11 minute read
Dr. Joycelyn Elders paves the way for AMHC
ELDERS’ INSPIRATION FROM EDUCATION
Elders was the eldest of eight children and spent much of her childhood working in cotton fields. This, however, never discouraged nor disrupted her interest in receiving a higher education.
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After graduating high school, Elders earned a scholarship to attend Philander Smith College in Little Rock. She scrubbed floors to pay her tuition while her siblings picked extra cotton and did chores for neighbors to help raise money for her bus fare.
These sacrifices did not go in vain. While in college, Elders attended a lecture featuring Edith Irby Jones, the first African American to attend the University of Arkansas Medical School (now the University of Arkansas for Medical Sciences), and who later became a physician. Elders, who never met a doctor until she was 16, saw what was possible and decided she would become a physician just like Jones.
And that she did.
THE MISSION OF THE COMMISSION
Elders went on to have an extensive medical career that was further extended in 1987 when former Governor Bill Clinton appointed her as director of the Arkansas Department of Health (ADH). In this role, Elders’ vision was simple — create access to adequate and appropriate healthcare services for minority populations in Arkansas. Tommy Sproles, director of primary care and rural health at ADH, shared Elders’ vision and passion for leading the charge to eliminate health disparities in the state. His connections with key members of the Arkansas Legislative Black Caucus (ALBC) greatly contributed to the cause. “At the time, Dr. Elders was my boss,” Sproles said. “We had support from legislatures that were physicians and dentists like Senator Dr. Jerry Jewell and Dr. W. H. Townsend, who wanted to do something to address these disparities. So, we got together and got the ball rolling.” In 1991, Dr. Elders presented the U.S. Department of Health and Human Services’ (DHHS) “1985 Report of the Secretary’s Task Force on Black and Minority Health” to the Arkansas General Assembly. It was the first comprehensive national minority health study addressing the health status of African Americans, Hispanics, Asian/Pacific Islanders, and Native Americans compared to that of whites. The report revealed that 60,000 excess deaths occurred each year in minority populations. Eighty percent of these deaths were due to cancer, cardiovascular disease, chemical dependency, diabetes, homicide, suicide, unintentional injuries, and infant mortality. The report shined a spotlight on minority disparities and set wheels in motion for the next 30 years of service to Arkansas’ minority communities. In July 1991, following Dr. Elders’ testimony, the Arkansas legislature passed Act 912, creating the Arkansas Minority Health Commission. Former Senator Bill Lewellen served as the lead sponsor of this bill and was backed by the leadership and support of the ALBC. From there, the mission of AMHC was established – to assure all minority Arkansans equitable access to preventive health care and to seek ways to promote health and prevent diseases and conditions that are prevalent among minority populations. The work begun by Dr. Elders would continue over the next thirty years through the leadership of the agency’s next seven directors who were committed to making the health of all minority Arkansans a priority.
The Beginning of the Mission Tommy Sproles
BY MICHELLE STEWART
Tommy Sproles’ healthcare experience started when he was a Navy corpsman in the Vietnam war. This continued as he transitioned into a physician’s assistant and later, the director of primary care and rural health at the Arkansas Department of Health (ADH). From this role, he was appointed by Dr. Joycelyn Elders as the first director of the newly formed Arkansas Minority Health Commission.
“When I became director, I wanted to see changes in the status of all minorities,” Sproles said. “I wanted things to be more equal. I could see change coming slowly and I wanted it to happen more rapidly because I didn’t want to have more people dying or suffering. If I could do my little bit, that is what I wanted to do.”
From the start of his tenure, Sproles had a champion in Dr. Elders. He defined her as a “game changer,” while he was simply one of the players who knew others the commission could collaborate with.
As the pioneering director of AMHC, it didn’t take Sproles long to realize that laying the foundation of the agency wouldn’t be easy. Although Act 912 created the commission, it came without funding. Dr. Elders generously gave Sproles $5,000 of her ADH budget, along with former AMHC Commissioner Joe Hill, who gave $5,000 from his program’s budget. This money allowed Sproles and the legislative health professionals who backed the mission of the commission to bring in and meet with other healthcare professionals to discuss what could be done to eliminate health disparities among Arkansas’ minority populations.
“[This funding] gave me the opportunity to get out into the community to see what was really going on,” Sproles said. “We were able to go to areas that were difficult to access, and I could meet those leaders and healthcare providers and discuss what needed to be done.”
Sproles knew the only way he was going to be able to operate the AMHC was if he received more funding. He submitted his financial request to the state legislature and received a $200,000 starting budget for the commission.
Having been previously housed in ADH, the first thing Sproles did with the new budget was move the commission into offices at 12th and University in Little Rock.
Dr. Joycelyn Elders
The commission started with very humble beginnings.
“The first few weeks, all we had was a large carboard box for a desk and our cell phones,” Sproles said. “We had to wait to buy furniture but when we did, we got used furniture. We wanted to use the money we got on [ more important] things, not looking good.”
With a budget in place, Sproles was able to travel and talk to leaders in rural areas. One of those meetings landed him in Mississippi where he heard about available tobacco settlement dollars.
“I came back and met with Governor Huckabee and told him we can get some of this money if we created a plan and applied for it.”
And so, CHART (Coalition for a Healthy Arkansas Today) was created. This group was comprised of healthcare providers, leaders from educational and research institutions and health advocacy organizations.
The CHART plan, also known as the Initiated Tobacco Settlement Proceeds Act of 2000, led to an initial $62 million dollars of tobacco settlement funding for the state of Arkansas. More than three percent of these funds were allocated to AMHC and continues to this day.
