by Elizabeth M. Smith

Alabama's Black Belt is part of a region that is home to both the richest soil and the poorest people in the United States. It is an area where economic stagnation is common and small, dying towns dot the landscape. Insufficient health care and underfunded and understaffed schools are the norm.

Still, the people who live in the Black Belt hold a strong and determined hope for a brighter future. The University of Alabama and Tuskegee University hope to work with them to overcome the formidable obstacles that have come from years of neglect.

Their collaborative effort is a project titled "Reducing Health Disparities in Alabama's Black Belt." It is better known as Project EXPORT, short for Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training. The project is being funded with a $7.5 million grant from the National Center on Minority Health and Health Disparities, a division of the National Institutes of Health.

The funds are being used to establish a "Center of Excellence" through facilities on both campuses. Each school has developed six core research areas that will fund new projects and enhance existing ones. During the five years of the project, Tuskegee and UA will expand and focus on infrastructure to decrease health disparities in diabetes, cardiovascular disease, cancer, hypertension, HIV/AIDS and infant mortality.

These activities will involve a broad array of faculty, students, staff and community members at both universities and beyond. Dr. Benjamin F. Payton, president of Tuskegee University, is principal investigator for the project, as is Dr. John C. Higginbotham, director of UA's Institute for Rural Health Research.

"In everything we do, we're working with Tuskegee and with communities," Higginbotham says. "I want to emphasize that we're not working on folks—we're working with folks, so that they have a voice have the ability to have input as well as a stake in what happens in their communities as we try to reduce the disparities."

Higginbotham says one of the things he and Dr. Alfonza Atkinson, dean of the College of Veterinary Medicine, Nursing and Allied Health at Tuskegee University and co-principal investigator of Project EXPORT, are doing is working with the Alabama Department of Public Health to implement a program in the Black Belt to screen for diabetics who have not previously been identified.

"The Alabama Department of Public Health was given that charge by Secretary of Health and Human Services Tommy Thompson, but the department was not given any additional resources to get that done," Atkinson says. "So, Dr. Higginbotham and I are working to assist the state in identifying these 200,000 cases, which is a big effort."

At each university, Project EXPORT has six specific core component areas that are complementary to each other and led by faculty on each campus. At UA, Core 1, the Administrative Core, takes care of the day-to-day business of the grant and is headed by Higginbotham.

Core 2, the Shared Resource Core, which facilitates sharing between the two universities, is led by Dr. Grant T. Savage, professor of management and marketing in the Culverhouse College of Commerce and Business Administration, with Dr. Jeri Dunkin, holder of the Martha Saxton Memorial Endowed Presidential Chair in the Capstone College of Nursing, as co-director.

Core 3, the Research Core, works with existing research and new applications for research. It is directed by Dr. James D. Leeper, professor of community and rural medicine in the College of Community Health Sciences, and co-directed by Dr. Rhoda Johnson, associate professor of women's studies in the College of Arts and Sciences.

Core 4 is the Pilot Project Core and is used to teach new and young investigators in conducting research, as well as funding pilot projects. Co-director Dr. Melissa C. Kuhajda is an assistant professor of community and rural medicine in CCHS and assistant director of research for the Institute for Rural Health Research. Co-director Dr. Sharol Jacobson is associate dean for research and practice and professor in the Capstone College of Nursing.

Core 5, the Training Core, is directed by Dr. John Wheat, professor of community and rural medicine in CCHS. This core helps fund all ongoing training efforts.

Core 6 is the Community Outreach and Information Dissemination Core, which focuses on research and education in children's insurance and other health topics. It is directed by Dr. Rex E. Culp, professor and research chair in the College of Human Environmental Sciences. Co-director is Tracy Carter, project manager for Covering Alabama Kids and Families in CHES.

Higginbotham says both universities hope their successes in developing the Center of Excellence will lead to greater future funding, so that they can have more impact on health disparities not only in the Black Belt of Alabama but also throughout the state and even across the nation.