The danger of the prospective swine flu pandemic for the African-American community is its vulnerability to illness and disease.

The disparities across a whole range of maladies leave individuals with weakened immune systems and communities with weakened public health infrastructure.

However, the opportunity to be involved in the design of the nation’s health care system is unparalleled.   The budget passed by Congress moves forward on the Obama administration’s goal to create a new health care financing architecture.  This will be the first revamping since the Roosevelt and Johnson administrations.

At the time of the design of Medicare, African-Americans were still scarce in most medical schools save the historically-black colleges and universities.   That also meant a shortage of black perspectives in medical policy positions, even though Dr. Charles Drew was responsible for one of the biggest health discoveries of the 20th century.

Since then, progress in integration was slowed by the Bakke decision which caused a slowing in the growth of African-American medical professionals.

As a result, black communities have gotten the crumbs left over from health care priorities.  Dr. David Satcher made a valiant effort as Surgeon General to define the extent of health disparities in the 1990s, but his service was followed by the active neglect of the Bush administration.

So we’ve never really had the information or the resources to operate at the highest policy levels until now.     With a major infection heading our way, we can’t afford to continue to let others decide whether we get medical care,  particularly preventive care.  If we do, we’ll continue to be at the back of the bus.

Let’s be blunt.  The federal government has a stockpile of 120 million doses of antiviral medicines in a country of 300 million.   It is not a good idea to hope that the flu will spread deliberately enough to allow those stockpiles to catch up.

One of the biggest objectives should be a national commitment to increasing black representation in the medical professions with improved financial aid for scholarships, more slots at the HBCU campuses and perhaps more HBCU medical schools.    The thaw with Cuba represents an opportunity to view its model of preventive health care as a strategy for addressing the needs of black neighborhoods.   Cuba also is able to create doctors more efficiently than U.S. institutions.

A comprehensive health education strategy that addresses children from the earliest ages encompassing nutrition, fitness and safe practices through culturally responsive methods is also essential.

The flu fear should be employed to make the case to people who are relying on drugs that they can’t continue to self-medicate.   If the border controls are strengthened finally, it can reduce the supply of drugs and weapons flowing over the border.

Drugs have become a proxy for the mental health needs of the black community.   Part of the new national design must include the kinds of culturally-responsive psychology and psychiatry that does more than just hand out pills, but actually helps define what it means to be a healthy black person.

Part of the role of the Obama family is to give each of us a feel for what it can be like to be completely self-actualized and secure.   Now that we know it can happen, we must provide the institutional support to spread the emotional well-being.

Just as the economic meltdown has enabled steps which would have been unfathomable, the swine flu attack will drive dramatic and rapid changes in American health care. We should not be afraid to propose the kind of solutions which will end health disparities.