Not One More Life: A History

Not One More Life (NOML) began in Atlanta in 2003 as a nonprofit organization. It was founded by LeRoy Graham, MD, a pediatric pulmonologist. He partnered with local Black churches and organized volunteer health professionals to offer asthma screenings and asthma education.

NOML addressed health inequities that adversely impact Black Americans with asthma. Data shows Black people are more likely to have poor asthma control and die due to asthma.

From 2003 to 2019, NOML hosted asthma screenings in 25 locations around the United States. The organization merged with Allergy & Asthma Network in 2019.

It continues as the Not One More Life Trusted Messengers program. Dr. Graham serves as medical director.

Photo of two Black EMS professionals administering self Covid-19 tests.

The impact of health inequities in the Black community

There are many social and economic barriers that can impact a person’s health.
These barriers are often referred to as social determinants of health.

Poor health can occur due to:
● discrimination and minority stressors
● inadequate housing
● lack of educational opportunities
● poor quality and expensive healthcare
● unsafe neighborhood conditions
● food insecurity and lack of access to healthy foods
● low or no income and lack of job security
● poor environmental conditions

Infographic on Path to Achieving Health Equity. It speaks about the issues of: Housing, Education, Affordable healthcare, discrimination, neighborhoods, food insecurity, stable income and environmental quality.
Many people of color mistrust the healthcare system. They also have experienced a history of systemic discrimination.

People of color often experience delays in treatment. They are frequently under- represented in clinical trials. In addition, there are fewer medical professionals of color in the healthcare system.

Systemic inequities continue to erode trust in the healthcare system. As a result, people of color are more at risk for getting sick or dying from preventable and treatable diseases. They are also more at risk for poor outcomes during infectious disease outbreaks such as COVID-19.

Response to the COVID-19 pandemic

Black communities have suffered greatly during the COVID-19 pandemic as compared to the white, non-Hispanic population. Black Americans have a:

2.5 times higher risk of getting COVID-19
4.5 times higher risk of being hospitalized due to COVID-19
2 times higher risk of death due to COVID-19

For this reason, NOML leaders spoke with leading pulmonologists, allergists and Black physicians on the front lines of the COVID-19 pandemic. The goal was to better understand how NOML could best respond to help the Black community during the crisis.

Evolving Not One More Life Into the Trusted Messengers Program

In 2020, NOML redefined its mission to address respiratory health inequities in communities of color by…

  • offering free COVID-19 testing
  • increasing lung screenings for people of color
  • improving access to important health information

Allergy & Asthma Network renamed it the Not One More Life Trusted Messengers program.

Black Americans, Hispanics & Native Americans face higher COVID-19 risks, compared to White, Non-Hispanic persons

Image showing stats of Covid risk in communities of color
Health professional at Trusted Messengers pilot program in Atlanta. He's leaning over a car helping with lung screenings.

National Expansion

The Trusted Messengers project continues in 2021. It will expand to more cities throughout the year.

The program offers an online option for screenings and digital follow-up. This allows people to participate if they do not live near one of the cities where screening events take place.


  • In 2021, Trusted Messengers will partner with local community leaders to reach those who are at greatest risk from COVID-19.
  • The program will use health disparity data, predictive analytics and weather trends to identify future COVID-19 hot spots.
  • Cities under consideration include Chicago, Cleveland, Nashville, Oakland, Philadelphia and The Bronx, New York.

Coordination with other national efforts

Trusted Messengers supports a nationwide effort to respond to the COVID-19 pandemic. The program has ongoing relationships with: 

Strategic Framework for Trusted Messengers

Strategic framework graphic for Trusted Messengers Not One More Life project. It includes the vision, mission, priorities, action areas, and principles.

Trusted Messengers is built on community partnerships

The Trusted messengers program connects with people in the community and builds relationships. have relationships built on trust with people in their communities.

How the new Trusted Messengers program works.

Trusted Messengers mobilizes trusted community leaders, health advocacy organizations and healthcare companies. Working together, these partners can help Black Americans lead healthier lives through:

  • community engagement
  • expanded healthcare access
  • digital innovation

Community Engagement

Trusted Messengers is built on a trust and belief in community-led solutions. The program works with local doctors and health professionals to offer free COVID-19 testing, lung health screenings and patient education. Expected outcomes include:

  • empowering people of color to make lifestyle changes to adopt healthy behaviors
  • restoring trust in the healthcare system

Healthcare Access

Increasing access starts by addressing interconnected, systemic barriers. These factors can come from inside and outside of the health system. Success will require a holistic approach. Barriers for at-risk patients with COVID-19 and chronic illnesses must be identified and fixed.

Digital Innovation

Digital tools support long-term engagement and solutions. Trusted Messengers translates insights from patient data into personalized solutions. Patients can then use a secure digital platform to proactively manage their health.

The digital program starts with in-person and digital health screenings. Health professionals identify high-risk individuals who are then enrolled in a 16-week digital program. The program provides support to help them manage their lung health.

Initial pilot – Atlanta, Georgia

In September 2020, Trusted Messengers began as a pilot program in Atlanta. Approximately 1,000 people were screened for COVID-19, asthma and COPD at two Atlanta-area churches, including the historic Ebenezer Baptist Church. Patients consulted with health professionals and received free resources.

Of the 1,000 people screened, 120 patients met the criteria for digital support. Thirty people enrolled in the Trusted Messengers 16-week digital follow-up program. The digital program, which includes health coaching, started on November 30.