Advancing Health Equity, Thirty Years Following the Heckler Report

By Eve J. Higginbotham, SM, MD

This month, the Department of Health and Human Services celebrates National Minority Health Month and more specifically acknowledges the 30th anniversary of the Margaret Heckler's Report on Black and Minority Health.

This month, the Department of Health and Human Services celebrates National Minority Health Month and more specifically acknowledges the 30th anniversary of the Margaret Heckler's Report on Black and Minority Health.[1] This report clearly "documented the existence of health disparities among, ethnic minorities in the United States and called such disparities "an affront both to our ideals and to the ongoing genius of American medicine."[2]  In this groundbreaking report, six causes of higher levels of mortality in blacks compared to whites were noted: cancer, cardiovascular disease and stroke, chemical dependency, diabetes, homicide and accidents, and infant mortality. Although this report clearly documented these disparities and the Institute of Medicine Report published in 2003, entitled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care[3] documented disparities in treatment, as a nation, we continue to grapple with the same challenges in achieving health equity that were noted some 30 years ago.  We are reminded about the opportunities in a thoughtful commentary recently published in JAMA, entitled "Achieving Health Design" by Wong and coauthors.[4] In this commentary, the authors affirm the importance of building community partnerships as a strategy for enhancing the efforts of health systems to optimize the health of the populations they serve. The data related to systemic hypertension are a painful reminder of the gap that still exists in cardiovascular disease, an area noted by the Secretary's Task Force 30 years ago. As noted by Wong and coauthors, 4 the rate of control of hypertension among African Americans is only 40.7%, indicating an important contributor to the disparity in the higher rate of complications related to hypertension among ethnic minorities.  Efforts to overcome these statistics must go beyond courses in cultural competency and neutralization of the health literacy in communities and include meaningful conversations with communities and the organizations that have established trusting relationships. The Viewpoint by Wong is worth reading, provides much needed food for thought, and creates an important way for us to consider how we may better care for the populations we serve.\


[1] .  Margaret Heckler, Secretary of Health and Human Services, Report of the Secretary's Task Force on Black and Minority Health, August 1985, accessed April 12, 2015,

[2] .  Extracted from Presentation of Jonca Bull, MD, Director FDA Office of Minority Health at the Institute of Medicine, Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities, April 9, 2015

[3] . Smedley, B, Stith, A, Nelson, A (eds) Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, Institute of Medicine, 2003

[4] . Wong, W., LaViest, T, and Sharfstein, J. "Achieving Health Equity by Design," March 9, 2015,