The Heckler Report, officially the Report of the Secretary's Task Force on Black and Minority Health, was a landmark 1985 report published by the US Government. [1] It is named after Margaret Heckler, who was Secretary of the Department of Health and Human Services from 1983 to 1985. [2] The Heckler Report investigated racial and ethnic disparities in health in the United States.
In 1977, the Association of Minority Health Professions Schools was formed by Louis Wade Sullivan, Ralph Cazort, Anthony Rachal, and Walter Bowie. In the early 1980s, they commissioned a study by Ruth Hanft which was published as "Blacks and the Health Professions in the 1980s: A National Crisis and A Time for Action". In March 1983, members of the Association of Minority Health Professions Schools met with Margaret Heckler, who was Secretary of the Department of Health and Human Services. [3] Heckler was said to be disturbed by the "Blacks and the Health Professions..." documentation of life expectancy disparities, calling it an "affront to our ideals and to the genius of American medicine". [4] A month later, Heckler contacted them to let them know that she had commissioned a taskforce to be led by Thomas E. Malone and Katrina Johnson. [3]
The Report of the Secretary's Task Force on Black and Minority Health was published in August 1985. [2]
The Heckler Report found that in the US, 60,000 deaths occurred each year due health disparities. It outlined the six causes of death that accounted for more than 80% of mortality among ethnic and racial minorities. The report included recommendations to reduce these health disparities, as well as to collect data of a higher quality for Hispanics, Asian Americans, American Indians, and Alaska Natives. [4]
The Heckler Report was the first effort by the US government to investigate health inequality among racial and ethnic minorities. [5] It has been called a "landmark", [1] "groundbreaking", [2] and "a transformative, driving force for change". [4] It has served as the "anchor" of federal efforts to reduce and eliminate racial and ethnic health disparities. [1] It directly led to the creation of the Office of Minority Health in 1986. [2] [4] Offices of minority health were additionally established in the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and Health Resources and Services Administration (HRSA) as a result of the report. [4]
Louis Wade Sullivan is an active health policy leader, minority health advocate, author, physician, and educator. He served as the Secretary of the United States Department of Health and Human Services during President George H. W. Bush's Administration and was Founding Dean of the Morehouse School of Medicine.
David Satcher, is an American physician, and public health administrator. He was a four-star admiral in the United States Public Health Service Commissioned Corps and served as the 10th Assistant Secretary for Health, and the 16th Surgeon General of the United States.
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.
Race and health refers to how being identified with a specific race influences health. Race is a complex concept that has changed across chronological eras and depends on both self-identification and social recognition. In the study of race and health, scientists organize people in racial categories depending on different factors such as: phenotype, ancestry, social identity, genetic makeup and lived experience. "Race" and ethnicity often remain undifferentiated in health research.
Jane L. Delgado is a Cuban-American clinical psychologist, health care advocate, non-profit executive, and author. She is president and CEO of the National Alliance for Hispanic Health. She is the author of The Buena Salud Guide book series and The Latina Guide to Health. In 2012 the series was acquired by William Morrow an Imprint of HarperCollins Publishers and published "Buena Salud Guide to Arthritis and Your Life."
Lisa A. Cooper is an American internal medicine and public health physician who is the Bloomberg Distinguished Professor of Equity in Health and Healthcare at Johns Hopkins University, jointly appointed in the Johns Hopkins School of Medicine, Johns Hopkins School of Nursing and in the departments of Health, Behavior and Society, Health Policy and Management; Epidemiology; and International Health in the Johns Hopkins Bloomberg School of Public Health. She is the James F. Fries Professor of Medicine in the Division of General Internal Medicine, Director of the Johns Hopkins Center for Health Equity, and Director of the Johns Hopkins Urban Health Institute. Cooper is also a Gilman Scholar and a core faculty member in the Welch Center for Prevention, Epidemiology, and Clinical Research. She is internationally recognized for her research on the impact of race, ethnicity and gender on the patient-physician relationship and subsequent health disparities. She is a member of the President’s Council of Advisors on Science and Technology (PCAST). In 2007, she received a MacArthur Fellowship ”genius” grant from the MacArthur Foundation.
Research shows many health disparities among different racial and ethnic groups in the United States. Different outcomes in mental and physical health exist between all U.S. Census-recognized racial groups, but these differences stem from different historical and current factors, including genetics, socioeconomic factors, and racism. Research has demonstrated that numerous health care professionals show implicit bias in the way that they treat patients. Certain diseases have a higher prevalence among specific racial groups, and life expectancy also varies across groups.
Margaret Mary Heckler was an American politician and diplomat who represented Massachusetts's 10th congressional district in the United States House of Representatives from 1967 until 1983. A member of the Republican Party, she also served as the 15th United States Secretary of Health and Human Services from 1983 to 1985, as well as United States ambassador to Ireland from 1986 to 1989.
