Health Disparities Briefing on Capitol Hill

APA Sponsors Congressional Briefing on Health Disparities

Over 100 congressional staff members and representatives of local advocacy groups attended a June 26, 2000 briefing sponsored by APA on health disparities in ethnic minority populations.

Psychologist Brian Smedley of the Institute of Medicine summarized the disparate impact many conditions (i.e. diabetes, high blood pressure, cancer) have on minority communities. Norman Anderson, Professor of Psychology at the Harvard School of Public Health, moderated the briefing and summarized current efforts in Congress and in the U.S. Department of Health and Human Services to work toward the elimination health disparities. David Williams, sociologist from the Institute of Social Research at the University of Michigan, spoke about the powerful influence of SES and other social factors on health. Hector Myers, psychologist from the University of California-Los Angeles, spoke about the role of biobehavioral factors, especially stress, that may explain why many health disparities persist. Finally, Jeanne Miranda, psychologist from Georgetown University, spoke about her research on screening for and treating depression in low-income Latina populations. Dr. Miranda is the chief author of a Surgeon General's report on mental health disparities in minority populations that will be released in the fall.

L-R: Jeanne Miranda, Hector Myers, David Williams, Brian Smedley, and Norman Anderson
From left to right: Jeanne Miranda, Hector Myers, David Williams, Brian Smedley, and Norman Anderson

The briefing was produced jointly by the Public Interest and Science staff in the APA Public Policy Office (PPO), and was cosponsored by the Consortium of Social Science Associations, the Society for the Psychological Study of Social Issues (SPSSI) and the National Association of Social Workers.

The briefing was well-timed because there are several bills in Congress that would increase the authorization for NIH research on health disparities and authorize new training programs for minority scientists. The bills are H.R. 2391 sponsored by Rep. Jesse Jackson, Jr. (D-IL); H.R. 3250 sponsored by Reps. Bennie Thompson (D-MS) and John Lewis (D-GA); and S. 1880, sponsored by Sen. Edward Kennedy (D-MA). These bills would also elevate the NIH Office of Research on Minority Health (ORMH) to center status. Unlike offices, centers at NIH have independent grant-making authority. NIH will likely act to pre-empt the legislation, and will give ORMH center status before the new year. At this writing it seems likely that Congress will take up H.R. 3250 before it adjourns.

APA is supportive of the legislation, but has been working to broaden the language in the bills to make it more inclusive. In meetings with the congressional sponsors, PPO lobbyists are emphasizing that "biomedical" research on health disparities is not all that is needed to close the many gaps in health status between majority and minority populations. Science advocacy staff are also working with NIH to ensure that the strategic plan for research to eliminate health disparities now being assembled at NIH includes behavioral and social science research among the priorities.

APA members have expressed concern that for a center to be given grant-making authority on health disparities will cause numerous jurisdictional disputes at NIH, where each of the institutes and centers currently funds research on aspects of health disparities. The intent of the sponsors of the legislation is that the center should add to, not take away from, current NIH research efforts on health disparities. Observers at NIH say it is possible, though may not be painless, for such a center to carve out a jurisdiction for itself.

"Increasing the amount of research aimed at understanding and eliminating health disparities is not only good policy," said Richard McCarty, Executive Director for Science at APA, "But it is a call for our sciences to provide leadership at NIH. Understanding the effects of culture, socioeconomic status, and disparate physiological effects of stress are squarely in the purview of the behavioral and social sciences."

June 2000