Why do blacks with advanced kidney disease live longer than whites?

Blacks more likely to progress to end stage disease, whites more likely to die before kidney failure

Blacks in the United States are more likely to require dialysis and develop end stage renal disease (ESRD) than whites, but they also live longer than whites once they reach later stages of kidney disease. A study of this phenomenon will appear in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN).

Csaba P. Kovesdy, MD (Salem VA Medical Center), John E. Anderson, MD, Stephen F. Derose, MD, and Kamyar Kalantar-Zadeh, MD, PhD (University of California Los Angeles), investigated by comparing 298 black and 945 white male patients with moderate and advanced chronic kidney disease (CKD) who were not on dialysis and who were treated within the Veteran Health Administration (VA) System.

"Studying patients with non-dialysis dependent CKD is important to determine the reasons behind the higher incidence of ESRD in blacks in order to address the root causes of this discrepancy," said Dr. Kovesdy. Conducting the study within the VA System allowed the researchers to analyze a group of patients in which blacks and whites had similar access to health care.

The investigators found that the rates of kidney function decline were similar in blacks and whites, but blacks were less likely to die once they reached moderate to advanced kidney disease.

The lower death rates in black patients with later stages of disease were mainly due to a lower prevalence of cardiovascular disease; the higher incidence of ESRD was explained by clinical characteristics such as lower initial kidney function.

The authors' suspect that lower death rates among blacks with moderate to advanced kidney disease is due to higher death rates among blacks in earlier stages of kidney disease. Blacks who survive earlier stages have fewer health issues (such as cardiovascular disease) than whites. This would explain why blacks had better survival rates than whites among the VA patients. "These survival discrepancies are quite different from what is seen in the general population, where black Americans typically experience higher mortality and lower life expectancy than whites," said Dr. Kovesdy. "More research is needed to explain these differences and to alleviate the racial and ethnic discrepancies in health outcomes in the US," he added. ###

Some of this material was presented at the American Society of Nephrology Renal Week 2008, Philadelphia, PA. This study is supported by grant 1R01DK078106-01 to Dr. Kovesdy and Dr. Kalantar-Zadeh. The study authors reported no financial disclosures.

The article, entitled "Outcomes Associated with Race in Males with Non-Dialysis Dependent CKD," will appear online at cjasn.asnjournals.org/ on April 15, 2009, doi 10.2215/CJN.06031108.

ASN is a not-for-profit organization of 11,000 physicians and scientists dedicated to the study of nephrology and committed to providing a forum for the promulgation of information regarding the latest research and clinical findings on kidney diseases. ASN publishes the Journal of the American Society of Nephrology (JASN), the CJASN, and the Nephrology Self-Assessment Program (NephSAP). In January 2009, the Society will launch ASN Kidney News, a newsmagazine for nephrologists, scientists, allied health professionals, and staff.

Contact: Shari Leventhal sleventhal@asn-online.org 202-416-0658 American Society of Nephrology

Image 2: CDC's Diabetes Program - Data & Trends

Patient preferences play role in racial disparities in rheumatoid arthritis treatment

New study examined whether African-American and white patients with RA differ in how they make trade-offs between risks and benefits related to treatment

Racial disparities in the delivery of healthcare occur even among insured populations with access to care. This suggests that some of the differences in health care utilization among different racial groups may be due to patient preferences. Rheumatoid arthritis (RA) treatment decisions are frequently complex, requiring multiple trade-offs between symptom relief, long-term reduction of disability, adverse events and serious complications. A new study examined whether African American and white patients with RA differ in how they make trade-offs between risks and benefits related to treatment. The study was published in the April issue of Arthritis Care & Research (www3.interscience.wiley.com/journal/77005015/).

Led by Dr. Liana Fraenkel of Yale University, researchers examined how 136 RA patients made trade-offs about specific treatment characteristics related to commonly used RA drugs. These included benefits such as the chance of remission or symptom improvement, and risks such as side effects and theoretical risk of cancer. They analyzed how patients made trade-offs in treatment decisions to determine how respondents value specific characteristics.

The results showed that there were significant differences in the ways that African American and white patients evaluated treatment characteristics. African American patients, who comprised 49 percent of the study sample, attached greater importance to the risk of toxicity, particularly for rare, serious adverse events, and less importance to the likelihood of benefit than white patients. For example, African Americans assigned the greatest importance to the theoretical risk of cancer, whereas white patients were most concerned with the likelihood of remission and halting radiographic progression.

Until now, it has been widely believed that differences in treatment by race can be corrected by changes in either health care providers or the health care system. This is because research on health care disparities has largely focused on access to care, lack of insurance, quality of care due to unconscious practitioner bias and social factors.

Although the Institute of Medicine's model of health disparities includes an acknowledgement that these may be due in part to differences in preferences of care, few studies have tested this notion and racial/cultural differences in risk/benefit perception remain an under-researched field.

"Our study is important because, to the best of our knowledge, this is the first study to formally assess whether risk preference for therapy is one of the potential explanations of the lower use among African Americans of more effective, although more risky, therapy for a chronic disabling disease," the authors state. They point out that disparate models of health and illness may lead to disparate patient preferences, as well as limited communication during clinical visits.

The study showed that African Americans were significantly more risk averse than their white counterparts, which the authors theorize may be due to "cultural risk aversion for gains." This type of risk aversion is based on a learned distrust or low expectations of the healthcare system that arise when a subgroup observes significant gains in lifespan, economic prosperity and power of the larger culture, but does not experience these gains even though they live in the same country or culture.

The authors conclude: "Given these results, physicians should confirm that patients have accurate expectations regarding the natural history and treatment of their disease, and ensure that patient preferences are based on an informed assessment of the pros and cons related to available treatment options." ###

Article: "Understanding Why Rheumatoid Arthritis Patient Treatment Preferences Differ By Race," Florina Constantinescu, Suzanne Goucher, Arthur Weinstein, Wally Smith, Liana Fraenkel, Arthritis & Rheumatism (Arthritis Care & Research), April 2009.

Contact: Sean Wagner medicalnews@bos.blackwellpublishing.com 781-388-8550 Wiley-Blackwell

Image: Rheumatoid Arthritis

Increase in p53 mutation linked to advanced colorectal cancer in blacks

PHILADELPHIA – Researchers have identified a possible genetic cause for increased risk for a more advanced form of colorectal cancer in blacks that leads to shorter survival, according to data published in Clinical Cancer Research, a journal of the American Association for Cancer Research.

Understanding the relationship between molecular defects and differences in colorectal cancer incidence, aggressiveness and clinical outcomes is important in individualizing the treatment and in eliminating racial disparities.

"Several studies have identified a disparity between African-Americans and whites for colorectal cancer. What this study does is pinpoint a possible genetic cause," said Upender Manne, Ph.D., associate professor in the Department of Pathology at the University of Alabama at Birmingham.

For the current study, Manne and colleagues analyzed 137 colorectal adenocarcinomas from African-American patients and 236 colorectal adenocarcinomas from non-Hispanic whites. Researchers assessed these carcinomas for p53 mutations and genotyped for codon 72 polymorphisms.

