The California Endowment, a private health foundation, announced a $4 million, five-year grant Wednesday to a fledgling regional health institute at Fresno State addressing the Valley's major health needs and inequities.

Those inequities involve medical problems linked to the region's poverty and to rural areas lacking health services.

The Central Valley Health Policy Institute, established last year, aims to coordinate health policy information and bring together health advocates in Fresno, Kern, Kings, Madera, Tulare and Merced counties.

The institute will collect, analyze and circulate research. It will train community leaders and offer a new master's degree specialty at California State University, Fresno. It will use that information to advocate for the area's medical needs in political forums and among medical decision-makers.

University President John Welty and Dr. Robert K. Ross, California Endowment president and chief executive, announced the funding award at Fresno State. They and Sister Ruth Marie Nickerson, president and chief executive of Saint Agnes Medical Center, explained the institute as a regional answer to the San Joaquin Valley's particularly serious health problems.

"We have a responsibility to invest these funds in a way that changes lives and the way we do things," Welty said.

Ross, a medical doctor and health administrator before assuming the endowment leadership, recalled his move from the East Coast to California, carrying an image of the state as a place of wealth and beaches. He found that the Valley did not fit his preconception.

Ross learned that the Valley suffers from bad air, poverty and health problems such as asthma, obesity and pockets of HIV infection. Statistical studies identify the region's medical challenges, he said.

A Fresno State study, "Healthy People 2010," published in January, found, for instance, that Valley residents suffer higher death rates from circulatory heart disease than California residents at large. A higher percentage of Valley residents is overweight.

Valley residents suffer the highest prevalence of diabetes in California. They have a higher death rate from lung cancer than the state at large and higher rates of sexually transmitted diseases, the study found.

Ross credited Nickerson as originator of the health institute idea to begin attacking these and other health disparities.

Nickerson said her concern over such health issues first led her to gather professionals to discuss what to do.

They began meeting at the Maddy Institute at Fresno State, and eventually decided to base the institute at the university.

The endowment's grant gives the institute real power to attack the problems it will study further, she said.

The endowment, with June 1 assets of about $2.7 billion, is the creation of the for-profit subsidiary of Blue Cross of California. The endowment has awarded grants of over $1 billion to organizations in the state.

Ross said that the endowment's grant will finance the first part of the health institute's work but that the people who take charge must figure out how to ensure its "sustained impact."

The institute must seek continuing grants for groups with special medical needs, such as farmworkers and people suffering from asthma, he said.

No other agency performs all these tasks specifically for the Valley, Ross said. Although developing better health data is part of the institute's mission, it doesn't end there.

"This is not just a think tank," Ross said. "We think of it as a 'do tank.' "

The institute will hire policy fellows and student trainees.

The institute will develop a health policy option at Fresno State in the existing master's degree program in public health. And it will train community leaders to find and use health policy information.

Welty mentioned university provost J. Michael Ortiz, soon leaving Fresno State to become president of Cal Poly Pomona, and Benjamin Cuellar, dean of the College of Health and Human Services, as key to formation of the institute in April 2002.

Cuellar said later that the institute plans to train 150 people in its first five years to become health policy leaders. The institute also plans to raise $1 million in that period to keep itself going.

"Our goal is to make it self-sustaining," he said.

The institute soon will hire a permanent executive director, who will hold a tenured faculty position. The institute will hire the successful candidate in September.