Under Bill Clinton the Department of Health and Human Services pledged to narrow the medical divide by 2010. Inside the giant federal health bureaucracy, some momentum continued after the White House changed hands. Every institute of the National Institutes of Health, for instance, has a mandate to develop a plan for addressing disparities in its programs. In July, the HHS Office of Minority Health will hold a "national leadership summit to eliminate racial and ethnic disparities."

But some minority health advocates worry that the Bush administration, distracted by high-profile issues like the threat of biological terrorism, will not give disparities priority in the agenda. And there's no doubt it will take pressure, and a moral imperative, to move an entrenched medical establishment and to provoke broad concern about an outrageous situation that the public has tolerated too long.

If nothing else, "Take a Loved One to the Doctor Day" by itself provides ample evidence that the alarms raised by the report might be muffled.

"People can take charge of their health, and participating in Take a Loved One to the Doctor Day can be a positive first step," Thompson said at an April 18 press conference. "Prevention and early detection of potential health problems are essential, and there are steps within our reach that we can all take to better protect ourselves and our families."

It is always tempting, and valid to a point, to pin responsibility on patients. Personal behavior is important in healthcare. If you smoke cigarettes, never see a dentist, eat crap, do drugs, live like a sloth, blow off your prescriptions, you put yourself at risk.

But in the context of the health gap, Thompson's message is weirdly patronizing, all the more so because his "Day" is a twist on the ever popular Take Our Daughters to Work Day. Is the subtext here that blacks, like 8-year-olds, must be led by the parental hand and shown what's good for them?

Even if that message was unintended -- and to be fair, let's assume it was -- it's a Band-Aid for what should be recognized as a public health emergency. More than a decade ago, researchers at Columbia University reported that black men in Harlem had a shorter life expectancy than men in Bangladesh. The day after Thompson announced Take a Loved One to the Doctor Day, the U.S. Centers for Disease Control and Prevention reported that in some cities the black-white differences in infant mortality are even more glaring than national statistics suggest.

In Pittsburgh and Tampa, black babies are three times as likely as white babies to die before the age of 1; in San Diego, nearly four times as likely; in San Francisco, nearly five times. Hauling your sister to a health fair in September will not save black infants anymore than trotting your daughter (and now your son) through your cubicle in April will obliterate pay gaps for women.

Nevertheless, some major black organizations and influential minority health advocates have signed up as "partners" in Sept. 24. The list includes Rainbow/Push Coalition, 100 Black Men of America, Congress of National Black Churches, National Black Womens Health Project, and the National Medical Association, the nations largest organization of African American physicians.

"It's always a positive step to get people to seek medical care," says Ruth Perot, executive director of the Summit Health Institute for Research and Education, a Washington, D.C., nonprofit that promotes health equity.

Perot, a passionate voice on minority health, takes a broad, deep view of the problems and remedies. Why did she endorse Sept. 24? She said she hoped it would encourage people not only to go to doctors but also to "very assertively seek the kind of care to which they're entitled."

But if assertiveness is the goal, why not urge people to make appointments for themselves? Didn't the pitch, Take a Loved One, send an opposite message, about patient helplessness, passivity or sheer irresponsibility?

"Im trying to be charitable." Perot says. "Im trying to acknowledge some blooming blossoms where I see them."

It should come as no shock that the blossoms are mostly window dressing. Big, costly improvements in Medicaid were never on the Bush agenda. Neither is more money or more muscle to crack down on civil rights violations, in healthcare or anywhere else.

And the notion that it is each black person's job to close the health gap fits neatly with the famous Bush ethic of personal responsibility. Across the board, from drug abuse to poverty to failing schools, the burden of solving societal problems is shifting from the government to the shoulders of the people who suffer most -- or their "loved ones."

Conveniently, Thompson's crusade also appears to mesh nicely with current public sentiment. Folksy campaigns are the name of the game in medical causes. AIDS has red ribbons and movie stars. Breast cancer has pink ribbons and teddy bears. ALS has navy pinstripe ribbons inspired by Lou Gehrigs Yankee uniform. Diabetes has gray ribbons to depict the despair of the disease and the hope, the "silver lining," that a cure will be found. The American Cancer Society has daffodils.

Now African Americans have Sept. 24, a finger-wagging day of obligation meant to placate poor and poorly served patients with health fairs. America still isn't a country where healthcare is colorblind, but it is the land of equal-opportunity kitsch.

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