Research Updates in Kidney and Urologic Health

Surgeon General Addresses Health Disparities

U.S. Surgeon General David Satcher spoke on "The National Strategic Plan for the Elimination of Health Disparities" at the National Institutes of Health (NIH) on July 23. Dr. Satcher was presenting the 7th annual John W. Diggs Lecture, sponsored by the Speakers Bureau of the NIH Black Scientists Association in collaboration with the National Institute of Allergy and Infectious Diseases' minority scientists advisory committee and Office of Special Populations and Research Training, the National Institute of Diabetes and Digestive and Kidney Diseases, the NIH Office of Equal Opportunity, the Office of Research on Women's Health, and the National Center on Minority Health and Health Disparities.

Dr. Satcher began by stating he believed John Diggs, a scientist and administrator at NIH from 1974 to 1993 and a leader in the NIH Black Scientists Association, would have been proud of the Department of Health and Human Services' initiative to eliminate health disparities among racial and ethnic groups.

Measurement of Disparities:
How Wide Is the Gap?

Dr. Satcher identified a wide variety of public health concerns ranging from the increasing prevalence of obesity to the ongoing effects of youth violence, environmental hazards, and sexually transmitted diseases. He noted several indicators of health disparities among races in America. He reported that American Indians are three times as likely as whites to have diabetes. Many of the disparities fall in the category of access to care. Dr. Satcher noted that up to 50 percent of Hispanics have no primary physician for ongoing care. One-quarter of African Americans are uninsured.

Leading Health Indicators: Healthy People 2010

Dr. Satcher explained that the national strategic plan to eliminate health disparities centered on the Healthy People 2010 initiative and 10 Leading Health Indicators. Targets for the 2010 initiative include access-to-care goals such as raising the percentage of insured people under 65 from the 1997 baseline of 83 percent to 100 percent and raising the percentage of people with a specific source of ongoing care from the 1998 baseline of 87 percent to 96 percent. Racial groups that are currently farthest from the target will benefit most by being placed on a par with the rest of the population.

Therapeutic Lifestyle Changes:
A Prescription for Prevention

Dr. Satcher observed that half of the deaths in America are attributable to lifestyle matters like diet or lack of exercise. He called attention to the Surgeon General's "Prescription for Health," which includes moderate physical activity, avoiding toxins like illicit drugs, eating five servings of fruits and vegetables a day, and responsible sexual behavior.

Dr. Satcher showed a chronological series of U.S. maps on which states with a prevalence of obesity greater than 15 percent were shaded in dark blue. Each map in succession showed more and more blue until the country was almost solid. Dr. Satcher reported that treating the consequences of overweight and obesity costs the country $99.2 billion a year.

Dr. Satcher said an estimated 30 percent of health costs incurred in this country could be avoided through preventive measures and early detection and treatment. He noted that 90 percent of the money spent on diabetes is directed to treating its complications. Dr. Satcher called for an investment in health promotion and disease prevention.

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