Racial and ethnic health disparities remain pervasive in most state health systems*. For most states where data are available, compared to their non-Hispanic white counterparts, blacks and American Indian/Alaskan Natives are more at risk of early death** (PDF | 653 KB) from treatable and preventable conditions; suffer serious pregnancy-related complications or death. die of heart disease or cancer. and are at greater risk of developing diabetes. The evidence is clear that they are deeply rooted health care disparities between and within states* (PDF | 2.9 MB). These disparities should create an appeal Health Justice Action (PDF | 4.7 MB).
Achieving health equity is a critical goal for behavioral health services. Equal access to high-quality and affordable behavioral health services and supports is a right of all individuals, regardless of race, age, ethnicity, gender identity, disability, socioeconomic status, sexual orientation, racial identity, or geographic location. Although this mountain can be difficult to climb, addressing health equity requires leadership, collaboration and support for sustainability. In January 2021, the Biden-Harris administration issued White House Executive Order 13985. The presidential directive increased the human costs associated with racism, chronic poverty, and other inequities and ordered the federal government to advance an ambitious justice agenda across the board. During Black History Month in 2023, President Biden reaffirmed the federal commitment to equality and signed a second executive order, further advancing racial equity and support for supported communities through the federal government, directing the federal government to continue and expand equality priorities for every American, including rural communities, communities of color, communities of color, LGBTQI+ people, people with disabilities, women and girls, etc.
The Office of Substance Abuse and Mental Health Services Administration (OBHE) coordinates efforts to reduce disparities in mental disorders and/or substance use among populations. OBHE’s mission is to advance equity in behavioral health care by aligning public health delivery efforts and services that promote mental health, prevent substance abuse, provide treatment, and facilitate support to promote recovery for racial, ethnic, and sexual gender minority populations and communities. While the task of achieving overall health equity for African Americans as a people has been and continues to be ambitious, we cannot deny the progress that has been made in public health and mental health infrastructure, national awareness, through legislation and program services. . Here are just a few important milestones that have advanced health equity for African Americans and other marginalized groups:
1915
National Negro Health Week begins in response to Tuskegee Institute findings that reinforced the poor health status of African Americans in the early 20th century.
1986
The Office of Minority Health of the US Department of Health and Human Services was created and is one of the most important outcomes of the Secretary’s 1985 Task Force Report on Black and Minority Health. The creation of the office offered to highlight minority health disparities as an issue of national importance.
2003
The Health Equity and Accountability Act introduced to improve the health and health care of minorities and eliminate racial and ethnic disparities in health and health care.
2009-Present
To address disparities in behavioral health care, the National Network to Eliminate Disparities in Behavioral Health (NNED) was created with the support of SAMHSA, the National Institutes of Health/National Institute on Minority Health and Health Disparities, The Annie E. Casey Foundation***, in collaboration with the National Alliance of Multi-ethnic Behavioral Health Associations. With a network of more than 1,500 community organizations, NNED operates out of SAMHSA’s OBHE and invites community organizations or agencies and individuals facing mental health or substance use disparities, with a particular focus on diverse communities, to become NNED members.
2018-Present
The Historically Black Colleges and Universities Center for Excellence in Behavioral Health (HBCU-CFE) was established by SAMHSA for the purpose of recruiting students into behavioral health careers addressing mental and substance use disorders, providing education that may lead to careers in behavioral health, and/or preparing students for advanced degrees in health behavior. One goal of HBCU-CFE is to increase the number of HBCU students who are prepared to enter the behavioral health field by helping students continue their education in behavioral health.
2020-Today
The African American Behavioral Health Center of Excellence established with the support of SAMHSA as one of three Centers of Excellence to develop and disseminate training and technical assistance for health professionals on topics related to addressing health behavior disparities.
This year is a new opportunity to reduce the burdens of health inequalities and expand the implementation of proven health equity strategies. There are also opportunities to expand the reach of health equity into public policy, community development, workforce development, and program services to name a few. Black History Month is a month to reflect on the strides people of African descent have made in America. There have been many. But collectively, America has not erased the tragic impact of racial health disparities. The march to the top of the mountain continues. Let’s go!
To learn more about the HHS Equity Action Plan, visit https://www.hhs.gov/equity/index.html#eap.
Resources
- African American Behavioral Health Center of Excellence: The African American Behavioral Health Center of Excellence (CoE) is a SAMHSA-sponsored national CoE located within the Morehouse School of Medicine’s National Center for Primary Care.
- Historically Black Colleges and Universities Center for Excellence in Behavioral Health (HBCU-CFE): The Center of Excellence emphasizes education, awareness, and preparation for careers in the treatment of mental and substance use disorders, including the treatment of opioid use disorders, serious mental illness (including First Episode Psychosis), and suicide prevention. The mission of HBCU CARES is to increase awareness and provide access to behavioral health fields for diverse students.
- National Network to Eliminate Disparities in Behavioral Health: NNED is a network of community-based organizations focused on the mental health and substance use issues of diverse racial and ethnic communities.
- Advancing Health Equity: A Resource to Help Communities Address the Social Determinants of Health (PDF | 4.7 MB): This workbook from the Centers for Disease Control and Prevention is intended for public health professionals and collaborators interested in addressing the social determinants of health to promote health and achieve health equity.
- SAMHSA’s Office of Behavioral Health Equity: OBHE promotes equity in behavioral health by reducing disparities in racial, ethnic, LGBTQI+ and other underresourced communities across the country, improving access to quality services and supports that enable all to thrive , participate in and contribute to healthier communities. OBHE was established pursuant to Section 10334(b) of Patient Protection and Affordable Care Act of 2010.
- White House Executive Order 13985: Advancing Equity and Racial Justice Through the Federal Government: President Biden signed Executive Order 13985 which charged the federal government with promoting equality for all, including long-underserved communities.
- White House Executive Order 14091: Further Advancing Racial Equity and Support for Underserved Communities Through the Federal Government: President Biden signed Executive Order 14091 to build on previous equity-related Executive Orders by expanding and strengthening equity promotion requirements for agencies and positions agencies to deliver better results for the American people.
*THE Commonwealth Fund 2020 Scorecard on Government Health System Performance provides an assessment of the 50 states and the District of Columbia on 49 measures of health care access, quality of care, service utilization and cost of care, health outcomes, and health care disparities by income.
**The Century Foundation is one of the oldest public policy think tanks in America. Their 2019 feature report, Racism, Inequality, and Health Care for African Americans (PDF | 653 KB)broadly examines the state of health care coverage for African American populations and highlights the social factors that influence their health outcomes, including risks of disparity.
*** The Annie E. Casey Foundation is included in recognition of their role in supporting the creation of NNED.