Overall, whites and African-Americans had a similar rate of p53 mutations. However, the frequency of the Pro72 allele was higher in blacks at 17 percent compared with 7 percent among whites. By contrast, the Arg72 allele frequency was higher in whites at 36 percent than in African-Americans, where the frequency was 19 percent.

representation of a complex between DNA and the protein p53

Presence of the Pro72 allele in blacks was associated with a more than two-fold increase in mortality due to colorectal cancer. "This paper shows that in a subset of patients with the Pro72 allele, and the susceptibility to p53 mutations may be a possible molecular explanation for the racial disparity," said Manne. ### The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and 80 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants.

The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention.

The AACR's most recent publication and its sixth major journal, Cancer Prevention Research, is dedicated exclusively to cancer prevention, from preclinical research to clinical trials. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

Contact: Jeremy Moore Jeremy.moore@aacr.org 267-646-0557 American Association for Cancer Research

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American Geographical Society awards honor Matthew Alexander Henson, on April 15 at UD

The American Geographical Society's awards ceremony on Wednesday, April 15, at the University of Delaware will honor past and present polar explorers - of this planet and of Mars.

Also recognized will be the researchers who oversaw the gargantuan task of relocating the society's library, described as "the largest privately owned geographical research collection in the western hemisphere," from New York to Wisconsin in the 1970s.

The public is invited to attend the ceremony, which begins at 7:30 p.m. at the Louise and David Roselle Center for the Arts. Register online at this Web page.

The ceremony will be Webcast live at this site and made available as a podcast after the event at the UD podcast Web site.

The lecture also will be simulcast into the University of Delaware's virtual world in Second Life, at this location. You must have an avatar in Second Life to visit using this link. Cullum Geographical Medal The Cullum Geographical Medal, "for those who distinguish themselves by geographical discoveries or in the advancement of geographical science,

" will be presented to Peter Smith, principal investigator of the Phoenix Mars Mission, and be awarded posthumously to Matthew Henson, the African American explorer who accompanied Commander Robert Peary on the 1909 expedition to the North Pole.

Born in Charles County, Md., Henson became an adventurer early in life, going to sea at the age of 12 as a cabin boy aboard a merchant ship. In 1887, while working as a stock clerk in Washington, D.C., he met Peary, then a U.S. Navy lieutenant, who offered him a job as his valet on a surveying expedition in Nicaragua. Peary was so impressed by Henson's skills and knowledge that he asked him to join him on his arctic adventures over the next two decades, culminating in the 1909 expedition to the North Pole.

Peary repeatedly acknowledged that he could not have reached the top of the world-a feat many believe to have been accomplished on April 6, 1909 - without Henson, who learned all he could from the native Inuit people, including their language, how to build a camp and repair sledges, drive a dog team, make fur clothing, and hunt.

Although Henson's role went largely unacknowledged at the time, later in life he was awarded honorary degrees by Howard University and Morgan College, given lifetime membership in the Explorers Club, and honored at the White House by President Eisenhower. In 1951, he signed the AGS Fliers' and Explorers' Globe at a lavish ceremony in New York's Waldorf Astoria Hotel. Upon his death in 1955, Henson was buried in Woodlawn Cemetery in New York City. In 1988, he was re-interred as a hero, at Arlington National Cemetery alongside Peary.

Leila Savoy Adrade, Henson's great-great grandniece, will accept the Cullum Medal on his behalf. Deirde C. Stam of the Palmer School of Library and Information Science, Long Island University, will offer remarks about Henson's life and accomplishments. In February, Stam republished Henson's 1912 autobiographical account of his North Pole journey. Issued through the Explorers Club of New York, the 2009 edition contains a wealth of new information about Henson.

Peter Smith, senior research scientist at the University of Arizona's Lunar and Planetary Laboratory, led NASA's Phoenix Mars Mission. The Phoenix Mars Lander, the first in NASA's Scout class, was launched on August 4, 2007, and touched down in the Martian arctic on May 25, 2008, to search the soil of the Red Planet for the building blocks of life.

During five months of operations, the probe confirmed the presence of frozen water just below the planet's surface, found minerals that form in liquid water, identified potential nutrients in the soil, and observed snow in the atmosphere. Phoenix's cameras captured more than 25,000 pictures, from grand landscapes to nanoscale images using the first atomic force microscope ever used outside Earth.

Throughout the mission, which ended in November 2008, Smith and his team controlled the lander from the University of Arizona's Science Operations Center, working closely with NASA's Jet Propulsion Laboratory in Pasadena, Calif., and Lockheed Martin Space Systems in Denver. An international assembly of scientific institutes in Canada, Denmark, Finland, Germany, and Switzerland also was involved.

Smith will deliver a public lecture on Thursday, April 16, at 7:30 p.m. at the Center for the Arts. Register for the free event at this Web site.

Samual F. B. Morse Medal

The Samuel Finley Breese Morse Medal, "for the encouragement of geographical research," will be presented to Barbara Borowiecki, professor emerita of geography, and William Roselle, director (retired) of the Golda Meir Library, at the University of Wisconsin-Milwaukee.

Borowiecki made the initial suggestion that the AGS Library in New York be moved to UW-Milwaukee. Used by researchers around the world, the library today numbers more than 1.2 million items, including maps and atlases, books and periodicals, LANDSAT images, photographs, and globes.

She and Roselle prepared a detailed feasibility study that was used to generate support for the project. The pair oversaw many of the details of the library's relocation from uptown Manhattan to Milwaukee, a distance of nearly 1,000 miles. The move took place from July 26 through Sept. 12, 1978, in 16 full-size moving vans.

On Friday, April 17, Roselle will describe "the moving experience" in the Department of Geography's seminar series. The talk will begin at 3:30 p.m. in Room 127 Memorial Hall. A reception will follow.

Borowiecki, a distinguished geomorphologist and horsewoman, was born and raised in Warsaw, Poland. She was a member of the Polish Underground during World War II. Her family immigrated to the United States in the 1940s. After receiving an engineering degree at Indiana University, she enrolled at the University of Wisconsin to pursue her doctorate in geography. Her research and teaching career at UW-Milwaukee focused on eolian and Pleistocene geomorphology and European regional geography.

Roselle, a native of Pennsylvania, received his B.A. from Thiel College and M.L.S. from the University of Pittsburgh. Prior to entering librarianship, he served two years in the U.S. Army and taught at the Milton Hershey School. He held posts at the Pennsylvania State University and the University of Iowa before going to the University of Milwaukee-Wisconsin, where he served two decades as professor and director of the Golda Meir Library. He is the brother of David Roselle, University of Delaware president emeritus.

The award ceremony will include brief remarks by each recipient and be followed by a reception, where Stam and Roselle will sign copies of their books.

