HEALTH PROMOTION AT ITS BEST Marilyn L. Johnson, MAS Washington, DC
National Medical Association (NMA) physicians have a propensity for community service, as illustrated by the fact that they have consistently been the founders and members of traditional African-American civic and service organizations across the nation. This concern for the physical and social welfare of persons of all races was rewarded in 1989 when the NMA was selected by the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) to lead its initiative to improve the health of African Americans by the Year 2000. The NMA is a partner in a cooperative agreement with nine other national organizations representing an array of special populations. These organizations include groups such as the American Association for Retired Persons (AARP), the Asian American Health Forum, the American Indian Health Care Association, and the American Association of University Affiliated Programs for Persons With Developmental Disabilities. The ODPHP, under the leadership of J. Michael McGinnis, MD, and Jim Harrell, has shown special sensitivity to the needs of the underserved-people who traditionally are not impacted by health messages aimed at the general public. This focus on special populations represents the first time the US Department of Health and Human Services has gone to such length to reach all Americans with its disease prevention/health promotion efforts. The ODPHP is seeking to meet an outlined 300 health objectives for the Year 2000, many of which Ms Marilyn L. Johnson is the Project Director of the National Medical Association's Healthy People 2000, Community Health Coalition Project. The pilot cities are Durham, North Carolina; Atlanta, Georgia; Detroit, Michigan; Richmond, Virginia; San Antonio and Houston, Texas; Los Angeles and Oakland, California; Orlando, Florida; New Orleans, Louisiana; Cleveland, Ohio; and Brooklyn, New York. Requests for reprints should be addressed to Marilyn L. Johnson, National Medical Association, 1012 10th St, NW, Washington, DC 20001. JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 84, NO. 7
specifically mention blacks. The NMA has responded to this call to action by its initation of the Community Health Coalition Project, the most comprehensive of all of the ODPHP Year 2000 cooperative agreement endeavors. While many of the other organizations are collecting much needed statistical data on disease prevalence among their populations, NMA physicians are actively responding to the dismal health statistics for African Americans that were documented in 1985 by the Secretary's Task Force on Black and Minority Health. Because the NMA and each of the other organizations received an award of only $50 000 a year for 3 years, the NMA and its physicians in participating chapters across the nation are using personal, professional, and financial resources to form coalition teams in 14 cities to educate African Americans where they congregate on a regular basis. History has shown people are not inclined to leave their homes to participate in health-related forums. The NMA program is unique in another way. The program recognizes that lack of access to care is just one of the reasons why blacks and other minorities are inclined to delay seeking medical treatment until their suffering becomes unbearable. The project has been structured to deal with the self-esteem of poor people and minorities because their self-esteem often is not as positive as it needs to be. As a result, many have difficulty consistently making decisions that reduce excessive morbidity and mortality. The coalition teams are comprised of local allied health professionals, community activists, and members of the clergy and the business communitypositive role models who demonstrate concern for persons who are most often ignored. Team members go into schools, churches, community centers, parks, housing developments, and businesses with representatives from organizations such as the American Diabetes Association, the Juvenile Diabetes Foundation, the 565
EDITORIAL
American Lung Association, the American Cancer Society, the American Heart Association, the American Red Cross, the Links, the National Association of Colored People, the American Academy of Ophthalmology, health departments, hospitals, police departments, insurance companies, and other local organizations. Members of Congress, mayors, students, ministers, bankers, entrepreneurs, reporters, prisoners, and public housing residents are joining this "Health Outreach Ministry." More importantly, the local NMA chapters in the pilot cities are gaining access to all forms of media. Inasmuch as the media is a valuable component of any health promotion effort, it is particularly vital for an effort targeting African Americans. Studies reveal that blacks tend to watch more television and listen to more radio than any other group. The NMAXs coalition activities are being documented in positive ways by these communications media-a feat that is difficult to accomplish during an era when so much negative activity is reported via these media. In fact, not only are the newspapers carrying our stories, major television network affiliates (ie, ABC, NBC, and CBS) have been responding as well. Plans have been made to expand the project's outreach to the media over the next several months because a lot of exciting activities are planned in conjunction with the NMA's upcoming convention in San Francisco. These massive efforts have not gone unnoticed. In fact, other federal agencies are seeking the NMAXs assistance in reaching African Americans with their messages. For example, the National Eye Institute is deeply concerned about the high rate of blindness in the black community as a result of undetected glaucoma and diabetic eye disease. To test the effectiveness of
