The knowledge that there is a consistent and powerful association between social factors and health outcomes is not only well established, but well known for centuries.1

Seemingly, intractable health problems in our society, such as health disparities among racial and ethnic groups, poor access to quality health care, lack of access to fresh fruits and vegetables, and alarming increases in uninsured populations, have social determinants as their root cause. Although the last few decades have brought substantial reductions in mortality to the U.S. population as a whole, the gap in health between racial and ethnic minority populations and whites continues.2 These disparities persist even when socioeconomic status and income are controlled.3 This supplemental issue features Racial and Ethnic Approaches to Community Health (REACH) communities that have played a pivotal role in developing new state and local policy initiatives and systems change within their communities.

REACH, the Centers for Disease Control and Prevention's (CDC's) leadership effort dedicated to finding solutions to health disparities, celebrated its 10th anniversary in 2010. Launched in 1999, CDC initiated REACH as the cornerstone of its efforts to eliminate racial and ethnic disparities in health. Through the REACH programs (REACH 2010, REACH U.S., and now, REACH for Communities Organized to Respond and Evaluate (CORE)), communities have been funded to close the health disparity gap in at least one of the following racial and ethnic minority groups: African Americans/blacks, American Indians/Alaskan Natives, Hispanic/Latino Americans, Asian Americans, and Native Hawaiians or other Pacific Islanders.

In addition, REACH communities have focused on reducing disparities in 1 or more of the following health priority areas: breast and cervical cancer screening and treatment, cardiovascular disease, diabetes, immunizations, asthma, hepatitis, tuberculosis, and infant mortality. In the current 2007 funding cycle (N = 40), 43% of REACH U.S. grantees (and their partners) have targeted cardiovascular disease as their health priority area, 60% are working to eliminate health disparities in diabetes, 35% have developed dual strategies in cardiovascular disease and diabetes, and 15% are implementing strategies to combat racial and ethnic disparities in breast and cervical cancer. To learn more about REACH, please visit: http://www.cdc.gov/reach/reach_2010/index.htm.

Over the years, national foundations and governmental health disparities task forces have repeatedly recommended placing high priority on policies aimed at improving health and eliminating inequalities in health and the determinants of these inequalities. In 2008, the World Health Organization's Commission on Social Determinants of Health submitted its landmark report.4 Each of the featured articles highlight how REACH communities are addressing one of the overarching recommendations made in the Commission on Social Determinants of Health Report for social action:

* Improve daily living conditions

* Tackle the inequitable distribution of power, money, and resources

* Measure and understand the problem and assess the impact of action

These manuscripts emphasize how REACH communities address different health priority areas across different racial and ethnic populations located in different geographic locations. These communities have implemented interventions and strategies that have led to positive health outcomes in racial and ethnic communities-that is, policy, systems, and environmental changes that have led to a reduction in health disparities with demonstrated strides toward achieving health equity.

Moreover, a crucial element of REACH's success has been the communities' commitment to a collaborative approach toward eliminating health disparities. Through work with policymakers, public and private organizations, and local citizens, REACH communities promote the elimination of health disparities by using the framework of the social determinants of health. With a focus on education, mobilization, advocacy, and local leadership, REACH communities use state and local data and national best practices to inform their development of public policies that will have a measurable impact on eliminating health disparities and promoting health equity.

-Joyce Buckner-Brown, PhD, MHS, RRT

National Center for Chronic Disease

Prevention and Health Promotion,

Division of Adult and Community Health,

Atlanta, GA

REFERENCE