Together, the award ceremony and public lecture mark the culmination of the University of Delaware's William S. Carlson International Polar Year Events, celebrating UD's president from 1946-1950, who was an Arctic explorer, and the University's significant polar research in the world's fourth International Polar Year, which began in March 2007 and concluded in April 2009. ###

Contact: Tracey Bryant tbryant@udel.edu 302-831-8185 University of Delaware

Making the list -- disparities in kidney transplant waiting lists

Blacks in poor neighborhoods suffer greatest inequality

You might expect that living close to a clinic that specializes in transplanting organs would put you at an advantage if you needed a new kidney. According to an upcoming study in the Journal of the American Society Nephrology (JASN), you would be wrong. The study found that distance from a patient's home to the nearest transplant facility has no bearing on whether an individual is placed on the transplant waiting list. However, the research identified other factors associated with disparities in waitlisting, including neighborhood poverty.

Access to kidney transplants is not equal for all patients, particularly when comparing patients of different races.

Caption: This is Rachel Patzer, MPH, from Emory University. Credit: N/A. Usage Restrictions: None.

To understand this disparity, Rachel Patzer, MPH, Sandra Amaral, MD, and their colleagues at Emory University in Atlanta analyzed data from 1998 to 2002 of 35,346 patients in Georgia, North Carolina, and South Carolina who had end-stage renal disease (ESRD). They found that black patients were less likely than whites to be placed on the kidney transplant waiting list, and this disparity was not associated with the distance to the nearest transplant center. They also found that as neighborhood poverty increased, the likelihood of being placed on the waiting list decreased for blacks compared with whites. "We found the most striking disparity in the poorest neighborhoods, where blacks were 57% less likely to be waitlisted for transplantation than whites," said Patzer.

The researchers offer several potential explanations for these racial disparities. Social, behavioral, cultural, and biologic factors may play a role, as could patient preferences (black patients have been shown to be less likely to want a transplant).

"Exploring the role of these factors in the observed racial differences in waitlisting outcomes is important in developing effective solutions for improving equality in access to healthcare," said senior author William McClellan, MD. Dr. Amaral adds, "Our study suggests that poverty also needs to be considered as an influential factor in these racial differences. Constructing future interventions that reach out to poorer communities may be one approach to mitigate racial disparity in transplantation." ###

Caption: This is William McClellan, M.D., from Emory University. Credit: N/A. Usage Restrictions: None.

The authors report no financial disclosures.

The article, entitled "Neighborhood Poverty and Racial Disparities in Kidney Transplant Waitlisting," will appear online at jasn.asnjournals.org/ on Wednesday, April 1, 2009, doi 10.1681/ASN.2008030335.

Founded in 1966, the American Society of Nephrology (ASN) is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

Contact: Shari Leventhal, sleventhal@asn-online.org 202-416-0658. American Society of Nephrology

African Burial Ground PHOTO ESSAY

Return to the Past to Build the Future. GSA’s African Burial Ground project began in 1991, when, during excavation work for a new federal office building, workers discovered the skeletal remains of the first of more than 400 men, women and children. Further investigation revealed that during the 17th and 18th centuries, free and enslaved Africans were buried in a 6.6 acre burial ground in lower Manhattan outside the boundaries of the settlement of New Amsterdam, which would become New York. Over the decades, the unmarked cemetery was covered over by development and landfill.

Managed by GSA, the overall project is a testimonial to a positive and collaborative partnership between many parties, including the Department of the Interior’s National Park Service, the U.S. Army Corps of Engineers, the Advisory Council on Historic Preservation, Howard University, the Schomburg Center for Research in Black Culture, and the African American community.

Today the site is a National Monument featuring a distinctive memorial that commemorates and communicates the story of the African Burial Ground—the single-most important, historic urban archaeological project undertaken in the United States.

The African Burial Ground National Monument, located at the corners of Duane and Elk Streets in lower Manhattan, is operated by the National Park Service. For directions to the site and more information, go to www.nps.gov/afbg The memorial is open Monday through Sunday 9:00 a.m. until 5:00 p.m. except Thanksgiving, Christmas, and New Years Day.

The African Burial Ground Visitor Center is located in the adjacent Ted Weiss Federal Building at 290 Broadway. The hours of operation are Monday thorough Friday, 9 a.m. to 5 p.m. except for federal holidays. For more information please contact: African Burial Ground National Monument National Park Service 290 Broadway New York, NY 10007 Phone 212-637-2019.

For more information on the U.S. General Services Administration, please go to www.gsa.gov This website contains information on GSA’s African Burial Ground project, the memorial, artwork, interpretive center, reinterment ceremony, scientific reports and more. africanburialground.gov

It has been estimated that as many as 200 burials may remain undisturbed on this site. Scientific analysis of the remains indicate that the remains found at 290 Broadway, are indeed of African origin or descent. Artifacts were found in and around the human remains. Some have been positively identified as relating to a specific individual.

All resources related to the ABG, including DNA samples, have been inventoried and stored in accordance with federal regulations and accepted professional standards. The government will select a long-term repository when all current research has been completed.

Access to these materials for future research will be determined on a case-by-case basis by appropriately qualified professionals.

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1 in 7 US teens is vitamin D deficient

Weill Cornell Medical College study finds prevalence highest among African-Americans

NEW YORK -- One in seven American adolescents is vitamin D deficient, according to a new study by researchers in the Department of Public Health at Weill Cornell Medical College. The findings are published in the March issue of the journal Pediatrics and were presented at the Pediatric Academic Societies' Annual Meeting in May 2008.

In children, vitamin D deficiency can interfere with bone mineralization, leading to rickets. In adults, it is linked to cardiovascular disease, cancer, diabetes, immune dysfunction and hypertension.

The study employs a new definition of vitamin D deficiency recommended by a group of scientists attending the 13th Workshop Consensus for Vitamin D Nutritional Guidelines in 2007. These experts collectively proposed that the minimum acceptable serum vitamin D level be raised from 11 nanograms per milliliter (ng/mL) to at least 20 ng/mL.

D3 cholecalciferol

Using the newer criteria, the study finds more than half of African-American teens are vitamin D deficient. Girls had more than twice the risk of deficiency compared with boys. And overweight teens had nearly double the risk of their normal-weight counterparts. "These are alarming findings. We need to do a better job of educating the public on the importance of vitamin D, and the best ways to get it. To meet minimum nutritional requirements teens would need to consume at least four glasses of fortified milk daily or its dietary equivalent.

Other foods rich in vitamin D include salmon, tuna, eggs and fortified cereals. A vitamin supplement containing 400 IU of vitamin D is another alternative," says Dr. Sandy Saintonge, assistant professor of clinical pediatrics and assistant professor of clinical public health at Weill Cornell Medical College, and a pediatric emergency physician at New York Hospital Queens, a member of the NewYork-Presbyterian Hospital Healthcare System. "We should also consider a national fortification strategy, perhaps including routine supplementation and monitoring of serum levels, but more research is needed to determine optimal vitamin D levels."

Of the specific findings, the authors were particularly concerned about the role of weight in deficiency. "Because vitamin D is stored in body fat, simply increasing the dosage of vitamin D may not be effective in overweight adolescents," notes senior author Dr. Linda M. Gerber, professor of public health in the Division of Biostatistics and Epidemiology and professor of epidemiology in medicine at Weill Cornell Medical College. "As the prevalence of childhood obesity increases, vitamin D deficiency may increase as well. In this group, appropriate nutrition could solve both problems."

