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    Seeking Equality in Health Care

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    Fewer black people enroll in clinical trials than whites, largely because they lack trust in the health-care system, says B. Lee Green, PhD, a researcher in the University of Alabama's School of Public Health. In a study published recently in the journal Ethnicity and Medicine, Green writes: "Many ... thought that the motives of the researchers might not be in [their] best interests. ... Many were uncomfortable with studies that involved blood, injections, and radiation."

    But a study by the National Cancer Institute in 1999 found that when black people with colon cancer enroll in clinical studies, they fare nearly as well as white people -- and do significantly better than other blacks who develop colon cancer. The difference, says researcher James J. Dingnam, PhD, is due to standardized treatment, which is often lacking in the real world. "It is not uncommon to find that treatment is not in keeping with what is recommended," Dignam told WebMD in a 1999 interview.

    As the Healthy People 2010 initiative grapples with these issues, the NIH's Office of Research on Minority Health has launched a hopeful effort. Its new web site offers a wealth of information on health topics and clinical research. It includes information on ways to improve prenatal health and reduce infant mortality; studies of childhood lead poisoning, HIV infection and AIDS, and alcohol and drug abuse; and research on cancer, diabetes, obesity, cardiovascular diseases, and other ailments.

    But, Jackson says, "that's not enough." Her Sisters Network has a web site but has found that teaching people one-on-one works best. "We go where the people are, door-to-door, to churches, to hair salons and talk to ladies under the hair dryers. We pass out flyers at our sororities and fraternities. We talk to people standing in line at the grocery store. It's what we call reaching the grass roots."

    Jackson's program is exactly the type of culturally relevant effort that's needed, says Emory's Thomas. "What works for the white community cannot just be repackaged and sent into the black or Hispanic community. There must be an emphasis on [the culture] of the communities we're trying to reach. We must work with the people in the solutions. They cannot just be passive in this."

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