1	Eliminating Disparities: A Call for Social Movement Building Arthur Chen, MD achen@alamedaalliance.com 510 747-4571 Voices From The Community Health & Wealth Disparities May 23, 2004
2	How Big Are These Challenges? Model Minority Myth Children and Adolescents Health & Wealth Disparities Cultural Competence Language Barriers Chronic Disease HIV/AIDS/DV/Health Access SARS/Avian Flu Developmental Disabilities Community Mental Health What Will It Take To Have Major Impact?
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9	Black and Minority Health Task Force Report 1985 Margaret Heckler, Secretary DHHS, 1985
10	Our Pathway towards Equity Fighting the Model Minority Myth Data Gathering to Identify Health Status Expanding Health Access Addressing Cultural and Linguistic Barriers plus Cultural Competence Expanding Research Initiatives Getting a Seat at the Table Building Outstanding Service Models
11	“A model should be supported and spread across the nation, teaching fairness, equity, democracy, and justice.” -Michael Bird Executive Director of the National Native American AIDS Prevention Center
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13	Tax Crusader Doctrines Supply-Side Economics: govt can cut taxes without severe cuts in spending Starving the Beast: taxes should be cut precisely in order to force severe cuts in public spending Goal: “Reducing the size and scope of govt by draining its life blood” Grover Norquist, Americans for Tax Reform
14	US Political/Policy Trends Massive Tax Cuts 2001 & 2003 $350 to $800 Billion over 10 years 2001 – reduced top income tax rate and eliminated estate tax 2003 – reduction of tax rate on dividend income
15	Ratio of Taxes to GDP US 26.3% 2002 Canada 38.2 1999 France 45.8 1999 Sweden 52.2 1999
16	Federal Budget - Discretionary Fiscal Year 2004 (Dollar amt in billions) Discretionary Total 819 Defense 390 Nondefense 429 Mandatory Total: I,234 Source: Office of MGT & Budget 2004
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18	US Federal Budget - 2003 Massive Military Build up Cost: $400+ Billion Afghanistan & Iraq War 03-04 Cost: $87 Billion
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20	Costs of War Combined Military Budget of the Four Top Military Spenders Other Than the US,2002 (Russia, China, Japan, UK) ……$193 Billion Annual US Education Budget … $52 Billion Annual US Housing Assistance …$29 Billion Sources: United for a Fair Economy; Dept of Defense; Ctr for Def Info; War Times, Dec-Jan 2004
21	Federal Budget - 2004 NIH $27.7 Billion HRSA 5.7 CDC 4.2 SAMHSA 3.4 Admin on Aging 1.3 CHC’s 1.6 Admin for Children & Families 13.4 N Ctr Minority Hlth & H. Dispties .193 Office of Minority Health .047 Office of Civil rights .034
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24	CROSSROADS? 40+ Years of Civil Rights Advances -8/28/63 Civil Rights Act of 1964 Voting Rights Act of 1965 Fair Housing Act of 1968
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27	Essential Truth of Social Change PEOPLE WHO SUFFER INJUSTICE ARE CRUCIAL TO OVERCOMING IT
28	Give people fish when they are hungry while teaching them to fish when possible. Work With them as partners on how to take ownership of the fish pond, too.
29	Public Health Policy Knowledge Base Social Intervention Strategies Public Will Kotelchuk and Richmond
30	SOLUTION??? Nothing Simple CONTINUE CURRENT FOCUS ORGANIZE ORGANIZE ORGANIZE!!!
31	Create Opportunities!!! Reach people at their level Listen and Learn Educate and Increase awareness of a vision for equality and principles for humanity!!! Move people towards ACTION!!!
32	“Never doubt that a small group of thoughtful citizens can change the world. Indeed, it is the only thing that ever has.” Margaret Mead
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36	SUMMARY Promote our Vision for social justice/equity in a free society. Continue Focused Interventions Sharpen Understanding of Key Debates in Democracies and how social change occurs Implement community education and engagement for ACTION Think of and Act on Multilevel Interventions Contribute and link to Broader Movement Building
37	“A lot of people are waiting for Martin Luther King or Mahatma Gandhi to come back but they are gone.” “We are it. It is up to us. It is up to you.” Marian Wright Edelman