Another concern is the increased risk of deficiency in girls, some of whom may become pregnant during adolescence. The authors note that a lack of vitamin D may increase maternal risk of preeclampsia and gestational diabetes and may be associated with reduced bone mineralization in the offspring.

Data was obtained from National Health and Nutrition Examination Survey III, a cross-sectional survey administered to a nationally representative sample of persons aged 2 months and older. Analyses were restricted to 2,955 participants aged 12 to 19.

The study was co-authored by Dr. Heejung Bang, associate professor of biostatistics in public health at Weill Cornell Medical College.

###

Weill Cornell Medical College

Weill Cornell Medical College, Cornell University's medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Weill Cornell, which is a principal academic affiliate of NewYork-Presbyterian Hospital, offers an innovative curriculum that integrates the teaching of basic and clinical sciences, problem-based learning, office-based preceptorships, and primary care and doctoring courses.

Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research in areas such as stem cells, genetics and gene therapy, geriatrics, neuroscience, structural biology, cardiovascular medicine, transplantation medicine, infectious disease, obesity, cancer, psychiatry and public health -- and continue to delve ever deeper into the molecular basis of disease in an effort to unlock the mysteries of the human body in health and sickness.

In its commitment to global health and education, the Medical College has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, the Medical College is the first in the U.S. to offer its M.D. degree overseas.

Weill Cornell is the birthplace of many medical advances -- including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson's disease, the first indication of bone marrow's critical role in tumor growth, and most recently, the world's first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. For more information, visit www.med.cornell.edu.

Contact: Lezlie Greenberg leg2003@med.cornell.edu 212-821-0560 New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

Exposure to family violence compromises physical and mental health of older women

New Rochelle, NY, March, 2009—Older African American women exposed to high levels of family violence during their lifetimes are at significantly greater risk of poor health status, according to a report in the current issue of Journal of Women's Health, a peer-reviewed journal published by Mary Ann Liebert, Inc. (www.liebertpub.com). This report is available free online at www.liebertpub.com/jwh

Higher lifetime exposure among older African American women to family violence, which may include intimate partner violence and elder maltreatment, is linked to worse physical and mental health, regardless of when the exposure occurred. Anuradha Paranjape, MD, MPH, Nancy Sprauve-Holmes, MPH, John Gaughan, PhD, and Nadine Kaslow, PhD, from Temple University School of Medicine (Philadelphia, PA) and Emory University School of Medicine (Atlanta, GA), used a survey to assess lifetime family violence levels, including physical violence, emotional, financial, and sexual abuse, neglect, and coercion, among 158 African American women 50 years of age or older attending ambulatory medicine clinics at a large inner-city public hospital in the southeastern U.S. The authors also gathered measures of the women's physical and mental health status.

In the article entitled, "Lifetime Exposure to Family Violence: Implications for the Health Status of Older African American Women," the authors conclude that a holistic approach to caring for older African American women should include greater awareness by clinicians of current and past violence exposure and the negative effects it may have on the health status of these women.

"This study provides further evidence of the enduring harmful effects that family violence can have on both mental and physical health, and in particular it highlights the association between such exposure and the health of older African American women," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, and Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA. ###

Journal of Women's Health, published monthly, is a core multidisciplinary journal dedicated to the diseases and conditions that hold greater risk for or are more prevalent among women, as well as diseases that present differently in women. Under the leadership of Editor-in-Chief Susan G. Kornstein, MD, and Deputy Editor Wendy S. Klein, MD, of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, the Journal covers the latest advances and clinical applications of new diagnostic procedures and therapeutic protocols for the prevention and management of women's healthcare issues. Journal of Women's Health is the Official Journal of the American Medical Women's Association (AMWA; www.amwa-doc.org).

Mary Ann Liebert, Inc. (www.liebertpub.com), is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Obesity Management, Breastfeeding Medicine, Thyroid, Metabolic Syndrome and Related Disorders, and Diabetes Technology and Therapeutics. Its biotechnology trade magazine, Genetic Engineering & Biotechnology News (GEN), was the first in its field and is today the industry's most widely read publication worldwide. A complete list of the firm's 60 journals, books, and newsmagazines is available at www.liebertpub.com

Mary Ann Liebert, Inc. 140 Huguenot Street, New Rochelle, NY 10801 www.liebertpub.com Phone: (914) 740-2100 (800) M-LIEBERT Fax (914) 740-2110

JOURNAL OF WOMEN’S HEALTH Volume 18, Number 2, 2009 In PDF format.

Contact: Amy Gleason Quarshie agleason@liebertpub.com 914-740-2149 Mary Ann Liebert, Inc./Genetic Engineering News

Genomic variations in African-American and white populations

Deletions, duplications or rearrangements of genomic regions in the human genomes produce differences in gene copy numbers, referred to as copy number variations (CNV). Those variations account for a substantial portion of human genetic diversity, and in a few cases, have been associated with behavioural traits or increased susceptibility to disease. A study published today in the open access journal BMC Genetics, describes a CNV map of the African American genome, and compares frequencies of CNVs between African American and white American/European populations.

Joseph P McElroy and colleagues from the Department of Neurology, University of California at San Francisco, recruited African Americans from 28 States and used their genomes to draw CNV comparisons with the White dataset. "To the best of our knowledge, this is the first detailed map of copy number variations in African Americans. Understanding the distributions of CNVs in a population is a first step to addressing their role in disease".

The authors employed an array of over 500,000 sequences whose position in the human genome is already known due to single nucleotide polymorphisms.

They first analysed the interaction of 50 blood samples of healthy African American females with this gene chip platform, and then used the results as a reference to assess copy number variation in samples from a further 385 African Americans, and an additional set of samples from 435 White individuals. In total, 1362 CNVs were detected in African Americans and 1972 in the White cohort. Across most of the genome, the frequency of CNVs did not differ greatly between the two populations. However, there were two duplications, one on chromosome 15, and one on chromosome 17, whose frequency varied markedly between the two groups.

The research team discovered that the duplication in chromosome 17 (region 17q21) is present in 45% of White but only in 8% of African American individuals. Another independent study has implicated the same region in mental retardation caused by a deletion due to duplication. Among the deleted genes, two of them, CRHR1 (corticitropin releasing hormone receptor 1) and MAPT (microtubule-associated protein tau), were previously associated with some neurological disorders. These two genes are not contained within the 17q21 region of CNV duplication, but map very close to it.

According to McElroy, "It would be good to know if the CNV duplication of the region might have an effect on the expression of these genes, which in turn could result in neurological disease. It is also interesting to find out whether the type of mental retardation associated with this locus is more common in Whites than in Africans or African Americans. If this is true, then it might be one of the first reported diseases with differing ethnic frequencies due to CNVs." ###

1. Research article, Copy number variation in African Americans Joseph P McElroy, Mathew R Nelson, Stacy J Caillier and Jorge R Oksenberg, BMC Genetics (in press)

During embargo, article available upon request via the media contact

2. BMC Genetics is an open access journal publishing original peer-reviewed research articles in all aspects of inheritance and variation in individuals and among populations. BMC Genetics (ISSN 1471-2156) is indexed/tracked/covered by PubMed, MEDLINE, BIOSIS, CAS, Scopus, EMBASE, Zoological Record, Thomson Reuters (ISI) and Google Scholar.

