The African-American population in Alabama's Black Belt, in the heart of the Deep South, is one of the nation's poorest and carries a disproportionate burden of chronic diseases and health disparities. African American citizens in the Deep South have mortality rates up to twice that of their white counterparts. This stems from higher incidence, prevalence, and mortality from eminently treatable conditions such as diabetes mellitus and colorectal cancer. African Americans comprise more than 60% of the population of the Black Belt, a region with 35% of its population living below the U.S. poverty level. As a leading research institution in the Deep South, we feel morally obligated and academically qualified to address this region's significant health disparities. Objectives. We propose the formation of the Regional Deep South Project Export Center (RESPECT) of Excellence for Minority Health, the main objective of which will be to systematically investigate the etiologies and bioethical implications of racial bias, with the ultimate goal of eliminating health disparities in diabetes and colorectal cancer. Methods. We will build on the University of Alabama at Birmingham (UAB)'s Minority Health and Research Center by establishing a training consortium with the Historically Black Colleges and Universities (HBCUs) in Alabama and formalizing other partnerships with specified minority community organizations. We propose 1) two research projects, grounded in theory of perceived racial discrimination, that will investigate racial bias in diabetes and colorectal cancer care; 2) pilot projects investigating racial bias and its elimination, anchored on a well-established research infrastructure with a prior commitment to excellence in resolving healthcare disparities; 3) an outreach network within the targeted population with a unique potential to make real progress in reducing health disparities, and 4) a plan for training and developing minority scientists and skilled health professionals through the partnership of Alabama's HBCUs and UAB, a major research university with 25% minority enrollment. The RESPECT objectives will be accomplished through four linked, but distinct units, which will include Administrative, Research (diabetes and cancer), Training, and Outreach Cores. Significance. The development of the RESPECT program has the potential to reduce health disparities in minority populations through a unique partnership of academic and community involvement. We also believe that it will improve the self-efficacy of members of the Deep South African-American community through future clinical trials, research projects, and outreach programs.
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