Autumn Allen (l) and Brian Gibbs

"The health care system addresses illness," said Brian Gibbs, director of the Program to Eliminate Health Disparities at the Division of Public Health Practice (DPHP). "Unfortunately, health as a priority or health as a focus isn’t necessarily a primary staple in communities of color or underserved communities."

The COHS coalition is coordinated by the Program to Eliminate Health Disparities at DPHP and includes members from the Massachusetts Department of Public Health, American Heart Association, Joslin Diabetes Center, Action for Boston Community Development, Boston Public Health Commission, Health Care For All, Tufts School of Medicine, NAACP Health Committee, several community health centers, a church, and others.

The coalition has subgroups that focus on specific tasks. There is a policy cluster, health promotion cluster, anti-racism cluster, and clinical care and research cluster. The clinical care and research cluster, for example, has helped organize blood pressure screenings at community events in Roxbury.

Health disparities between Caucasian and non-Caucasian groups of Americans have been identified in studies. Last spring, the Institute of Medicine released a report, saying that members of minority groups tend to receive lower-quality health care than Caucasians do, even when insurance status, income, age and severity of conditions are comparable. Other studies have indicated differences in treatment and mortality rates between Caucasian and non-Caucasian group members related to conditions such as diabetes and kidney disease.

Gibbs explained that the coalition’s focus on cardiovascular health resulted from research he performed with Camara Jones, former assistant professor of health and social behavior and epidemiology at HSPH. Jones, a cardiologist, trained "Healthy Heart Advisors" to survey Roxbury residents about health status and behaviors, as well as about their perceptions on how racism has affected their health. The work formed a ready foundation for ensuing surveys about topics such as awareness of cardiovascular disease and cholesterol issues. For example, a 2001 survey of 123 attendees at a health summit in Roxbury revealed that 78 percent thought that heart disease was a very big or big health problem in Roxbury and that 65 percent thought that racism affects heart disease; 20 percent said they had a personal experience related to racism and heart disease.

The surveys are intended to help the COHS coalition refine a community action plan aimed at improving the cardiovascular health of Roxbury residents.

"We are trying to figure out what people need so that we can then fill in the gaps," said Autumn Allen, the program’s coordinator, who helps collect the coalition’s survey data.

The coalition is also involved in several research projects, such as the "Healthy Heart Initiative," funded by Brigham and Women’s Hospital to develop and evaluate strategies for nutrition education to increase heart-healthy eating habits.

"We can anticipate the growth of chronic health conditions related to heart disease, diabetes, and other conditions facing us down the road," said Gibbs. "Now, we need to figure out who needs to be at the table to address those problems, and I think the answer should be asked across race, class, and culture. Otherwise, we will continue to see disparities."