on minority health issues

June 30, 2004

Julie Louise Gerberding, MD, MPH, FACP
Director, Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333

Dear Dr. Gerberding:

On behalf of the American College of Physicians (ACP), representing more than 115,000 doctors of internal medicine and medical students, I am writing to express our concern over the Centers for Disease Control and Prevention's (CDC) "Futures Initiative" and the effect it may have on the agency's commitment to minority health issues. ACP agrees with the intent of the initiative-- to better position the CDC to meet the unique challenges of the 21st century. However, we are concerned that this organizational realignment of priorities and investments will undermine CDC programs devoted to minority health and health disparities.

The two overarching goals of the "Futures Initiative"- health preparedness and health promotion and prevention of disease, injury and disability-- are consistent with the mission of the CDC and with ACP's public policy. Despite these laudable objectives, critics have suggested that the result of the CDC's reorganization will be to weaken one of its most critical offices devoted to reducing health care disparities-the Office of Minority Health. ACP, therefore, would like to know how this structural change will affect the CDC's overall commitment to minority health and the elimination of racial and ethnic disparities in health care. We ask that you specify where exactly the functions previously held by the Office of Minority will be assigned and whether funding for all the issues previously dealt with by the Office of Minority Health will continue.

ACP recognizes that some of the CDC's structural reforms can, in some ways, better position the CDC to understand minority health and work to reduce racial and ethnic disparities. For instance, the CDC's new "life stages" approach will allow the agency to understand more about how people behave at different stages of their lives so that it can better match its interventions and information to the needs of Americans. Through enhanced marketing and partnerships and the development of explicit targets for reducing racial and ethnic health disparities, the CDC will be able to better assess the needs of specific racial and ethnic populations and target health communications to those needs. But it appears that these efforts will be spread thin across the agency, with no common charge linking their functions. ACP fears this will undervalue the issue of minority health at a time when the public needs to be better informed about this worsening problem.

ACP has a long-standing commitment to the elimination of racial and ethnic disparities in health care, illustrated through our focus on minority health, health disparities, quality, coverage for the uninsured and the revitalization of internal medicine. The College has repeatedly called on Congress and others to strengthen the national Office of Minority Health and appropriately fund elimination of health disparities programs and projects, including the Minority HIV/AIDS Initiative and the Office for Civil Rights.

The CDC, and the administration, is understandably shifting resources to bioterrorism and homeland security. However, this should not be done at the expense of domestic programs as fundamental to improving the health of the American people as minority health. As the CDC continues to transform, ACP asks that you work to preserve the invaluable functions and title of the Office of Minority Health. This critical office coordinates educational programs for our most vulnerable populations, facilitates partnerships for increased research and data collection to better understand the needs of minority groups, and recruits and trains ethnically/racially diverse minority public health professionals who are more likely to serve and understand minority patients. We look forward to your response and to working with you to ensure that the goal of eliminating racial and ethnic disparities in health care is preserved at the CDC.

Sincerely,

Charles K. Francis, MD, FACP
President