3. BioMed Central (http://www.biomedcentral.com/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.

Contact: Charlotte Webber charlotte.webber@biomedcentral.com 44-782-531-7342 BioMed Central

Difference in fat storage may explain lower rate of liver disease in African-Americans

DALLAS – March 27, 2009 – Where different ethnic groups store fat in their bodies may account for differences in the likelihood they'll develop insulin resistance and non-alcoholic fatty liver disease, researchers at UT Southwestern Medical Center have found.

According to research reported in the online edition and the March issue of Hepatology, African-Americans with insulin resistance might harbor factors that protect them from this form of metabolic liver disease.

Despite similarly high rates of associated risk factors such as insulin resistance, obesity and diabetes among African-Americans and Hispanics, African-Americans are less likely than Hispanics to develop non-alcoholic fatty liver disease, or NAFLD. The disease is characterized by high levels of triglycerides in the liver and affects as many as one-third of American adults.

Caption: Researchers, including Drs. Jeffrey Browning (left) and Richard Guerrero, have demonstrated that where different ethnic groups store fat in their bodies may account for variations in the rates those groups develop insulin resistance and non-alcoholic fatty liver disease. Credit: UT Southwestern Medical Center. Usage Restrictions: Please use our credit line.

"If we can identify the factors that protect African-Americans from this liver disease, we may be able to extrapolate those to other populations and perhaps develop targeted therapies to help populations prone to NAFLD," said Dr. Jeffrey Browning, assistant professor of internal medicine in the UT Southwestern Advanced Imaging Research Center and the study's senior author. Previous research has shown that when African-Americans do develop NAFLD, they're less likely to reach the later stages of liver disease.

Prior work by Dr. Browning and other UT Southwestern scientists has revealed that NAFLD is more prevalent among Hispanics than African-Americans or Caucasians.

For the current study, Dr. Browning and his colleagues analyzed data gathered in the multi-ethnic, population-based Dallas Heart Study. Starting in the year 2000, more than 2,100 participants provided blood samples and underwent multiple body scans with magnetic resonance imaging and computed tomography to examine the liver, heart and other organs. Body composition, including fat distribution, also was scrutinized.

The study found that African-Americans and Hispanics both have obesity rates of about 48 percent among their respective populations, as well as diabetes rates of about 21 percent. Only 23 percent of African-Americans, however, have NAFLD, compared with 45 percent of Hispanics.

Similarly, African-Americans are less likely to have high levels of triglycerides and abdominal fat – both characteristics of insulin resistance – when compared with Hispanics or Caucasians, even though overall rates of insulin resistance among all groups are the same, researchers found.

"This presents something of a paradox," Dr. Browning said.

The explanation might lie in where different ethnic groups typically store fat.

Obese Hispanics tend to deposit fat in the liver and visceral adipose tissue – the area around the belly. Obese African-Americans deposit fat predominantly in subcutaneous adipose tissues – the area around the hips and thighs, Dr. Browning said.

"This may be protective," Dr. Browning said. "In animal studies, if subcutaneous fat is increased as opposed to visceral fat, you can actually reverse fatty liver disease."

Scientists aren't sure why the location of fat storage matters.

"This seems to argue that there is a fundamental difference in the lipid metabolism between African-Americans and Hispanics or Caucasians, and this difference is maintained even when insulin resistance is present," Dr. Browning said.

Differences in liver-fat content in Caucasians seem to be based on gender. Caucasian males are at the highest risk for NAFLD, on par with the risk faced by Hispanics in general. Caucasian females are on par with the African-American population, at about 23 percent. Caucasian females, like African-Americans, might benefit from the greater predilection to store fat in lower extremities.

"Research studies traditionally have been based on examining Caucasian males, but this information suggests that there are sometimes ethnic and gender differences that need to be studied individually to determine if there are important clues we're missing because we're lumping everybody together," Dr. Browning said.

Researchers next will study how differences in metabolism affect fatty liver disease. ###

Other researchers from UT Southwestern involved in the study were lead author Dr. Richard Guerrero, a postdoctoral trainee clinician in internal medicine; Dr. Gloria Vega, professor of clinical nutrition; and Dr. Scott M. Grundy, director of the Center for Human Nutrition.

The study was funded by the Donald W. Reynolds Foundation and the National Institutes of Health.

Visit www.utsouthwestern.org/digestive to learn more about UT Southwestern's clinical services in digestive disorders, including liver disease.

Dr. Jeffrey Browning -- www.utsouthwestern.edu/findfac/professional/

Contact: LaKisha Ladson lakisha.ladson@utsouthwestern.edu 214-648-3404 UT Southwestern Medical Center

Do Americans have an identity crisis when it comes to race and ethnicity?

Say goodbye to Italian-Americans and German-Americans and say hello to Vietnamese-Americans, Salvadoran-Americans and a bunch of other hyphenated Americans.

The way people identify themselves in the United States is changing, and the way the federal census classifies them by race or ethnicity isn't painting a clear portrait of America, according to new research.

University of Washington demographers who analyzed 2000 census data contend that because of the way the census was structured many Hispanics or Latinos were eventually lumped into a category called "some other race." So many were placed in that category that it was the third-largest group behind whites and blacks in the census. This led to mistaken reports last year that whites, as opposed to non-Hispanic whites, were projected to be a minority in the U.S. by 2050. Actually, whites -- including Hispanic whites -- are expected to comprise upwards of 70 percent of the population in 2050.

Bizarro (New) © Dan Piraro, King Features Syndicate.

"The truth is many people probably can't accurately report the origins of their ancestors," said Anthony Perez, lead author of a new study and a UW post-doctoral fellow in sociology and the university's Center for Studies in Demography and Ecology. His co-author is Charles Hirschman, a UW professor of sociology and former president of the Population Association of America. The research appears in the March issue of the journal Population and Development Review.

"We have a fair degree of knowledge about where our parents and grandparents came from," said Perez. "But with every generation the number of our ancestors doubles and it is difficult to know the ethnic and racial details of all of them. Many people might have more ethnic or racial groups in their backgrounds than they imagine."

Most Americans, except for recent immigrants, probably descended from multiple geographic, ethnic and racial origins, and the United States was multi-ethnic and multi-racial from the start, the researchers contend.

"With the exception of indigenous people, everyone came from somewhere else. They were immigrants," said Perez. "Frontier societies absorbed many indigenous people and we also have a long history of interracial unions between Americans of European and African descent. It is not just Barack Obama, but most of us are a bunch of 'mutts' from different cultures and backgrounds."

All of this led to what is called Americanization, or the blending away of the specific ancestries that people brought with them. Typically Americanization begins with immigrants coming to the U.S., settling in neighborhoods with their compatriots and retaining their ethnic roots. But within a generation, they or their children learn English, intermarry with other Americans of different backgrounds and their ancestral ties begin to fade. With several more generations, most Americans begin to lose track of their increasingly complex family trees.

