As we celebrate National Women's Health Week, we reaffirm our commitment to women's health - and look ahead to new innovations, new platforms, and new opportunities in our efforts to empower women and advance health equity for women in all communities.

In August 2012, the U.S. Department of Health and Human Services launched the Reducing Cancer Among Women of Color Challenge. The challenge called on software developers and entrepreneurs to create an application for mobile devices that would help women in underserved and minority communities access information about cancer screening and preventive services, link to electronic health records, and connect with providers and community health workers. This was the first-of-its-kind, effort to engage and empower women of color in the fight against cancer - and put technology to the test in addressing deep-rooted health disparities.

Each year, more than 68,000 women in the United States die from breast, cervical, uterine, and ovarian cancers. Given gaps in education, prevention, early treatment, quality of care, and access to networks of support, a disproportionate burden of these diseases falls upon women of color.

In the face of these disparities, the developer community stepped up to the challenge. As submissions came in from all across the country, a panel of judges comprised of federal and private experts in health care and health information technology set to work assessing the entries. Selection criteria included: capacity to provide users with general, easy-to-access information about screenings; securely communicate with patient health records or provider-sponsored patient portals; provide user-specific reminders about preventive services; accommodate multiple languages; encourage patient and family engagement with providers; and connect patients to community health workers who can provide support in adhering to complex care plans.

Based on these criteria, first place, second place, third place, and honorable mention distinctions were awarded. On behalf of the HHS Office of Minority Health and Office of the National Coordinator for Health Information Technology, I am excited to announce the winners:

• 1st Place: Everhealthier Women (Designer: Big Yellow Star) – a bilingual (English and Spanish) mobile web app that helps women track cancer prevention tasks through mobile web and SMS text messaging.
  
  
• 2nd Place: Nonmaskable (Designer: Broadstone Technologies) – a bilingual (English and Spanish) mobile web app, designed for smartphones and feature phones, that raises awareness around cancer prevention among women of color by empowering them with the information and tools needed to actively manage their health and wellbeing.
  
  
• 3rd Place tie: Cancerguard (Designer: Appbrahma) – an iPhone app that aims to help reduce the risk of cancer among minority women by providing tools and services such as links to cancer information guides and publications, workshops and health promotion events, counseling services, support groups and electronic medical records.
  
  
• 3rd Place tie: Cancer Awareness (Designer: HW-Technology) – a smartphone app that aims to provide women of color with information about breast and gynecologic cancer in their native languages. The app assists minority women in the use of preventative measures and encourages them to share their experiences with cancer survivors and other members of their community.
  
  
• Honorable Mention: Support Health (Designer: Netzealous) – an Android-based mobile app designed for patients, physicians, and advocates in an effort to empower women in minority and underserved communities to prevent cancer. The app's features including multilingual support, a symptoms tracker, health alerts, and shared medical record capacity.

We are excited to provide new tools to help minority women and those in underserved communities take control of their health by receiving a list of screening and preventive services and details on how to better coordinate their information and care.

The Reducing Cancer Among Women of Color Challenge is a partnership between the HHS Office of the National Coordinator for Health Information Technology and the HHS Office of Minority Health. To learn more about the app challenge, the winners, and information on how to download the winning apps please visit: http://challenge.gov/ONC/402-reducing-cancer-among-women-of-color and http://www.health2con.com/devchallenge/reducing-cancer-among-women-color-challenge/.

Last month marked the third anniversary of the Patient Protection and Affordable Care Act, a landmark effort to make health insurance coverage more affordable and accessible. Among the many provisions guiding health reform, the Affordable Care Act includes requirements to ensure the health care system provides adequate coverage for individuals in need of services for mental and substance use disorders. According to a report from the HHS Assistant Secretary for Planning and Evaluation (ASPE), the Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage in a generation.

Starting January 2014, an estimated 27 million uninsured individuals will have access to health insurance, and 25 percent of uninsured adults have a mental health condition or substance use disorder or both. The Affordable Care Act presents critical opportunities to improve access to care for these individuals. Building on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), the Affordable Care Act ensures that mental health and substance use services for newly covered individuals are provided at parity with medical and surgical benefits. The law also requires all new small group and individual market plans to cover 10 Essential Health Benefit categories, including mental health and substance use disorder services.

