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Introduction: Addressing Racial and Ethnic Disparities: Lessons from the REACH 2010 Communities

Eliminating racial and ethnic disparities in health defines the core mission of public health and requires primacy in all of our actions. We know disparity elimination is achievable; we seek only to assure that minority populations attain the existing health status of the majority population, not some theoretical or utopian state of health. Given this modest aim we must be impatient with our progress, and seek ever more effective interventions and strategies to close these gaps. How can we hasten our progress? The Centers for Disease Control and Prevention established REACH (Racial and Ethnic Approaches to Community Health) 2010 to eliminate health disparities, one of the goals of Healthy People 2010. Launched in 1999, REACH is designed to eliminate disparities in the following six priority areas: cardiovascular disease, immunizations, breast and cervical cancer screening and management, diabetes, HIV/AIDS, and infant mortality. The racial and ethnic groups targeted by REACH 2010 are African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, and Pacific Islanders. In fiscal year 2004, CDC supported 40 REACH 2010 projects in the nation. The articles in this special supplement to Journal of Health Care for the Poor and Underserved document lessons learned by the REACH 2010 communities and clearly show that a clear and focused goal to eliminate disparities can succeed. The eleven papers and the Guest Editorial in this issue of JHCPU report on interventions and research conducted around the nation as part of the REACH 2010 initiative. The Editorial, by Dr. Garth Graham of the Office of Minority Health, sounds the call for more concerted attention to health disparities dividing the U.S. population. The research papers fall into two broad groups, papers focused on community-based participatory research and papers focused on race, ethnicity, and health. Bronx Health REACH is a coalition formed in 2001 at the initiative of the Institute for Urban Family Health to reduce morbidity and mortality resulting from diabetes and related cardiovascular disease in a predominantly minority community in the Bronx. The problems being addressed are severe: for example, the mortality rate for women 18–64 years of age from diabetes in this Bronx community is 20 times higher than in a nearby wealthy and predominantly White community. Bronx Health REACH comprises 40 community-based organizations. The INTRODUCTION