This blending has dramatically transformed Native Americans and Hawaiian-Pacific Islanders, most of whom acknowledge multiracial heritage. At the same time, very few whites and blacks acknowledge common ancestry on censuses and surveys.

"The low levels of racial mixture reported by whites and blacks represent an astounding loss of memory or a reluctance to acknowledge such mixing," said Perez. "One-fifth of African-Americans identified multiracial origins in the 1910 census and researchers think that number probably is low. Yet in Census 2000, just 2 percent of blacks and 0.4 percent of white acknowledge shared ancestry. The blurring of memories over many generations, the stigma of race mixing and a long history of segregation and political polarization have probably contributed to the amnesia of shared ancestry among many white and black Americans.

"Whites are notoriously inconsistent about the specifics of ethnic identity. We don't put a lot of stock in their answers because they often change their minds on follow-up questions. There also is inconsistency between parents and their children. The majority of whites have multiple ancestries and some will pick theirs on the basis of cuisine, a favorite relative or trends. And who isn't Irish on St. Patrick's Day?" he said.

What will Americans look like in another 50 years? Perez isn't sure.

"The future face of America is uncertain. It's like predicting the weather 50 years from now. If current rates of intermarriage continue, there is likely to be continued blurring of race and ethnic divisions. Even the race and ethnic categories used in the census may change, as they have in the past. For Asians and Hispanics, there is likely to be continued blending, as with previous generations of immigrants." If intermarriage between blacks and whites continues to increase in the coming year, perhaps there will be greater acknowledgement of their shared ancestry. But this will likely depend also on how well we bridge the social and economic gaps between groups."

The research was supported by the National Institute of Child Health and Human Development. ###

For more information, contact Perez at 206-543-4572 or adperez@u.washington.edu.

Contact: Joel Schwarz joels@u.washington.edu 206-543-2580 University of Washington

Racial biases fade away toward members of your own group

COLUMBUS, Ohio – White people don't show hints of unconscious bias against blacks who belong to the same group as them, a new study suggests.

But this lack of bias only applied to black people in their group, according to the findings. Most white people in the study still showed evidence of some unconscious bias towards blacks who were in an opposing group, or who were unaffiliated with either group.

What impressed the researchers, however, was just how quickly these group bonds could form. The lack of bias toward fellow black group members was uncovered just minutes after whites joined the mixed-race group, and without participants even meeting their fellow members personally.

Jay Van Bavel

"The results suggest that when we share some kind of identity with a group of people, we automatically and immediately feel positively toward them, regardless of race," said Jay Van Bavel, co-author of the study and post-doctoral fellow in psychology at Ohio State University. "You can think in terms of people who go to the playground and play a game of pickup basketball.

All it takes is a flip of a coin to make someone your teammate, and at least for that game, you're going to feel positively toward your teammates, white and black."

Van Bavel conducted the study with William Cunningham, assistant professor of psychology at Ohio State. Their study appears in the March issue of the journal Personality and Social Psychology Bulletin.

The study involved two separate but related experiments with college students, one done in Canada and one in the United States.

The students took a computer test commonly used by psychologists to reveal unconscious, or automatic racial bias. The test examines people's first reactions to seeing a black face, before their conscious mind can edit and override biases.

Even though most people disavow any racial bias, this test consistently shows that about three-quarters of white North Americans have some level of unconscious racial bias, Van Bavel said. These unconscious thoughts can lead people to make biased decisions without realizing they are being biased. For example, a manager may pass over a resume of a person whose name suggests she is an African American, without even recognizing why he is doing it, according to Van Bavel.

William A. Cunningham

The computer test flashes pictures of black and white faces quickly on the screen followed nearly instantaneously by positive words (such as love) or negative words (such as hatred). Participants have to very quickly – within about one-half of a second -- categorize the words as positive or negative.

In general, white people find it more difficult to correctly classify positive words when they were first shown a photo of a black person.

"Seeing a black face automatically activates this association with negative things for many white people and if they don't have time to correct this negative image – which they don't in this study – they associate negative words with black faces," Cunningham said.

In the first experiment, 109 students at the University of Toronto were randomly assigned to one of two groups made up for the study – one named the Lions and the other called the Tigers. A control group learned about the two groups, but was not assigned to either one of them.

Members of the Lions and Tigers were shown photos of the members of both groups, and told it was important to learn who belonged to their team, and who belonged to other team.

Later, they were given the computer bias test. Results showed that students in the control group, who were not a member of either mixed-race group, showed a preference for white faces over black faces, as was expected.

But white members of the two teams showed no bias against black members of their own teams. They did, however, show bias towards black members of the opposing team.

"Team members were evaluating people based on whether they were on the same team – not evaluating them based on their race," Cunningham said.

The second experiment involved 126 students at Ohio State. The setup was essentially the same, except that participants also evaluated white and black faces that were not members of either of the two groups. Results showed that white students showed no bias against blacks who belonged to their team. They showed nearly equivalent levels of bias towards black members of the opposing team, and black members who were not associated with either team.

This suggests that whites were showing increased positive feelings toward black members of their own team, but not increased negative feelings toward blacks who belonged to the opposing team.

"White students felt the same toward blacks on the opposing team and people who didn't belong to any team," Van Bavel said. "That means liking people from your team doesn't mean you have to hate members of the other team."

Van Bavel said the unconscious biases studied in this research have real-life consequences.

"What's dangerous about these attitudes is that they can come into play even when we're not aware of them, and even when we think we are being egalitarian," he said.

But this study suggests there may be ways to battle this unconscious, automatic racism.

"We want to change how people see someone at the very earliest stages. If you see someone as a member of your own team or group, race may not even come to mind. You are thinking about that person in terms of some kind of shared relationship," Van Bavel said.

In the real world, this means creating contexts to show how people are connected whenever possible. This may mean emphasizing our shared identities as residents of a city, fans of a sports team or members of a church.

"It's part of human nature to feel positively about members of our own group," Cunningham said. "The challenge is to find ways to call attention to our shared identities." ###

Contact: Jay Van Bavel, Van-bavel.1@osu.edu or William Cunningham, (614) 247-6139; Cunningham.417@osu.edu

Written by Jeff Grabmeier, (614) 292-8457; Grabmeier.1@osu.edu

Contact: Jay Van Bavel Van-bavel.1@osu.edu 614-247-6139 Ohio State University

Study quantifies racial disparities in cancer mortality rates between blacks and whites

African Americans have a shorter life expectancy than whites, and cancer plays a major role in this disparity. African Americans are more prone to get cancer; they tend to present at a later, deadlier stage; and they have poorer survival rates after diagnosis.

But to what extent are each of these three factors responsible for the disparity in cancer mortality? A new UCLA study, published in Journal of General Internal Medicine Feb. 18, answers that question, finding that for most types of cancer, the disparity in mortality is almost entirely due to the fact that African Americans are more likely to get cancer in the first place. Their stage at presentation and survival after diagnosis play a much smaller role.