Improvements to the health care system will not only benefit individuals with behavioral health conditions, but also other groups who experience health disparities. Racial and ethnic minority populations are disproportionately uninsured, face systemic barriers to health care services, and often receive lower quality care and experience worse health outcomes. A concerted effort is needed to ensure that individuals from diverse racial and ethnic populations in need of mental health or substance use services are able to benefit from the expansion of coverage offered by the Affordable Care Act.

As the open enrollment period for the Health Insurance Marketplace approaches, targeted approaches for outreach and enrollment of diverse populations will be critical to reaching these vulnerable groups. The Office of Behavioral Health Equity at SAMHSA has partnered with four national associations (National Asian American Pacific Islander Mental Health Association, National Council on Urban Indian Health, National Latino Behavioral Health Association, and National Leadership Council on African American Behavioral Health) to identify and support the implementation of culturally appropriate outreach and enrollment practices, with the goal of increasing health insurance coverage among diverse populations.

Improved coordinated care and the integration of primary and behavioral health care, supported by Affordable Care Act provisions, will also benefit minority populations in need of mental health or substance use services. Individuals from racial and ethnic minority groups are more likely to seek services from primary care providers; therefore, integrated care models can increase access to behavioral health services. Coordinated care also offers the potential to provide improved services for prevention and early intervention. SAMHSA funds the Primary and Behavioral Health Care Integration program, to provide support to communities to coordinate and integrate primary care services into publicly funded, community-based behavioral health settings, resulting in improved access to primary care services; improved prevention, early identification and intervention to reduce the incidence of serious physical illnesses, including chronic disease; increased availability of integrated, holistic care for physical and behavioral disorders; and better overall health status of clients.

Through these provisions and an emphasis on reducing health disparities, the Affordable Care Act presents critical opportunities for making access to health care more affordable for diverse populations. Now as the federal government partners with communities, we can work together to ensure these opportunities become a reality.

Cross-posted from AIDS.gov blog.

Since 1991, routine vaccinations of infants has reduced hepatitis B virus (HBV) infection rates in children by more than 95 percent. And the incidence of acute hepatitis C (HCV) has declined 90 percent since 1992, in large part due to the screening of the blood supply. This progress illustrates the impact that public health policies and practices can have in only a few decades. And these successes should be celebrated.

During May’s national observance of Hepatitis Awareness Month, we are reminded that several racial and ethnic minority populations in the United States are disproportionately affected by viral hepatitis¹.

• African Americans are twice as likely to be infected with HCV compared to the general U.S. population. While African Americans represent only 12 percent of the U.S. population, they make up roughly 22 percent of the estimated 3.2 million chronic HCV cases. (Read my earlier blog post about working to eliminate viral hepatitis disparities in the African American community.)

• Hispanic adults aged 40 years and older are 30 percent more likely to be newly infected with HBV than their non-Hispanic white counterparts, due to lower vaccination rates.

• Asian Americans and Pacific Islanders (AAPIs) represent half of the estimated 1.4 million HBV-infected persons in the U.S., despite the fact that they only make up 5 percent of the overall population, as Assistant Secretary for Health Dr. Howard Koh observed in his blog post about this disparity earlier this month. While AAPIs have a disproportionately high prevalence of HBV, as well as liver cancer and liver failure associated with chronic infection, HBV is vaccine-preventable. However, many AAPIs encounter cultural barriers to receiving adequate and high quality health care² from an array of factors that may contribute to the high incidence of HBV-related mortality.

The HHS Office of Minority Health (OMH) is working to address these disparities as a partner in the cross-agency implementation of the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. In fact, OMH is a participating agency in more than a dozen of the specific actions detailed in the Action Plan. These efforts include working with Federal partners to reach specific at-risk populations with culturally sensitive and linguistically appropriate evidence-based interventions to strengthen community-based programs providing testing and linkages to care, particularly those serving foreign-born populations, as well as by publishing periodic reports on viral-hepatitis-associated health disparities and integrating hepatitis A and B vaccination as a standard of care in Federal prevention and clinical programs that serve priority populations.

