Health News 

                                                                                                                                                    NMA President Calls for " Diversity" Among Healthcare Workers 

Washington, D.C. Oct. 20, 2003---National Medical Association President Randall W. Maxey, MD., Ph.D., (left) testified in Chicago before the Sullivan Commission on Diversity in the Healthcare Workforce regarding the urgent need to increase minority healthcare professionals. He noted that many minorities do not have access to quality, affordable healthcare, largely due to "the absence of healthcare professionals who look like them, are committed to serving them, or who are culturally competent to meet their healthcare needs."

Speaking on behalf of the National Medical Association, Dr. Maxey made several recommendations aimed at expanding the number of minority physicians and healthcare workers. The recommendations include a call for additional financial support for programs, initiatives and medical schools that have an expressed purpose of increasing the number of African-American and other minority physicians.

The 15-member Sullivan Commission, comprised of key health, corporate, academic, and legal experts, has conducted field hearings to examine the nation's shortfall of medical professionals who work in under-served communities. The Chicago hearing was the fourth in a planned series of six public meetings to address the crisis in the nation's health care gap and the role of diversity in finding solutions. The Commission is led by its chairman, Dr. Louis Sullivan, former U.S. Secretary of Health and Human Services, President Emeritus of Morehouse School of Medicine, and a long-standing member of the National Medical Association.

In his testimony, Dr. Maxey stated that the NMA is troubled by President Bush's fiscal year 2004 budget, which severely curtails support for programs that focus on such areas as diversity in healthcare, primary care medicine and dentistry, health educational training centers; and public health workforce development.

Describing diversity in the healthcare work force as a "compelling state interest," Dr. Maxey said the United States must demonstrate that it has the will and commitment to achieve parity of diversity in healthcare professions. Accordingly, he said, the nation needs to embark upon a "paramount objective" to produce and maintain a diverse American healthcare workforce that mirrors the diversity found in the general population.

Dr. Maxey cited statistics that illustrate the under-representation of minorities in the healthcare field. Although African Americans, Hispanic Americans, and American Indians represent more than 25 percent of the U.S. population, they comprise less than 14 percent of physicians, 9 percent of nurses, and 5 percent of dentists. Dr. Maxey pointed out that the under-representation of minorities in the health professions is not a new problem. He noted that several years ago the Pew Commission concluded that "Today's generation of health professionals does not fully represent the diversity of the nation, and as a result, significant numbers of people are not receiving the most effective care." In recent years, the problem of under-representation has become even more dire.

Specifically, Dr. Maxey presented six recommendations that he urged the Sullivan Commission to adopt and advocate for implementation:

Preserve and increase funding of current federal programs and initiatives that aim to promote diversity in America's healthcare professions. Collect and report data on race and ethnicity related to admissions, matriculation, graduation and placement of graduates of medical schools and other institutions providing healthcare training. This is critical to making informed and effective decisions about how best to achieve diversity. Provide increased funding for medical schools that have an historic mission to train African-American physicians as well as physicians from other minority groups. At the same time, bolster efforts to create greater access for minority students into predominantly white medical schools. Endorse and support a re-examination of the tools used by America's medical schools to determine admission. Current evidence suggests that standardized tests are not foolproof predictors of clinical performance or success as a medical professional, and that additional criteria should be considered. Set forth a planned approach through which future and practicing physicians actively participate in the effort to achieve parity of diversity in the healthcare workforce. Endorse the establishment of a National Physicians Medical Academy as a source of highly qualified minority physicians who are dedicated to providing quality healthcare in under-served communities. The Academy would include a comprehensive program of identifying and nurturing students from minority populations to become physicians.

Additionally, as part of his testimony, Dr. Maxey asked the Sullivan Commission to ensure a wide dissemination of its recommendations, establish coalitions between public and private sector groups to generate funding for the medical education of minorities, and require training programs for health professionals to incorporate a "best practices" methodology into their curricula.

Source: NMA (an organization of African-American physicians in the U.S.)

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New Guidelines for treatment of African Americans with High Blood Pressure

The International Society on Hypertension in Blacks (ISHIB) and several U.S. medical leading experts have developed for the first time a set of guidelines for treating high blood pressure in African Americans.

These recommendations, which fell under the headline "Management of High Blood Pressure in African Americans", can be read in an article published in the March 10 edition of the Archives of Internal Medicine .

It is well known that Blacks in the U.S. are to a great extent more likely to die of high blood pressure than whites because current treatment strategies have primarily been unsuccessful.  The new guidelines urge health care providers to treat hypertension in Blacks as follows:

1)Many African American will need to start on at least two medications in order to effectively lower their blood pressure;

2) ISHIB recommends a lower blood pressure target of 130/80 mm Hg for Blacks with high blood pressure and other conditions like heart disease, kidney disorders or diabetes;

3)The Society also suggests that African American with diabetes should receive medications that have been shown to slow the progression of kidney disease, such as ACE inhibitors or angiotensin II receptor blockers (ARBs) as part of their combination of medications.

The new recommendations are endorsed by some of the U.S. leading health organizations: the American Heart Association, the Association of Black Cardiologists, the Consortium for Southeastern Hypertension Control and the National Medical Association.

Nearly 40 percent of Blacks in the U.S. suffer from heart disease and 13 percent have diabetes. Thirty-two percent of people on dialysis due to kidney failure are African-American.  Because high blood pressure contributes to all of these conditions, ISHIB is urging health care provider to act more aggressively to lower the blood pressure of patients with these disorders - especially those with diabetes and/or kidney disease - to less than 130/80mm Hg.  This is a significant change from the previous standard of 140/90 mm Hg (for most patients) and 130/85 mm Hg (for those with diabetes) recommended in 1997 by the federal government.

In addition, ISHIB emphasizes lifestyle modification and recommends the DASH Diet ( Dietary Approaches to Stop Hypertension)  In carefully conducted clinical studies, this diet was shown to lower blood pressure significantly, especially in African Americans.  The DASH Diet is rich in fruits, vegetables and fiber.  It also emphasizes the consumption of low-fat dairy foods, meat and poultry.

"For too long, African Americans have not received appropriate treatment for their high blood pressure because of a lack of knowledge about medications, diet and other factors," said Elijah Saunders, M.D., a founder of ISHIB and head of the division of hypertension at the University of Maryland Medical Center in Baltimore, Md.. "ISHIB's guidance is clear: assess patients' risk for heart and kidney disease, follow the DASH Diet and prescribe a combination of medications to get to the recommended blood pressure level."

Sources: The Archives of Internal Medicine, March 10, 2003 Ed.; the Cincinnati Herald

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