566
physician-headed outreach programs, the National Eye Institute recently provided funding for two of our Year 2000 cities to add eye components to their programs. While Delutha King, MD, is the principal investigator of the overall Year 2000 initiative, Claude Cowan, MD, an ophthalmologist, was selected as the principal investigator of this portion of the project. He is developing a continuing medical education program on glaucoma detection and treatment for nonophthalmologists that is being taken very seriously. At the same time, physicians are being advised to take more proactive roles in monitoring their own health behaviors and those of their patients. Disease associated with smoking, poor nutrition and obesity, unprotected sex, and alcohol and other drug use can be prevented only if individuals understand the role they play in determining their own morbidity and mortality, and only if culturally sensitive programs are instituted to assist in behavioral change. National Medical Association physicians are charged with the responsibility of not only holding patients accountable through appropriate history taking and referrals but also by setting good personal examples for the patients who depend on them. Female health-care providers need to take the time to get physicals. Breast, cervical, lung, and colon cancers; heart disease; diabetes; and hypertension affect health professionals at unacceptably high rates. Male health-care professionals need to be equally concerned about prostate, lung, colorectal, and pancreatic cancers; stroke and heart disease; glaucoma; and kidney disease. We are all at risk for acquired immunodeficiency syndrome (AIDS) and other sexually transmitted diseases, if we do not protect ourselves. Personal screening is a must! We invite each of you to join us in this important endeavor!
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 84, NO. 7
National Medical Association (NMA) physicians have a propensity for community service, as illustrated by the fact that they have consistently been the founders and members of traditional African-American civic and service organizations across the nation. This concern for the physical and social welfare of persons of all races was rewarded in 1989 when the NMA was selected by the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) to lead its initiative to improve the health of African Americans by the Year 2000. The NMA is a partner in a cooperative agreement with nine other national organizations representing an array of special populations. These organizations include groups such as the American Association for Retired Persons (AARP), the Asian American Health Forum, the American Indian Health Care Association, and the American Association of University Affiliated Programs for Persons With Developmental Disabilities. The ODPHP, under the leadership of J. Michael McGinnis, MD, and Jim Harrell, has shown special sensitivity to the needs of the underserved-people who traditionally are not impacted by health messages aimed at the general public. This focus on special populations represents the first time the US Department of Health and Human Services has gone to such length to reach all Americans with its disease prevention/health promotion efforts. The ODPHP is seeking to meet an outlined 300 health objectives for the Year 2000, many of which Ms Marilyn L. Johnson is the Project Director of the National Medical Association's Healthy People 2000, Community Health Coalition Project. The pilot cities are Durham, North Carolina; Atlanta, Georgia; Detroit, Michigan; Richmond, Virginia; San Antonio and Houston, Texas; Los Angeles and Oakland, California; Orlando, Florida; New Orleans, Louisiana; Cleveland, Ohio; and Brooklyn, New York. Requests for reprints should be addressed to Marilyn L. Johnson, National Medical Association, 1012 10th St, NW, Washington, DC 20001. JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 84, NO. 7