Among the steps OMH is taking is our partnership with the Association of Asian Pacific Community Health Organizations (AAPCHO) and the Hepatitis B Foundation to launch the Hep B United national campaign. The campaign aims to end hepatitis B by supporting community-based groups in their efforts to increase hepatitis B awareness, screening, vaccination, and access to care for all Americans, and AAPIs in particular. Just this week, the Hepatitis B Initiative of Washington, DC , a campaign partner, co-hosted an education session during the National Association of Professional Asian American Women conference to encourage screening and testing for viral hepatitis.

OMH encourages everyone to take the online viral hepatitis risk assessment recently launched by the CDC. In less than five minutes, this online tool will assess an individual’s risk for viral hepatitis in response to a series of questions — and will generate a summary of recommendations for testing and vaccination that people can print and take to their doctor to discuss. Our goal is that this risk assessment tool will raise awareness about this silent epidemic among members of the public, as well as the health care community. We are hoping that all of our partners will help us share information about this exciting new tool and encourage people to use it.

During Hepatitis Awareness Month and beyond, we invite all of you to join us, in and across your communities, as we continue our fight against viral hepatitis.

¹"Achieving health equity to eliminate racial, ethnic, and socioeconomic disparities in HBV-and HCV-associated liver disease." The Journal of Family Practice. April 2010, Vol. 59, No. 04 Suppl: S37-S42. Accessed online at http://www.jfponline.com/pages.asp?AID=8516 May 29, 2012.

²Upadhyaya N,et. al. "Chronic hepatitis B: perceptions in Asian American communities and diagnosis and management practices among primary care physicians." Postgrad Med. 2010 Sep; 122(5):165-75. Accessed via http://www.ncbi.nlm.nih.gov/pubmed/20861600  on May 29, 2012.

Asthma affects nearly 26 million Americans, including 7 million children. While advancements in treatment and interventions have improved health outcomes for many suffering from this respiratory disease, that progress has not yet reached everyone. Poor and minority children bear the greatest burden of the disease, suffering from asthma at higher rates, experiencing greater exposure to environmental triggers, and receiving less access to quality care.

Today, the Obama Administration launches a new approach to closing that gap: the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities. The result of a collaborative interagency effort led by the U.S. Department of Health and Human Services (HHS), the U.S. Environmental Protection Agency (EPA), and the U.S. Department of Housing and Urban Development (HUD), the Action Plan presents a framework for coordinating federal resources to get the right asthma care with the right support to the children who need it most.

Asthma currently affects 16 percent of non-Hispanic black children, 10.7 percent of American Indian and Alaska Native children, and 7.9 percent of Hispanic children (16.5 percent among Puerto Rican children), compared to 8.2 percent of non-Hispanic white children and 6.8 percent of Asian children. Minority children with asthma are also less likely to receive regular care and recommended treatment, and more likely to be hospitalized for their condition. For example, non-Hispanic black children are twice as likely to be hospitalized and four times more likely to die due to asthma than non-Hispanic white children.

In many instances, the burden of disease among minority children is worsened by social and environmental factors relating to where children live, learn, and play – such as environmental exposures to tobacco smoke, air pollution, mold, or other allergens and pollutants and lack of family resources for asthma management at home.

While we do not yet have interventions that prevent the onset of asthma, we know that there are evidence-based measures that can reduce asthma mortality and improve the quality of life for those living with the disease. The Action Plan seeks to reduce barriers to comprehensive care, improve intervention strategies, and strengthen partnerships among federal programs to better reach communities with racial and ethnic asthma disparities.

In doing so, the Action Plan builds on major federal initiatives to reduce health disparities, promote health equity and expand access to health care - most notably, the Affordable Care Act and the HHS Action Plan to Reduce Racial and Ethnic Health Disparities. The Affordable Care Act represents one of the most significant efforts in our nation's history to increase access to affordable, high-quality care - ensuring, for example, that children cannot be denied health insurance because of pre-existing conditions such as asthma; and investing in community health centers, which provide care to vulnerable and underserved communities. In turn, the HHS Disparities Action Plan provides a coordinated roadmap to realizing a nation free of disparities in health and health care.

