The University Record, September 3, 1997
Louis Sullivan addressing the African American Health Summit. In the background is a striking poster titled 'Ancestral Ties,' done for the Summit by Ann Arbor artist Jon Onye Lockard. Lockard also is an adjunct lecturer at the Center for Afroamerican and African Studies. Photo by Bob Kalmbach
For the United States to realize the full potential of its democratic goals and creed, "we need the talents of every one of our citizens," Louis Sullivan said at the Aug. 14 African American Health Summit. That, he emphasized, means that "the health status of African Americans and other minority groups is important to the nation as a whole."
Sullivan, who served as Secretary of Health and Human Services (HHS) in 1989-93 and is now president of the Morehouse School of Medicine in Atlanta, said that "disability, disease and death afflict the nation's poor and minority communities" at a disproportionately high rate.
The Centers for Disease Control report that the life expectancy of Black Americans has declined since the 1980s while it has risen in the country as a whole, Sullivan said, which means that "the gap in the health of the rich and poor widened in the last 20 years."
The statistics on heart disease, stroke, high blood pressure, cancer, lupus and violence "all tell the same story," he said. The incidence of heart disease is 46 percent higher for Black men versus white and 69 percent higher for Black women compared with whites, he reported. Stroke is 98 percent and 77 percent higher, respectively, in comparison with the same two groups.
Tackling inequities in health and health care is "not a glitzy subject," Sullivan told an audience of more than 100 in the Ypsilanti Marriott. In fact, he said, some politicians have argued that HHS has no need for the Office of Minority Health, which monitors health statistics and advocates reforms in health policy and laws.
"We're told these health problems are unsolvable because they are genetic or environmental," Sullivan said, "but they are not determined by genes, and they are not too complex to solve by ordinary means."
The first of Sullivan's recommendations for addressing the problems was "to provide the same level of preventive health care services" to all Americans rather than to continue the "two-tier" system now in place. He also recommended that the country "honor the dignity, needs and inherent value of all of our patients"; expand access to health care; make health care more affordable; and provide health care choices to citizens, especially by doubling the number of primary care physicians.
Sullivan said that the Healthy People 2000 federal program has listed many preventive goals that people should pursue on their own. These include eating less fat, exercising more, avoiding abuse of harmful substances and taking precautions to avoid fatal injuries.
Such recommendations should not obscure the fact that the nation is losing ground in several areas, Sullivan said, citing illicit drug use, AIDS, health problems caused by pollution, infant mortality, low-birth-weight babies and tobacco consumption.
Sullivan cited studies showing that "every dollar invested in prenatal care saves about three dollars in post-natal costs," and said similar improvements in other areas of public health would be similarly cost-effective.
Prenatal and other preventive care now draws about $5 billion in federal spending, "less than 1 percent of the budget," Sullivan said. "We should go to at least $50 billion, or 10 percent of the budget. Such an investment would save dollars and lives down the line."
The African American Health Summit was sponsored in part by the U-M Minority Health Care Initiative, a unit of the U-M Health Systems. Gloria Edwards, administrative director of the Initiative, said that the three-year-old program is based on the awareness that African Americans and some other minority groups are faced "with chronic and devastating illnesses."
"It would be incongruous for an institution like the University of Michigan Health System not to be invested in doing something for those in their own neighborhood," Edwards said. "We must use high-tech and clinical care for those in our service areas, including adjacent counties."
Edwards said her office is looking both at economic factors and at "feelings of intimidation" that have led African Americans and members of other minority groups to avoid being treated at the Medical Center. "We are acquainting our staff with issues and conditions that affect minority people of color, with the cultural aspects that influence people's attitude toward health care," she said. "We want people to respect cultural differences without sacrificing quality of care."
An important part of the U-M program, Edwards said, is a community outreach effort in which "we ask the community, 'What do you think you need in health care programs?'" As a result of these inquiries, the U-M is offering immunization; back-to-school physicals; screenings for prostate cancer, hypertension and diabetes; and other services.