specifically mention blacks. The NMA has responded to this call to action by its initation of the Community Health Coalition Project, the most comprehensive of all of the ODPHP Year 2000 cooperative agreement endeavors. While many of the other organizations are collecting much needed statistical data on disease prevalence among their populations, NMA physicians are actively responding to the dismal health statistics for African Americans that were documented in 1985 by the Secretary's Task Force on Black and Minority Health. Because the NMA and each of the other organizations received an award of only $50 000 a year for 3 years, the NMA and its physicians in participating chapters across the nation are using personal, professional, and financial resources to form coalition teams in 14 cities to educate African Americans where they congregate on a regular basis. History has shown people are not inclined to leave their homes to participate in health-related forums. The NMA program is unique in another way. The program recognizes that lack of access to care is just one of the reasons why blacks and other minorities are inclined to delay seeking medical treatment until their suffering becomes unbearable. The project has been structured to deal with the self-esteem of poor people and minorities because their self-esteem often is not as positive as it needs to be. As a result, many have difficulty consistently making decisions that reduce excessive morbidity and mortality. The coalition teams are comprised of local allied health professionals, community activists, and members of the clergy and the business communitypositive role models who demonstrate concern for persons who are most often ignored. Team members go into schools, churches, community centers, parks, housing developments, and businesses with representatives from organizations such as the American Diabetes Association, the Juvenile Diabetes Foundation, the 565
EDITORIAL
American Lung Association, the American Cancer Society, the American Heart Association, the American Red Cross, the Links, the National Association of Colored People, the American Academy of Ophthalmology, health departments, hospitals, police departments, insurance companies, and other local organizations. Members of Congress, mayors, students, ministers, bankers, entrepreneurs, reporters, prisoners, and public housing residents are joining this "Health Outreach Ministry." More importantly, the local NMA chapters in the pilot cities are gaining access to all forms of media. Inasmuch as the media is a valuable component of any health promotion effort, it is particularly vital for an effort targeting African Americans. Studies reveal that blacks tend to watch more television and listen to more radio than any other group. The NMAXs coalition activities are being documented in positive ways by these communications media-a feat that is difficult to accomplish during an era when so much negative activity is reported via these media. In fact, not only are the newspapers carrying our stories, major television network affiliates (ie, ABC, NBC, and CBS) have been responding as well. Plans have been made to expand the project's outreach to the media over the next several months because a lot of exciting activities are planned in conjunction with the NMA's upcoming convention in San Francisco. These massive efforts have not gone unnoticed. In fact, other federal agencies are seeking the NMAXs assistance in reaching African Americans with their messages. For example, the National Eye Institute is deeply concerned about the high rate of blindness in the black community as a result of undetected glaucoma and diabetic eye disease. To test the effectiveness of
566
physician-headed outreach programs, the National Eye Institute recently provided funding for two of our Year 2000 cities to add eye components to their programs. While Delutha King, MD, is the principal investigator of the overall Year 2000 initiative, Claude Cowan, MD, an ophthalmologist, was selected as the principal investigator of this portion of the project. He is developing a continuing medical education program on glaucoma detection and treatment for nonophthalmologists that is being taken very seriously. At the same time, physicians are being advised to take more proactive roles in monitoring their own health behaviors and those of their patients. Disease associated with smoking, poor nutrition and obesity, unprotected sex, and alcohol and other drug use can be prevented only if individuals understand the role they play in determining their own morbidity and mortality, and only if culturally sensitive programs are instituted to assist in behavioral change. National Medical Association physicians are charged with the responsibility of not only holding patients accountable through appropriate history taking and referrals but also by setting good personal examples for the patients who depend on them. Female health-care providers need to take the time to get physicals. Breast, cervical, lung, and colon cancers; heart disease; diabetes; and hypertension affect health professionals at unacceptably high rates. Male health-care professionals need to be equally concerned about prostate, lung, colorectal, and pancreatic cancers; stroke and heart disease; glaucoma; and kidney disease. We are all at risk for acquired immunodeficiency syndrome (AIDS) and other sexually transmitted diseases, if we do not protect ourselves. Personal screening is a must! We invite each of you to join us in this important endeavor!
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 84, NO. 7
