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Federal Program To Address Racial, Ethnic Health Disparities May Go Unfunded

Silvia León showcases some healthy foods inside her fridge, Oct. 17, 2017.

Photo by Matthew Bowler

Above: Silvia León showcases some healthy foods inside her fridge, Oct. 17, 2017.

Dried mangoes, cashews and 12-grain bread sit on a side table in Silvia León’s yellow kitchen. Red grapes and salad mix are stored front and center in her refrigerator. Two miniature watermelons ripen on the tiled counter top. Where there was once junk food, there are now healthy options, León said.

“We have home-cooked meals here, ya know, we hardly have anything you can pop in the microwave,” said the mother-of-three.

She said the changes came after completing Project Concern International’s community health worker program that targeted Latinas. The free course provides health and wellness training to minority populations that run a higher risk of some preventable diseases, such as diabetes. However, federal support for the local initiative, and others like it across the country, is on the chopping block.

House and Senate bills awaiting full approval by December do not contain dollars for the program known as Racial and Ethnic Approaches to Community Health or REACH. Supporters of the program say it is effective and can save money, while opponents say there is just not enough funding.

The Prevention Institute’s Sana Chehimi is urging lawmakers to restore the REACH program, and the nonprofit organization is promoting a letter that the public can submit to leaders on relevant committees.

“One of the really important reasons it matters is because there are still really wide inequities in health outcomes based on race and ethnicity, and the REACH program ... has a really, really long track record of working with communities and most importantly in communities to develop approaches and strategies that really work,” Chehimi said.

It is also cost-effective, she said.

The Prevention Institute pointed to a 2011 study led by a Johns Hopkins University professor that, according to the abstract, found “eliminating health disparities for minorities would have reduced direct medical care expenditures by about $230 billion and indirect costs associated with illness and premature death by more than $1 trillion for the years 2003-2006 (in 2008 inflation-adjusted dollars).”

Chehimi said this was not the first year that REACH funding had been threatened but claims it is the first time that it was lacking in appropriations legislation from both the House and the Senate.

U.S. Rep. Tom Cole, a Republican from Oklahoma who chairs a House appropriations subcommittee that includes Health and Human Services said at a July hearing the cuts were due to “an allocation issue” because there were fewer dollars to go around.

“We have a $5 billion lower allocation, and you want to plus up some things we all agree on here because, again, nobody’s asking for offsets in the areas that were plussed up,” Cole said in response to U.S. Rep. Barbara Lee, D-Oakland, calling for REACH to be restored.

But he said Lee made “ a good point” about the need to back minority health programs and would be willing to work with her on the issue.

Cole’s office directed a request for comment to a spokeswoman for the U.S. House Committee on Appropriations, who declined.

The subcommittee’s ranking member, U.S. Rep. Rosa DeLauro, D-Conn., said she opposes the reduction and will continue to push for its restoration in the final budget, which Congress must approve by early December.

“The REACH program does vital work to decrease health disparities in minority communities—disparities that are far too prevalent in our nation,” DeLauro said in a statement.

The chair and ranking member of the Senate appropriations subcommittee on health did not respond to a request for comment. The Centers for Disease Control and Prevention, which administer REACH, also did not immediately provide a response.

León said she was disappointed to learn funding that supports the local program she completed in 2015 could be cut. She said the initiative helped hammer home the consequences of negative habits and empowered her to make simple changes on a large scale.

León said she proposed to the parent-teacher organization at her children’s school that they encourage healthier food options at events. For example, the cookies, cakes and other sweets used to celebrate birthdays have been replaced.

“We give them pencils. We give them notebooks and stickers and reward them that way,” León said.

She estimated about 400 students attend the school.

Supporters of the program say it is effective and can save money, while opponents say there is just not enough funding.

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