“Getting the funds was my greatest achievement and how we got AMHC up and running,” Sproles said. “It has been going great ever since.”
Sproles may not have had an easy start as first director of AMHC, but he certainly has no regrets.
“I look back and say that it was all worth it. The commission has come a long way.”
Sproles, a continued supporter of AMHC, leaves the commission with a word advice that is befitting of his accomplishments in the beginning.
“Don’t forget the mission.”
Tommy Sproles
Arkansas Tobacco Settlement Commission
THE ARKANSAS TOBACCO SETTLEMENT COMMISSION (ATSC) was established by a vote of the people in 2000. This Act designated all tobacco settlement proceeds to be directed to the use of improving the health of Arkansans. Arkansas can be proud in knowing we were one of only a handful of states to make this important commitment to the future health of our citizens. The Act created seven funded programs: Arkansas Aging Initiative Arkansas Biosciences Institute Fay W. Boozman College of Public Health Medicaid Expansion Program Minority Health Initiative Tobacco Prevention & Cessation Program UAMS East/Delta Arkansas Health Education Center
These programs carry out the mission and spirit of the Act, which was to create a stronger and healthier Arkansas. The ATSC website provides the important work these programs have accomplished, along with highlights and achievements they have reached.
WWW.ATSC.ARKANSAS.GOV
Arkansas Tobacco Settlement Commission
101 East Capitol Avenue, Suite 108 | Little Rock, Arkansas 72201 Phone: 501-683-0072 | Fax: 501-683-0078
There are several agencies and organizations in Arkansas that partner with the Arkansas Minority Health Commission (AMHC) to help prevent IM.
THE FIGHT BACK AGAINST TOBACCO
BY BRITTANY DESMUKE
TOBACCO USE has an extensive yet damaging history. In the late 1800s, cigarette smoking quickly grew in popularity. As more companies began producing and creatively marketing the product, the tobacco industry swelled. By 1901, 3.5 billion cigarettes were sold in the U.S. As tobacco usage continued to climb, increasing rates of lung cancer closely followed.
In response, the U.S. Surgeon General released a report in 1964 that addressed the dangers of cigarette smoking, which led to the 1965 Cigarette Labeling and Advertising Act. This required every cigarette package to display a warning label that read, “Cigarettes may be hazardous to your health.” Despite the warnings, many people continued to smoke.
By 1985, lung cancer became the number one cause of death in women, surpassing breast cancer.
And Arkansas only contributed to the devastating statistics. By the late 1990s, Arkansas had the 11th
highest rate of smoking among adults, the fourth-highest rate of death from lung cancer and heart disease, and the secondhighest rate of death from stroke.
Unfortunately, the Natural State wasn’t alone. Healthcare costs were skyrocketing across the nation due to smoking related diseases.
To provide aid for the damage done, 46 state attorney generals and four major tobacco corporations signed the Tobacco Master Settlement Agreement (MSA). This multi billion-dollar agreement was designed to settle lawsuits for past and future medical claims related to tobacco use.
As a participant of the settlement, Arkansas agreed to accept $62 million the first year and $50 to $60 million each year after over the course of 25 years. There was no restriction on how the funds could be used, so the Coalition for a Healthier Arkansas Today (CHART) was developed to help make that decision. Together this group of healthcare professionals, leaders and organizations decided that the funds should go where they would have the greatest impact on the health of Arkansans. This was all spelled out in the plan they developed known as the Initiated Tobacco Settlement Proceeds Act of 2000 (Initiated Act 1).
Once Initiated Act 1 was passed, MSA funding was granted to the following healthcare programs and institutions: • Arkansas Department of Health Tobacco Prevention and Cessation Program
• UAMS Centers on Aging • Fay W. Boozman College of Public Health • UAMS East Regional Campus • Arkansas Biosciences Institute
• Tobacco Settlement Medicaid Expansion Program • Arkansas Minority Health Initiative “The legislature and the Initiated Act set these programs up to serve specific populations,” said Matt Gilmore, Arkansas Department of Health Programs Policy Coordinator. “I think a lot of the programs cross over and help support the other one in different ways. There’s no duplicate of services, but I think they do reach across, where one program can’t meet a need, another program jumps in to help do that. I think they’ve all been successful and they all continue to try to meet the goals [of Initiated Act 1] in a changing landscape.” The Arkansas Minority Health Commission (AMHC), which manages the Arkansas Minority Health Initiative, has aimed to do just that.
The agency uses the tobacco settlement funds to offer preventive screenings for tobacco-related illnesses like heart disease and diabetes, while also continuing to develop various outreach programs and fund pilot projects directed at improving minority health. AMHC also continues to monitor and advocate for health policy changes that directly benefit minorities and contribute to related research.
Through the use of sponsored health events, partnerships, and its Mobile Health Unit, AMHC is committed to reaching its goal of providing preventive screenings in all 75 counties in the state.
To date, Arkansas’ tobacco use among adults and high school students is still greater than the national average. With the latest surge of e-tobacco products and their popularity among adults and adolescents, the AMHC and related health programs still have a lot of work to do.
“The programs that are established are pivoting and recognizing the emerging products that are coming out,” said Gilmore. “I think that the programs are staying well informed in trying to address those issues and are very in tune and work well together with the research capabilities offered, but also the outreach programs that aim to come together and meet the needs of the communities they serve.” For more information about Initiated Act 1 and the programs it funds, visit healthy.arkansas.gov/programs-services/topics/ arkansas-tobacco-settlement-commission.
Matt Gilmore