Overall, African American men live 1.47 fewer years than white men, and African American women 0.91 fewer years than white women, due to all cancers combined. The results spotlight the need for greater prevention efforts aimed at African Americans.

Comparison of SEER and NHIS data on years of potential life lost (YPLL) due to specific cancers and all cancers combined. YPLL = years of potential life lost before age 75 per 1,000 persons, where n is the number of persons at risk for death in the population. Other GI = other gastrointestinal cancers, including esophageal, pancreatic and liver.

This is the first time that researchers have quantified the role that disparities in cancer incidence, stage at diagnosis and survival after cancer plays in African Americans' shorter life expectancy, according to lead author Dr. Mitchell D. Wong, associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. "Putting a number on it is very informative, because when you look at the figures, you see that the reason their mortality is worse is almost entirely due to the fact that blacks are more likely to get cancer," Wong said. "This highlights the importance of prevention — it's where most of the efforts should be." A notable exception to this pattern was breast cancer. While white women are more likely to get breast cancer than African American women, the disparities between whites and blacks in stage at presentation and survival after diagnosis for breast cancer had a large impact on the racial gap in life expectancy.

"This argues for much more research and efforts to close the gap in breast cancer screening and treatment," Wong said.

The researchers analyzed data from the Surveillance and Epidemiology End Result (SEER) cancer registry and the National Health Interview Survey (NHIS). Together, the data sets covered about 2.7 million white and 291,000 African American cancer patients from 12 geographic regions in the United States: San Francisco/Oakland, Connecticut, Detroit, Hawaii, Iowa, New Mexico, Seattle (Puget Sound), Utah, Atlanta, Alaska, San Jose/Monterey and Los Angeles.

Among the other findings:

* Cancer incidence, stage at diagnosis and post-diagnosis survival accounted for 1.12, 0.17 and 0.21 years, respectively, in the life-expectancy disparity among men.
* Among women, those categories accounted for 0.41, 0.26 and 0.31 years, respectively.
* The difference in incidence of cancer had a greater impact on the racial gap in cancer mortality than did the stage at which the cancer was diagnosed.
* The differences in post-diagnosis survival were significant with only two types of cancer: breast (0.14 years) and prostate (0.05 years).

"Continuing to improve cancer treatment and screening is undoubtedly important to improving life expectancy and quality of life for all adults, yet substantial disparities in cancer mortality will persist unless we can find ways to address the enormous impact of racial differences in cancer incidence," the researchers concluded. ###

In addition to Wong, study authors included Susan L. Ettner and Martin F. Shapiro of the David Geffen School of Medicine at UCLA, and John Boscardin of the division of geriatrics at the San Francisco Veterans Administration Medical Center.

The National Institute on Aging, the National Center on Minority Health and Health Disparities, a Pfizer Scholars Grant in Clinical Epidemiology, and a Doris Duke Charitable Foundation Clinical Scientist Development Award funded this study.

The General Internal Medicine and Health Services Research Division in the department of medicine at the David Geffen School of Medicine at UCLA provides a unique interactive environment for collaborative efforts between health services researchers and clinical experts with experience in evidence-based work. The division's 100-plus clinicians and researchers are engaged in a wide variety of projects that examine issues related to access to care, quality of care, health measurement, physician education, clinical ethics and doctor-patient communication. Researchers in the division have close working relationships with economists, statisticians, social scientists and other specialists throughout UCLA and frequently collaborate with their counterparts at the RAND Corp. and the Charles Drew University of Medicine and Science.

Contact: Enrique Rivero erivero@mednet.ucla.edu 310-794-2273 University of California - Los Angeles

Heart failure strikes younger African-Americans at the same rate as older Caucasians

Treating hypertension and obesity key to heart failure prevention

Heart failure—a disabling and often deadly form of heart disease—is hitting African Americans in their thirties and forties at the same rate as Caucasians in their fifties and sixties, according to a study featured as the lead article of the March 19 issue of the New England Journal of Medicine.

One in 100 African-American men and women developed heart failure at an average age of 39, 20 times the rate in Caucasians, according to Racial Differences in Incident Heart Failure Among Young Adults. Heart failure in African Americans was associated with risk factors such as hypertension and obesity that were already present when these adults were in their twenties.

Treating hypertension and obesity key to heart failure prevention. Heart failure—a disabling and often deadly form of heart disease—is hitting African Americans in their thirties and forties at the same rate as Caucasians in their fifties and sixties, according to a study featured as the lead article of the March 19 issue of the New England Journal of Medicine.

One in 100 African-American men and women developed heart failure at an average age of 39, 20 times the rate in Caucasians, according to Racial Differences in Incident Heart Failure Among Young Adults. Heart failure in African Americans was associated with risk factors such as hypertension and obesity that were already present when these adults were in their twenties.

"These findings should be a wake-up call on the need for African Americans and physicians to address risk factors that can lead to heart failure. Heart failure is disproportionately hitting African Americans in the prime of their lives," said Kirsten Bibbins-Domingo, Ph.D., M.D., lead author of the study and a scholar with the Harold Amos Medical Faculty Development Program of the Robert Wood Johnson Foundation. Bibbins-Domingo is an assistant professor of medicine, epidemiology and biostatistics at the University of California, San Francisco (UCSF) and co-director of the UCSF Center for Vulnerable Populations at San Francisco General Hospital.

Each year, heart failure—also known as congestive heart failure—affects about 5 million people in the United States and results in nearly 300,000 deaths, according to the National Heart, Lung, and Blood Institute, a part of the National Institutes of Health. Heart failure affects the heart's ability to pump blood to the lungs or oxygen-rich blood to the rest of the body and can cause debilitating fatigue, shortness of breath and, eventually, death.

Heart failure is traditionally perceived as a form of heart disease that mostly affects the elderly. The results of the study suggest, however, that heart failure can occur at much younger ages, particularly among African Americans.

Physicians and patients should be aware of the risk factors such as hypertension and obesity and work to prevent and treat these conditions, even among young adults.

"These findings illustrate the importance of identifying solutions to the social, economic, environmental and health care-related factors that contribute to persistent health disparities," said Robert Wood Johnson Foundation President and CEO Risa Lavizzo-Mourey, M.D., M.B.A. "The study results also highlight the urgency of reversing the childhood obesity epidemic. Today's unhealthy children are tomorrow's unhealthy adults. We know that obese children are being diagnosed with conditions previously considered adult illnesses, such as type 2 diabetes and hypertension, and they're at higher lifetime risk for a host of serious health problems, including heart disease, stroke, diabetes, asthma and some forms of cancer. The harsh reality is that, unless we act now to reverse the epidemic of childhood obesity, we may raise the first generation of Americans who will live sicker and die younger than their parents."

This study found that each 10 mmHg increase in diastolic blood pressure (the "bottom" number) among African Americans in their twenties doubles the likelihood of developing heart failure when they are in their forties. "It doesn't matter how young a patient is—hypertension needs to be diagnosed and treated," Bibbins-Domingo said. "The longer you have uncontrolled hypertension, the greater the chance that you will develop heart failure."

