Eight years ago, shortly after the inauguration of the newly elected 43rd president of the United States, Minority Nurse published an editorial titled “Welcome to Washington, Mr. Bush.” In this open letter to the new president, we urged him to be a unifying force and work across party lines to find real solutions to the urgent problem of racial and ethnic health disparities in America.
Well, we all know how that turned out.
Four years later, MN tried it again. We published another open letter to the newly re-elected President Bush, suggesting that it was time to stop wasting taxpayer dollars on ideology-based programs like sexual abstinence education and start increasing federal funding for proven minority health improvement programs that actually work.
We all know what happened with that, too. Or rather, what didn’t happen.
But now, things are a little different. Our nation has just elected a president who has not only promised to make the elimination of health disparities a top priority but has already put his money where his eloquent mouth is by sponsoring legislation such as the Indian Health Care Improvement Act, the Communities of Color Teen Pregnancy Act and the Minority Health Improvement and Health Disparity Elimination Act during his brief term in the U.S. Senate. So let’s try it one more time:
Dear President Obama:
Welcome to Washington! Here at MN, our ears are still echoing with your much-needed campaign promise to, as you put it, “tackle disparities in health care.” Unfortunately for your ambitious health reform agenda, you are taking the helm at a time when our nation is in the grip of an extremely serious crisis. (Nurses call it “coding.”) The worst economic meltdown since the Great Depression, a staggering budget deficit, two endless wars and other pressing messes the previous administration has left for you to mop up will demand your urgent attention. Federal money and resources for waging war on unequal health outcomes will be painfully tight.
But despite all this, we hope you will somehow find the means to also work on your promises to, among other things, increase funding for the Indian Health Service, implement a national HIV/AIDS strategy, increase the cultural and linguistic competence of the health care workforce and fund proven evidence-based interventions, such as patient navigators, to reduce chronic disease disparities in communities of color. Please don’t let your empowering campaign mantra of “yes we can” become “no we can’t” or “not now” when it comes to minority health.
Editor’s Notebook
Mr. President, you have publicly stated that nurses will have a place at the table as you craft your health reform plan. We hope this place will be right up at the front of the table, and that nurses of color will be fully represented. We urge you to reach out—not just across political aisles but to vital organizations such as the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), as well as the many individual nurse leaders within those associations—distinguished researchers, clinicians, educators and health policy experts—who have clearly demonstrated that nurses, even more so than the medical profession, are leading the way in developing the practical solutions to health inequities this country desperately needs.Because when it comes to helping you achieve your goal of making equal health care opportunity a reality for all Americans, yes nurses can. Signed, sealed and delivered.
Back when he was a presidential candidate, Barack Obama promised to develop and begin to implement a comprehensive national HIV/AIDS strategy in the first year of his presidency. According to his campaign Web site, this initiative would, among other things, develop programs to reduce HIV infection, promote AIDS prevention, increase access to care and reduce HIV-related health disparities. Specifically, Obama pledged to fight HIV/AIDS disparities in minority communities by “promoting innovative HIV/AIDS testing initiatives in minority communities and partnering with community leaders.”
Now, only a little more than three months into his presidency, the Obama White House has taken an important first step in that direction by launching a major national AIDS awareness initiative, Act Against AIDS. Administered by the federal Centers for Disease Control and Prevention (CDC), this five-year, multifaceted communication campaign features messages and outreach targeted specifically to the minority communities most severely affected by AIDS. Initially, the campaign will focus on African Americans, who represent roughly half of all new HIV infections and AIDS deaths in the U.S. each year. Subsequent phases will focus on other high-risk minority populations, including Hispanics and men who have sex with men (MSMs).
To capture the public’s attention and raise awareness of the fact that the AIDS epidemic is still a serious health threat in America despite recent advances in treatment, the first phase of the Act Against AIDS campaign emphasizes the message that “every nine and a half minutes, another person in the U.S. is infected with HIV.” The CDC has created “9½ minutes” campaign materials in a variety of media, including video, audio, print and online.
The campaign’s Web site, www.cdc.gov/nineandahalfminutes/, provides a wealth of information on HIV prevention, testing (including how to locate the nearest HIV test site), living with HIV and delaying the onset of AIDS. Perhaps most important, the site (which includes a Spanish-language version) offers uncensored, straight talk about condoms, safe sex and other HIV-prevention issues—a welcome change from the watered-down information that was all too prevalent during the Bush years.
As for partnering with community leaders, the CDC has created the Act Against AIDS Leadership Initiative, a collaborative effort between 14 of the nation’s most influential African American organizations, to integrate HIV prevention into each organization’s outreach programs. Groups participating in this initiative include the NAACP, the National Urban League, 100 Black Men of America and the National Council of Negro Women.
Nurses can find more information about the Act Against AIDS awareness campaign, along with free downloadable videos, podcasts, fact sheets and other campaign materials, at www.cdc.gov/nineandahalfminutes/.
During all the recent discussion and debate over President Barack Obama’s $787 billion economic stimulus package, we’re heard plenty of talk about things like “shovel-ready projects,” “rebuilding crumbling infrastructure” and “green energy jobs.” But what about nurse-ready projects? Does the massive stimulus program, which the President signed into law on February 17, contain any federal spending measures aimed at improving the nation’s health care, especially for poor, uninsured and medically underserved populations?
The answer is a big “yes.” Although you may not hear much discussion about them on the nightly news, the newly signed American Recovery and Reinvestment Act of 2009 includes such provisions as:
• $500 million for nursing and health professions training, including $300 million for the National Health Service Corps, which provides scholarships and education loans for nurse practitioners, certified nurse-midwives, primary care physicians and other health professionals. The remaining $200 million will be divided between HRSA Nursing Workforce Development programs—such as the Scholarships for Disadvantaged Students program and the Faculty Loan Repayment Program/Minority Faculty Fellowship Program—and health professions training programs.
• $1 billion to fund evidence-based disease prevention and wellness programs, including $300 million for immunizations and $650 million for community-based prevention programs.
• $87 billion in additional federal Medicaid funds for states.
• A temporary increase in Medicaid payments to hospitals that treat large numbers of uninsured and underinsured patients.
• Elimination of out-of-pocket costs for American Indians and Alaska Natives enrolled in Medicaid.
• $1.3 billion to extend a program that provides Medicaid coverage for persons who transition from welfare to work.
• $10 billion in additional funding for the National Institutes of Health (NIH), including $8.5 billion allocated for research.
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