On Nov. 22, President Bill Clinton signed into law the "Minority Health and Health Disparities Research and Education Act of 2000" at a White House ceremony attended by APA's Chief Executive Officer Raymond D. Fowler, PhD, who was invited to the event in recognition of the significant role played by APA members and Public Policy Office (PPO) staff in achieving congressional passage of the legislation.
This landmark legislation expands health-care funding and research for minorities and rural Americans by giving more prominence to the National Institutes of Health (NIH) Office for Research on Minority Health, by elevating it to the National Center for Research on Minority Health and Health Disparities. The new center will conduct and support basic clinical research, the training of health professionals and the dissemination of information to improve the health of underserved populations.
Although PPO organized the effort, it was APA members--from those in graduate school to those in divisions of APA, nonprofit research organizations, ethnic-minority psychological associations, universities and state psychological associations--who made the difference.
"I will be forever grateful to the many APA members who responded to my calls over the past year and a half despite their very busy schedules," says Lori Valencia Greene, PPO's senior legislative and federal affairs officer. "It is in large part because of them that this bill is now law with the vital inclusion of behavioral research and training."
From the start, APA sought to expand the scope of the legislation to ensure that it recognized the key contributions of behavioral science in health care. An earlier version of the bill introduced by Rep. Jesse Jackson Jr. (DIll.), along with Reps. Neil Abercrombie (DHawaii), and Xavier Becerra (DCalif.) sought solely to elevate the Office for Research on Minority Health at the NIH to "center" status. That bill evolved into a more comprehensive piece of legislation introduced by Sen. Edward Kennedy (DMass.) and Representatives Jackson, Bennie Thompson (DMiss.), Charles Norwood (RGa.), and John Lewis (DGa.).
Despite its laudable goal, the bill only referred to biomedical research and training and did not specifically include the behavioral and social sciences. Such a provision helps to ensure that psychologists are eligible for funding through the newly created National Center on Minority Health and Health Disparities.
PPO's concerted effort to broaden the legislation to include behavioral research and training proved to be an uphill battle, due in large measure to a lack of congressional understanding of the role behavioral factors play in health. PPO led an advocacy campaign to make the legislation inclusive and ensure its congressional passage.
The result was the establishment of a new NIH center with a $100 million budget--including $20 million in new funding--slated for conducting and supporting research, training and the dissemination of information. Among other provisions, a new $35,000 graduate loan forgiveness program is now authorized for health researchers--including psychologists--who agree to engage in minority health disparities research or other health disparities research.
APA members in action
Scyatta Wallace, a graduate student at Fordham University, furthered PPO's efforts on this legislation last summer as the first Dalmas A. Taylor Summer Minority Policy Fellow (sponsored by the Society for the Psychological Study of Social IssuesSPSSI). She worked side by side with PPO staff on Capitol Hill, developing a briefing paper of examples of social science research on health disparities and assisting with the PPO congressional briefing in June on "Research on Minority Health Disparities."
"I got a chance to see what the advocacy process is like, not just through theory and textbooks, but by real hands-on experience," says Wallace. "I think it's essential to know how the public and policy-makers perceive psychology and how we can inform their views."
From October 1999 to August 2000, Adrienne Stith, PhD, was the SPSSI James Marshall Scholar in PPO. She was the point person for the congressional briefing and negotiated with sponsors of the legislation for language that was inclusive of the behavioral and social sciences. She also played a major role in strategizing within the Racial and Ethnic Health Disparities Coalition on lobbying efforts.
Brian Smedley, PhD, the study director for the Institute of Medicine's report on "The Unequal Burden of Cancer," was asked by PPO staff to moderate the congressional briefing. (For more information on the briefing, visit the PPO Web site.) The other panelists included Norman Anderson, PhD, the first director of the NIH Office of Behavioral and Social Sciences Research and now at Harvard University; Jeanne Miranda, PhD, of Georgetown University, Hector Myers, PhD, of the University of California, Los Angeles; and David Williams, PhD, University of Michigan.
Several of the panelists, accompanied by PPO staff, lobbied the sponsors of the legislation regarding the critical role of behavior in health.
PPO is a founding member of the Racial and Ethnic Health Disparities Coalition, comprised of lobbyists of color to support and promote legislative and budget initiatives that will increase the nation's effectiveness in closing the health disparity gap. In addition to lobbying effectively for passage of the health disparities legislation, the coalition has advocated for increased funds in fiscal year 2001 appropriations for:
The new NIH Center on Minority Health and Health Disparities.
The Indians into Psychology program.
The Substance Abuse and Mental Health Services Administration.
The Minority Fellowship Program.
Several initiatives to address the needs of American Indians as proposed by Dolores Bigfoot, PhD, University of Oklahoma Health Services Center.
The document was subsequently endorsed by the individual organizations of the Council of National Psychological Associations for the Advancement of Ethnic Minority Interests (CNPAAEMI) and the Society for the Psychological Study of Ethnic Minority Issues. It was sent to chairs of the Congressional Black Caucus, the Congressional Hispanic Caucus, and the Congressional Asian and Pacific Islander Caucus and was well received.
"Through the quiet and forceful voices of ethnic-minority psychologists, CNPAAEMI and their allies," says Joseph E. Trimble, PhD, of APA's Div. 45 (Ethnic Minority Affairs), "attention was given to the long-standing concerns demonstrating once again what can happen when seemingly disparate groups form an alliance and work to achieve a common goal--a goal that for any group by themselves may appear insurmountable and daunting."
As time was running out in the fall with Congress scheduled to adjourn for the year and a few House members standing in the way of a floor vote, PPO staff were able to call upon those state psychological associations in districts with key members of Congress to request phone calls to be made to their representatives. PPO staff then followed up with lobby visits. One office reported receiving more than 30 calls that day and expressed their new-found support for the bill.
Says PPO's Valencia Greene, "As Washington lobbyists, we can best perform our job with the active support of the membership, and in this case, it worked beautifully."
To keep informed and/or get involved in advocacy initiatives of the Public Interest, Science, and Education Directorates, join PPO's Public Policy Advocacy Network.
(To see the bill as passed by Congress, go to thomas.loc.gov and enter "Minority Health and Health Disparities Research and Education Act of 2000" in the box labeled "By word/phrase.")