Today, as agencies across the government join together in launching a comprehensive effort to address racial and ethnic disparities in asthma, we can celebrate another step forward in fulfilling our vision of a nation where everyone has a chance to live a healthy life. Learn more about the Asthma Disparities Action Plan at http://www.epa.gov/asthma/childrenstaskforce.

Cross-posted from the AIDS.gov blog.

During February's observance of African American History Month, please join us in working to end the unfortunate history of viral hepatitis' disproportionate impact on the African American community. This Administration is working hard to reduce and eliminate health disparities and achieve health equity.

Unfortunately, viral hepatitis is a health problem that is often overlooked by the public as well as healthcare providers. This, despite the fact that viral hepatitis is a leading infectious cause of death, claiming the lives of 12,000-15,000 Americans each year. As many as 5.3 million Americans are living with viral hepatitis, though most do not know that they are infected. This places them at greater risk for severe, even fatal, complications from the disease and increases the likelihood that they will spread the virus to others.

What Is Hepatitis?
"Hepatitis" means inflammation of the liver. It is most often caused by a virus. In the U.S., the most common types are hepatitis A, hepatitis B, and hepatitis C. All of these viruses cause acute, or short-term, viral hepatitis. But the hepatitis B and C viruses (HBV and HCV) can also cause chronic hepatitis, in which the infection is prolonged, sometimes lifelong. Chronic hepatitis can lead to cirrhosis, liver failure, and liver cancer. In fact, viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.

Viral Hepatitis Disparities
Within the African American community, significant hepatitis-related health disparities exist. For example:

Hepatitis B

• Hepatitis B can be prevented by a vaccine; however, African American children have lower HBV vaccination rates than non-Hispanic white children.
• Since 2004, rates of hepatitis B have remained steady among all racial/ethnic populations. However, new infections of hepatitis B remain the highest among African Americans, with 2.3 cases per 100,000 people.

• African Americans are twice as likely to be infected with hepatitis C when compared with the general U.S. population and chronic liver disease, often hepatitis C-related, is a leading cause of death among African Americans ages 45-64.
• While African Americans represent only 12% of the U.S. population, they make up about 22% of the chronic hepatitis C cases. In fact, African Americans have a substantially higher rate of chronic hepatitis C infection than do Caucasians and other ethnic groups.

Viral Hepatitis Action Plan
My Federal colleagues and I are committed to ensuring that new cases of viral hepatitis are prevented and that persons who are already infected are tested; informed about their infection; and provided with counseling, care, and treatment. In fact, last year we issued Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care & Treatment of Viral Hepatitis (PDF 672KB), which outlined robust and dynamic steps that are now underway across the government to increase viral hepatitis awareness and knowledge among health care providers and communities, and improve access to quality prevention, care, and treatment services for viral hepatitis. (Read more about the Action Plan.)

In addition, the Viral Hepatitis Action Plan is both supported by and complements several other initiatives unfolding within HHS and across the Federal government, including the:

• The National HIV/AIDS Strategy, which helps us address the significant rates of HIV-HCV coinfection;
• The National Prevention Strategy, which calls for us to enhance early detection of HIV, viral hepatitis, and other sexually transmitted infections and improve linkage to care;
• The U.S. National Vaccine Plan, which will help us reduce the incidence of vaccine-preventable hepatitis A and B;
• The HHS Action Plan to Reduce Racial and Ethnic Health Disparities; and
• The infectious disease and immunization objectives of Healthy People 2020, which specifically seek to reduce new hepatitis A, B, and C infections and increase viral hepatitis awareness among infected persons.

Your Help Is Essential
These are all part of our response to the silent epidemic of viral hepatitis. But we need your help, too. So, during African American History Month, please help by learning more about viral hepatitis, educating family and friends about this silent killer in the African American community, and encouraging conversations with healthcare providers about vaccinations for hepatitis A and B and screening for hepatitis C for those who may have been exposed.

Together, we can make viral hepatitis history.