News: CJ Exclusives

State Grants Aimed at Minority Health

Money comes from the N.C. Health and Wellness Trust Fund

The state plans to give grants of up to half a million dollars to government agencies or nonprofit corporations that can devise suitable plans to improve the health of minority North Carolina residents.

Among the requirements are:

• The organization asking for the money must have a record of successful projects to improve public health.

• It must submit a clean audit report.

• The measures described in its grant proposal must be ones that have proven to be effective.

• The beneficiaries must be minorities. It will be all right if some whites happen to benefit, but the emphasis is on other races.

The money — $8.9 million altogether — was ponied up by the N.C. Health and Wellness Trust Fund. That is one of the agencies that were established by the General Assembly to receive and spend money from the 1998 settlement between states and four cigarette manufacturers.

Part of the settlement money is spent for programs to help people quit smoking or discourage them from starting. Some can also be used to promote the general health of the population, which is the function of the Health and Wellness Trust Fund.

The fund is governed by an 18-member commission, composed mostly of doctors, other health professionals, and academics. Lt. Gov. Beverly Perdue is the chairman.

Since 2001 when it was organized, the fund has disbursed more than $300 million — $127 million for health initiatives and $78 million to fund a prescription drug assistance program.

The fund proclaims that it “invests in programs and partnerships to address access, prevention, education and research that help all North Carolinians achieve better health.”

Officials of the fund say they see no discrimination in the grants for which they are now seeking proposals, which are to help equalize the health of whites and people of other races. It calls the program the Eliminating Health Disparities Initiative.

Alison K. McLaurin, a spokeswoman for the Health and Wellness Trust Fund, said in an interview that proposed projects would not be denied grants just because they would aid whites as well as members of other races. She said that whites in poor socio-economic conditions are among those who are on the short end of health disparities.

But the ethnic nature of the project is clear in the call for grant proposals.

It cites the 2003 Racial and Ethnic Disparities Report Card, published by the North Carolina Office of Minority Health and Health Disparities. The fund says the Report Card showed that “African American, Native American and Latino population groups experience the greatest disparities in most areas of health status” between 1997 and 2001.

The report said that blacks were 1.2 times more likely to die of heart disease than were whites, and American Indians were 1.3 times more likely. It cited similar ratios for diabetes, prostate cancer, breast cancer, and stroke.

In addition to those diseases, the Health and Wellness Fund lists obesity and cardiovascular diseases as targets for the grant proposals.

An organization or agency applying for a grant can ask for up to $50,000 for a planning period that can span the last six months of 2005. It can ask for up to $450,000 to finance the program itself, which might require up to three years to implement.

Government health programs specifically targeting minority races are not new, and they are not confined to state government, although North Carolina got an early start. The state’s Office of Minority Health and Health Disparities has existed in the Department of Health and Human Services for 14 years.

The office operates on a budget of more than $1 million a year. Last year the General Assembly gave it a one-time appropriation of $2 million extra to distribute to agencies around the state as a “Community-Focused Eliminating Health Disparities Initiative.”

A spokesman for the office, Leslie Brown, said grants have been approved for 15 county health departments and 45 nonprofit organizations. They range from about $5,000 for a planning grant to about $50,000 for an implementation grant.

The state secretary of Health and Human Services, Carmen Hooker-Odom, has made it one of her goals to eliminate the disparities in health statistics among the races. She assigned the Office of Minority Health and Health Disparities to coordinate efforts among the other divisions in the department.

Elsewhere, the National Institutes of Health, a branch of the U.S. Department of Health and Human Services, has an agency that focuses on nothing else. It is called the National Center for Minority Health and Health Disparities, and it operates on a budget of about $200 million a year.

The U.S. Centers for Disease Control in Atlanta has reorganized its Office of the director to create an Office of Minority Health.

Many states have followed the trend by financing programs that are aimed at improving the health of people of races other than whites.

Foundations are funding research, and universities have produced papers advocating such programs and defending them against criticism that raced-based programs are an inappropriate use of public money.

No critics — at least none audible to ordinary people — have questioned the government’s statistics on race and diseases. But there have been other suggestions for what to do about it.

For example, Christopher H. Foreman Jr. of the Brookings Institution has suggested that “the African-American community must become ever more engaged by, and anchored within, the private sector.”

It is there, in the private world, Foreman wrote, that there is wealth “from which flows both an enlarged collective voice and expanded personal choice.”