Historically black medical schools: addressing the minority health professional pipeline and the public mission of care for vulnerable populations.

Substantial changes in not only access to care, cost, and quality of care, but also health professions education are needed to ensure effective national healthcare reform. Since the actionable determinants of health such as personal beliefs and behaviors, socioeconomic factors, and the environment disproportionately affect the poor (and often racial/ethnic minorities), many have suggested that focusing efforts on this population will both directly and indirectly improve the overall health of the nation. Key to the success of such strategies are the ongoing efforts by historically black medical schools (HBMSs) as well as other minority serving medical and health professional schools, who produce a disproportionate percentage of the high-quality and diverse health professionals that are dedicated to maintaining the health of an increasingly diverse nation. Despite their public mission, HBMSs receive limited public support threatening their ability to not only meet the increasing minority health workforce needs but to even sustain their existing contributions. Substantial changes in health education policy and funding are needed to ensure HBMSs as well as other minority-serving medical and health professional schools can continue to produce the diverse, high-quality health professional workforce necessary to maintain the health of an increasingly diverse nation. We explore several model initiatives including focused partnerships with legislative and business leaders that are urgently needed to ensure the ability of HBMSs to maintain their legacy of providing compassionate, quality care to the communities in greatest need.

Commentary: funding the diversity programs of the Title VII Health Professions Training grants: an urgent need.

Federal funding to all Title VII programs has been reduced in recent years, and the Health Professions Training for Diversity Programs have fared disproportionately poorly. And, for FY2009, the administration recommends total elimination of all Title VII funding. Historically black health professions schools are in particular need of Title VII support to successfully pursue their missions of education, research, care, and service. Such schools generally have a legacy of undercapitalization, modest annual revenue sources, and a relatively low tuition revenue base in comparison with nonminority health professions schools. Yet, they occupy a unique niche in supplying health professionals to underserved communities and educating minority students, and they should be considered a national resource. Without annual support from Title VII health professions training programs, the affected institutions would face severe financial challenges to maintaining their academic programs, including support of faculty, students, and research. The authors, who are the presidents, respectively, of Morehouse School of Medicine and Meharry Medical College, therefore urge Congress and the administration to restore Title VII funding to the dollars 300 million level.This commentary is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

Reducing unintentional injuries on the nation's highways: research and program policy to increase seat belt use.

Death, disability, and injury from motor vehicle accidents constitute a public health crisis. The goal of this paper is to describe how Meharry Medical College's Center for Community Based Research plans to address this problem. A model of how high-risk groups are influenced to engage in behaviors that increase risk for traffic crashes is articulated. Five strategies for reducing risk for motor vehicle morbidity and mortality are identified: 1) influencing the individual at the point of decision; 2) mobilizing communities and coalitions to support individual and systems changes; 3) modifying environmental factors to modify behaviors; 4) changing laws and public policy; and 5) working towards the elimination of underlying causes. The Center for Community Based Research's promotion of seat belt use, based on each of these five strategies, is described. Addressing the public health crisis resulting from death and injury on the nation's roads and the excess risk faced by minority groups in this country will require the coordinated efforts of many groups. This work must be driven by research, the outcome of which will be a reduction in preventable injury, disability and premature death.