Satcher to play key role in minority health issues - US Surgeon General David Satcher

Black Issues in Higher Education, March 5, 1998 by Charles Dervarics

David Satcher's confirmation as U.S. Surgeon General will give the former Meharry Medical College president a leading role in a new Clinton administration effort to improve health care for people of color.

Satcher, Meharry's president from 1982 to 1993, won Senate confirmation February 10 and was installed in the post at a White House ceremony shortly afterward. He won confirmation by a 63-35 vote after moderate Republicans joined Democrats in defeating a filibuster from conservatives.

One of Satcher's first priorities is to help lead a new presidential initiative on minority health. President Bill Clinton used his national radio address on February 21 to announce the new, $400 million program designed to eliminate health disparities between Whites and minorities.

The president said the plan would help address some troubling trends, including data showing that prostate cancer affects twice as many Blacks as Whites. Diabetes also is three times more prevalent among American Indians than among Whites, said Clinton, who called such disparities "unacceptable."

Funds for the $40-million plan would flow over a five-year period, not counting expected contributions from the private sector. Major philanthropic organizations would kick off the effort with a national conference on minority health this spring, according to the White House.

As the nation's top physician, Satcher would help direct this effort, officials said. The Surgeon General most recently served as director of the U.S. Centers for Disease Control and Prevention (CDC) before his confirmation.

The new initiative also would provide a new focus on minority health at a time when similar federal programs may have to face cuts. For instance, the federal government's Office on Minority Health (OMH) would get less money next year under the President's new budget request.

Headquartered at the Department of Health and Human Services (HHS), OMH would receive $23 million next year, $6 million less than current funding. The office seeks to improve health services, combat diseases, and conduct research on issues affecting minority groups.

HHS, however, said the reduction would not affect ongoing research and outreach projects, some of which involve Black colleges. The 1998 funding level contained a one-time increase to support a new technology infrastructure and a one-time construction project, HHS said.

The HHS budget also contains $291 million for health-professions training, including efforts to support diversity. Federal programs include Centers of Excellence, which serve about 4,000 under-represented students at medical, dental, and pharmacy schools.

Additionally, the new budget contains $80 million to address racial health disparities, the agency said.

But the president's latest plan would give minority health a new visibility, both within the government and in urban areas, Of the $400 million in the president's latest proposal, about $30 million a year would go to at-risk communities to focus on one or two healthcare problems. The remainder of funds would go to the CDC to focus on areas such as diabetes, child immunizations, HIV/AIDS, cancer screening and management and infant mortality.

The new initiative also shows that Satcher, who has directed the CDC since 1993, has gained a central role in the administration following an unexpectedly tough confirmation battle that featured opposition from many right-wing Republicans.

Conservatives had opposed Satcher's nomination in part because he refused to speak out against late-term abortions, a practice conservatives refer to as "partial-birth abortions." And he also came under criticism because he would give youngsters access to federally funded family planning services without parental consent.

Earlier, Sen. John Ashcroft (R-Mo.) had called the Satcher nomination "a direct assault on the values of millions of pro-family conservatives."

However, Satcher had strong support among GOP moderates -- including Sen. Bill First (R-Tenn.), a physician who chairs the Senate's health subcommittee.

Satcher has entered a job left vacant for more than three years following the resignation of Joycelyn Elders, M.D., who faced criticism for her comments on sexuality. Clinton's last nominee for the job, obstetrician Henry Foster, M.D., face opposition after he acknowledged performing several abortions in his medical practice.