John Ruffin

In May 2000, John Ruffin, director of the NIH Office of Research on Minority Health (ORMH) accompanied Surgeon General David Satcher to Capitol Hill, where they outlined NIH actions to research and eliminate health disparities among racial and ethnic groups; they endorsed legislation that would create a National Center on Minority Health and Health Disparities at NIH (see above "Title I" of the Health Care Fairness Act).

By year’s end, the Center had sailed into existence through a bill handily passed by Congress and happily signed by the president on November 22; Ruffin, who had steered the ORMH since its inception in 1990, was named the new Center’s director; and each NIH institute and center had crafted its own detailed "strategic plan" for targeting and eliminating health disparities related to its particular sphere of research. An NIH web site dedicated to health disparities went up in July:

Prelude to a Center

The health picture of minority populations in the United States, generally acknowledged as the basis for the country’s low health status ranking among the industrialized nations, had prompted President Clinton in 1998 to launch the Racial and Ethnic Health Disparities Initiative, which set a national goal of eliminating these disparities by 2010. The legislation to establish the new NIH center was introduced the following year, and NIH responded to the initiative by establishing the trans-NIH Working Group on Health Disparities. Co-chaired by NIAID Director Anthony Fauci and NIH Acting Deputy Director Yvonne Maddox, the Working Group has aided the ICs in developing their strategic plans.

Center Projections

In signing the bill, President Clinton noted with satisfaction that it authorized more than $150 million to create a new center at NIH directly related to the initiative he’d announced two years before to counter racial and ethnic health disparities.

The legislation calls for an NIH-wide comprehensive plan and budget for the conduct and support of such research and requires the Center director to report annually to congressional committees, the HHS secretary, and the NIH director on relevant intramural and extramural activities. A Center advisory group will be created by HHS.

In general, the Center and, specifically, its head are directed and empowered to fund health-disparities investigators and designated "centers of excellence." Chosen institutions could receive funding to offer biomedical and behavioral research training to a significant number of members of minority or other health-disparity populations, as well as to update existing research facilities or construct new ones. Such funding would be limited to five years and subject to annual approval by the Center director.

The act also mandates an educational loan repayment program aimed at increasing both the amount of health-disparities research and the numbers of minority researchers: Investigators who agree to pursue minority-health or other health-disparities research can be awarded up to $35,000 for each year of such research—and at least 50 percent of investigators awarded such contracts must be members of a health-disparity population.

The act enlists other agencies in the health-disparities mission as well: The Agency for Healthcare Research and Quality is required to identify disadvantaged populations in regard to the quality, outcome, cost, or use of health-care services—and to help develop strategies for change; the National Academy of Sciences is charged with conducting a comprehensive study of HHS systems and practices relating to the collection of data on race or ethnicity.

Return to Table of Contents