Young adults are often unaware that they have hypertension, and even when aware are often untreated or undertreated. Physicians may be reluctant to treat younger adults because cardiovascular complications are perceived to be rare and far in the future. "Our study suggests that the complications of high blood pressure can occur much earlier and should serve as a reminder that current guidelines recommend identification and treatment of blood pressure regardless of the age of the patient," said Bibbins-Domingo. ###

The CARDIA Study—for Coronary Artery Risk Development in Young Adults—was undertaken to describe the development of risk factors for heart disease in young adults. CARDIA—funded by the National Institutes of Health—began in 1985 with 5,115 African-American and Caucasian men and women ages 18 to 30, recruited from Birmingham, Ala., Chicago, Minneapolis and Oakland, Calif.

Resources on heart failure and hypertension are available on the National Heart, Lung, and Blood Institute's Web site:

• Diseases and Conditions Index: Heart Failure: www.nhlbi.nih.gov/health/
• Diseases and Conditions Index: High Blood Pressure: www.nhlbi.nih.gov/health/dci/.

The Harold Amos Medical Faculty Development Program (AMFDP) is celebrating 25 years of increasing diversity in medicine. The program was established to increase the number of faculty from historically disadvantaged backgrounds who can achieve senior rank in academic medicine and who will encourage and foster the development of succeeding classes of such physicians. AMFDP is an extension of the Minority Medical Faculty Development Program. The program name was changed to honor Harold Amos, Ph.D., who was the first African American to chair a department, now the Department of Microbiology and Medical Genetics at the Harvard Medical School. He remained engaged with the program until his death in 2003. For more information, visit www.amfdp.org.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.

Contact: Jennifer Combs jcombs@iqsolutions.com 240-221-4256

Helping The Fresh Air Fund Help inner city children

The Fresh Air Fund is an independent, not-for-profit agency that provides free summer vacations to New York City children from low-income communities. Jenny Morgenthau is the Executive Director.

More than 1.7 million children have been helped since 1877 and nearly 10,000 New York City children now enjoy free Fresh Air Fund programs annually. In 2006, 5,000 children visited volunteer host families in suburbs and small town communities across 13 states from Virginia to Maine and Canada; 3,000 children attended five summer camps on a 2,300-acre (9 km2) site in Fishkill, New York; and the fund’s year-round camping program serves an additional 2,000 young people each year.

In 2006, 75% of the total income of the fund came from private individuals.

News Facts:

• Fresh Air Fund Host Families
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It has received multiple grants from the Carnegie Corporation, an organization that has supported more than 550 New York City arts and social service institutions since its inception in 2002, and which was made possible through a donation by New York City mayor Michael Bloomberg.

The Fresh Air Fund is an independent, not-for-profit agency that provides free summer vacations to New York City children from low-income communities. Jenny Morgenthau is the Executive Director.

More than 1.7 million children have been helped since 1877 and nearly 10,000 New York City children now enjoy free Fresh Air Fund programs annually. In 2006, 5,000 children visited volunteer host families in suburbs and small town communities across 13 states from Virginia to Maine and Canada; 3,000 children attended five summer camps on a 2,300-acre (9 km2) site in Fishkill, New York; and the fund’s year-round camping program serves an additional 2,000 young people each year.

In 2006, 75% of the total income of the fund came from private individuals.

It has received multiple grants from the Carnegie Corporation, an organization that has supported more than 550 New York City arts and social service institutions since its inception in 2002, and which was made possible through a donation by New York City mayor Michael Bloomberg.

The program

Boys and girls from six to eighteen years old, visit over 300 Fresh Air Friendly Towns each summer. Children on first-time visits are six to twelve years old and stay for two weeks. The program also has a special one-week option for New York City families who would like to host children on their summer vacations outside the city.

Over 65 percent of all children are invited to stay with host families again, year after year. Youngsters may continue with The fund through age eighteen, and many spend the entire summer in the country. Children and volunteer families often form bonds of friendship that last a lifetime.

Each placement with a host family costs the fund $629 (2006).

Selection of children

Children are selected to participate based on financial need. Children are from low-income communities, with the majority receiving some form of public assistance. Youngsters are registered by more than 90 social service and community organizations in all five boroughs of New York City.

Host families

Volunteer host families open their homes to inner-city children for two weeks or more in the summertime. Each Friendly Town community is supervised by a committee of volunteers. Committee members select host families after reviewing their applications, visiting them in their homes and checking their personal references.

There are no financial requirements for hosting a child. Most hosts simply want to share their homes with inner-city youngsters. Host families are not paid. The fund has a program for placing children who have special physical or emotional needs.

In 2004, twelve teens were invited to holiday in Switzerland by Credit Suisse First Boston.

The camping program

Around 3,000 New York City youngsters, aged eight to fifteen, attend five Fresh Air camps on a 2,300-acre (9 km2) site in the Sharpe Reservation near Fishkill, New York.

* Camp Hidden Valley is for boys and girls with and without special needs, eight to twelve years old
* Camp Tommy (named after board member/designer Tommy Hilfiger for his dedication and support of Fresh Air children) is for boys aged twelve to fifteen
* Camp Anita Bliss Coler is for girls aged nine to twelve
* Camp Hayden-Marks Memorial is for boys aged nine to twelve
* Camp Mariah is a coed camp for youngsters aged twelve to fourteen (career campers)

Additionally, 2,000 young people participate in year-round weekend camping experiences.

Special features shared by all camps include a planetarium, model farm, wilderness trail and ropes course. Since 1999, many of the campers have received free guitar lessons on Spirit guitars donated by the Gibson Foundation.

Each placement in a camp costs the fund $1,234 but gives much happiness to many children.

Seven youngsters each year spend the summer at Camp Pioneer on the Sharpe Reservation, training to be counselors.

Career Awareness Program

The innovative Career Awareness Program is designed to help New York City youngsters understand the relationship between school and work and how to make choices that will determine their futures. Youngsters aged twelve to fourteen participate in job shadowing that offers a close-up view of business, and a career fair. The year-round program includes weekend camping trips and an intensive three-and-a-half week summer session at the Career Awareness Camp – Camp Mariah. The career camp is named in honor of Board member/singer Mariah Carey for her dedication, support and commitment to Fresh Air youngsters. Career awareness graduates continue to receive support through the PreOccupations Club and benefit from the guidance of volunteer mentors.

History of The Fund

In 1877, the Reverend Willard Parsons, minister of a small rural parish in Sherman, Pennsylvania, asked members of his congregation to provide country vacations as volunteer host families for children from New York City tenements. This was the beginning of the tradition. By 1884, Reverend Parsons was writing about the fund for the New York Tribune, and the number of children served grew. In 2006, close to 10,000 New York City children experienced the joys of summertime in Friendly Towns and at five Fund camps in upstate New York. When the New York Herald Tribune went out of business in 1966, the New York Times took over sponsorship.

New York City Volunteers

The fund has an active group of New York City volunteers. Metropolitan area volunteers help the fund reach out to New York City parents and children, support Camping, Career Awareness and Friendly Town programs and seek in-kind donations.

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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article, Fresh Air Fund