XV. Eliminating Racial and Ethnic Disparities

FY 2000 Performance Plan - Revised Final FY 1999 Performance Plan

Eliminating Health Disparities in Chronic Disease

The continuing disparities in the burden of death and illness associated with chronic diseases, such as cancer, cardiovascular disease, and diabetes, experienced by African-Americans, Hispanics, American Indians and Alaska Natives, and Asian-Americans and Pacific Islanders, compared to the U.S. population as a whole demands national attention. The health disparities associated with chronic diseases offers a compelling reason for addressing this issue. Examples of ethnic health disparities in chronic disease include:

• Diabetes - The prevalence of diabetes in African-Americans is approximately 70 percent higher than whites and the prevalence in Hispanics is nearly double that of whites.
• Cardiovascular disease - Racial and ethnic populations have higher rates of hypertension, tend to develop hypertension at an earlier age, and are less likely to undergo treatment to control their high blood pressure.
• Cancer - For men and women combined, African-Americans have a cancer death rate about 35 percent higher than that for whites (171.6 vs. 127.0 per 100,000). The death rate for cancer for African-American men is about 50 percent higher than it is for white men (226.8 vs. 151.8 per 100,000).

The demographic changes that will unfold over the next decades magnify the importance of addressing disparities in health status especially with regards to chronic diseases. CDC intends to address these three chronic disease issues as part of the President's Initiative on Race. Recognizing that the future health of the American people as a whole will be influenced substantially by our success in improving the health of racial and ethnic groups, CDC is committed to addressing the disparities associated with diabetes, cardiovascular disease, cancer and infant mortality through new and existing disease prevention and health promotion strategies.

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	FY 2000
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 the following focus areas: cancer, cardiovascular disease, diabetes and infant mortality. CDC will fund selected community demonstration projects in FY 99.	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.

Verification/Validation of Performance Measures: By the end of FY 1999, a RFA will be developed and selected community demonstration projects will be funded. In FY 2000, CDC will fund 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, who will be determined later, 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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