XV. Eliminating Racial and Ethnic Disparities

FY 2000 Performance Plan - Revised Final FY 1999 Performance Plan

Eliminating Health Disparities in Adult Immunizations

The reduction in the incidence of vaccine-preventable disease is one of the most significant public health achievements of the past 100 years. The major factor in this success is the development and widespread use of vaccines, which are among the safest and most effective preventive measures. Billions of dollars are saved each year through the use of vaccines.

Older adults are at increased risk for many vaccine-preventable diseases. Approximately 90 percent of all influenza-associated deaths in the United States occur in people aged 65 and older, the fastest growing age group of the population. Reduction of deaths in this age group has been hindered in part by relatively low vaccine utilization. Immunization os one of the most cost-effective strategies to prevent needless morbidity and mortality. Each year, however, an estimated 45,000 adults die of infections related to influenza, pneumococcal infections, and hepatitis B despite the availability of safe and effective vaccines to prevent these conditions and their complications. In addition, the overall cost to society for vaccine-preventable diseases exceeds $10 billion each year.

There is a disproportionate burden of these diseases in ethnic populations. Although vaccination levels for pneumococcal infections and influenza among people 65 years and over have increased slightly for African-American and Hispanics, the coverage in these groups remains substantially below the general population and the year 2000 targets.

Performance Goals and Measures

Performance Goal: To achieve meaningful improvement in the lives of racial and ethnic populations who now suffer disproportionately from the burden of disease and disability. To develop the necessary tools and strategies that will enable the Nation to meet the far more challenging goal of eliminating these health disparities by the year 2010.

Performance Measure:

FY Baseline	FY 1999 Appropriated	FY 2000 Estimate
N/A	CDC, in collaboration with interagency workgroups, will develop a community planning RFA to fund communities to conduct planning activities for community-based demonstrations of prevention and service delivery interventions whose mission is to eliminate racial and ethnic health disparities for Adult immunization. CDC will fund up to five community planning projects to improve adult immunization and eliminate racial and ethnic disparities.	CDC will fund selected communities to implement interventions based on community planning activities. Grantees will collaborate with interagency content workgroups and community leaders to develop implementation and evaluation programs for selected community demonstration programs whose mission is to eliminate racial and ethnic health disparities for the following focus areas: cancer, cardiovascular disease, diabetes, and infant mortality. The interagency workgroups will provide scientifically and socially substantiative assistance in the formulation of the implementation and evaluation plans. These plans will be culturally relevant and unique to each of the communities for which they are designed.
Total Program Funding	$10,000	$35,000

Verification/Validation of Performance Measures: By the end of FY 1999, a RFA will be developed and community planning projects will be funded. In FY 2000, CDC will fund selected communities to implement interventions. Grantees will report on the development of implementation and evaluation plans which will be reviewed by CDC staff. FY 2000 measures will also be evaluated by site visits.

Links to DHHS Strategic Plan

These performance objectives are related to DHHS Goals 1: Reduce major threats to the health and productivity of all Americans. Development and implementation of the plan to Eliminate Ethnic Health Disparities is an inter-agency effort within DHHS. CDC will collaborate with other federal agencies in developing and implementing this initiative. Specific objectives for implementation of the initiative must be determined through a collaborative inter-agency process.

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