Racial inequality in the United Statesof America identifies the social inequality and advantages and disparities that affect different races within the country. These can also be seen as a result of historic oppression, inequality of inheritance, or racism and prejudice, especially against minority groups.
The Office of Minority Health (OMH) is an American federal agency created in 1986. It is one of the most significant outcomes of the 1985 Secretary's Task Force Report on Black and Minority Health, also known as the "Heckler Report". The Heckler report "was a landmark effort in analyzing and synthesizing the present state of knowledge [in 1985] of the major factors that contribute to the health status of Blacks, Hispanics, Asian/Pacific Islanders, and Native Americans." The Office the Heckler Report established is dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities. OMH was reauthorized by the Patient Protection and Affordable Care Act of 2010.
Societal racism is a type of racism based on a set of institutional, historical, cultural and interpersonal practices within a society that places one or more social or ethnic groups in a better position to succeed and disadvantages other groups so that disparities develop between the groups. Societal racism has also been called structural racism, because, according to Carl E. James, society is structured in a way that excludes substantial numbers of people from minority backgrounds from taking part in social institutions. Societal racism is sometimes referred to as systemic racism as well.
The White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders (WHIAANHPI) is a United States governmental office that coordinates an ambitious whole-of-government approach to advance equity, justice, and opportunity for Asian Americans, Native Hawaiians, and Pacific Islanders. The Initiative collaborates with the Deputy Assistant to the President and AA and NHPI Senior Liaison, White House Office of Public Engagement and designated federal departments and agencies to advance equity, justice, and opportunity for AA and NHPIs in the areas of economic development, education, health and human services, housing, environment, arts, agriculture, labor and employment, transportation, justice, veterans affairs, and community development.
Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values, beliefs, and feelings. This process includes consideration of the individual social, cultural, and psychological needs of patients for effective cross-cultural communication with their health care providers. The goal of cultural competence in health care is to reduce health disparities and to provide optimal care to patients regardless of their race, gender, ethnic background, native languages spoken, and religious or cultural beliefs. Cultural competency training is important in health care fields where human interaction is common, including medicine, nursing, allied health, mental health, social work, pharmacy, oral health, and public health fields.
Clarice D. Reid is an American pediatrician born in Birmingham, Alabama, who led the National Sickle Cell Disease Program at the U.S. National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health. She went on to become the Director of Division of Blood Diseases and Resources at NHLBI. Reid was a member of the 1985-1986 Taskforce on Black and Minority Health. She has also served as President Emeritus on the American Bridge Association's Education and Charitable Foundation, and has scored a rare perfect bridge score.
In the United States, use of deadly force by police has been a high-profile and contentious issue. In 2022, 1,096 people were killed by police shootings according to The Washington Post, while according to the "Mapping Police Violence" project, 1,176 people were killed by police in total.
The weathering hypothesis was proposed to account for early health deterioration as a result of cumulative exposure to experiences of social, economic and political adversity. It is well documented that minority groups and marginalized communities suffer from poorer health outcomes. This may be due to a multitude of stressors including prejudice, social alienation, institutional bias, political oppression, economic exclusion and racial discrimination. The weathering hypothesis proposes that the cumulative burden of these stressors as individuals age is "weathering," and the increased weathering experienced by minority groups compared to others can account for differences in health outcomes. In recent years, the biological plausibility of the weathering hypothesis has been investigated in studies evaluating the physiological effects of social, environmental and political stressors among marginalized communities. This has led to more widespread use of the weathering hypothesis as a framework for explaining health disparities on the basis of differential exposure to racially based stressors. Researchers have also identified patterns connecting weathering to biological phenomena associated with stress and aging, such as allostatic load, epigenetics, telomere shortening, and accelerated brain aging.
The National Economic Association (NEA) is a learned society established in 1969, focused on initiatives in the field of economics.
The COVID-19 pandemic has revealed race-based health care disparities in many countries, including the United States, United Kingdom, Norway, Sweden, Canada, and Singapore. These disparities are believed to originate from structural racism in these countries which pre-dates the pandemic; a commentary in The BMJ noted that "ethnoracialised differences in health outcomes have become the new normal across the world" as a result of ethnic and racial disparities in COVID-19 healthcare, determined by social factors. Data from the United States and elsewhere shows that minorities, especially black people, have been infected and killed at a disproportionate rate to white people.
Joneigh Khaldun is the Vice President and Chief Health Equity Officer at CVS Health. Prior to serving in this position, she served as the Chief Medical Executive for the State of Michigan and Chief Deputy Director for Health in the Michigan Department of Health and Human Services. On February 10, 2021, she was announced as a member of the COVID-19 Health Equity Task Force under the Biden-Harris administration.
The COVID-19 pandemic has had an unequal impact on different racial and ethnic groups in the United States, resulting in new disparities of health outcomes as well as exacerbating existing health and economic disparities.