NYC Marijuana Possession Arrests Skyrocket, Illustrate NYPD Racial Bias VIDEO

The NYPD arrested and jailed nearly 400,000 people for possessing small amounts of marijuana between 1997 and 2007,

a tenfold increase in marijuana arrests over the previous decade and a figure marked by startling racial and gender disparities, according to a report released Tuesday at the New York Civil Liberties Union.

The report, The Marijuana Arrest Crusade in New York City: Racial Bias in Police Policy 1997-2007, is the first ever in-depth study of misdemeanor marijuana arrests in New York City during the Giuliani and Bloomberg administrations.

Researched and written by Prof. Harry G. Levine, a sociologist at Queens College, and Deborah Peterson Small, an attorney and advocate for drug policy reform, the report is based upon two years of observations in criminal courts as well as extensive interviews with public defenders; Legal Aid and private attorneys; veteran police officers; current and former prosecutors and judges; and those arrested for possessing marijuana.

“The massive, organized and relentless pursuit of these arrests under two mayors and three police commissioners represents a crusade by law enforcement,” Levine said. “But that term does not capture other important characteristics of these arrests – including the harm they inflict on black and Latino young people and their families.”

Between 1997 and 2007, police arrested and jailed about 205,000 blacks, 122,000 Latinos and 59,000 whites for possessing small amounts of marijuana. Blacks accounted for about 52 percent of the arrests, though they represented only 26 percent of the city’s population over that time span. Latinos accounted for 31 percent of the arrests but 27 percent of the population. Whites represented only 15 percent of those arrested, despite comprising 35 percent of the population.

Government surveys of high school seniors and young adults 18 to 25 consistently show that young whites use marijuana more often than young blacks and Latinos. The arrests also are heavily skewed by gender. About 91 percent of people arrested were male.

“The numbers speak for themselves,” said Donna Lieberman, executive director of the NYCLU. “The NYPD routinely targets young men based on their skin color and where they live. Arresting and jailing thousands for marijuana possession does not create safer streets. It only fosters distrust between the police and community and strips hundreds of thousands of young New Yorkers of their dignity.”

The arrests, which cost taxpayers up to $90 million a year, are indicative of the NYPD’s broken windows approach to law enforcement, in which police focus on minor offenses as a method of reducing crime. This approach, also called quality of life policing, has caused a dramatic spike in stop-and-frisk encounters between police and city residents.

In 2007, the NYPD stopped nearly 469,000 New Yorkers. Eighty-eight percent were found completely innocent of any wrongdoing. The racial disparity in the stop-and-frisk encounters is almost identical to the disparity in marijuana arrests: Though they make up only a quarter of the city’s population, more than half of those stopped were black.

Robin Steinberg, executive director of the Bronx Defenders, said the increase in marijuana arrests is linked to the quality of life initiative and the increase in NYPD stop-and-frisk street interrogations.

“If you work in this community for any length of time, you see it first hand – police randomly stopping and searching kids on the streets,” she said. “It’s no surprise that so many residents feel like they are living in a police state. The people in these neighborhoods are subject to a level of intense policing not found in affluent communities.”

Marijuana arrests do not reduce serious or violent crime. According to a study by two University of Chicago professors, these arrests only take police off the streets and divert them into nonessential police work. What they do succeed in is driving thousands of young men of color into the criminal justice system.

“By targeting black and Latino youth for misdemeanor marijuana arrests, the NYPD is labeling children with criminal records for offenses the law deems a violation, not a crime,” said Small, executive director of Break the Chains, a non-profit organization that advocates for reforms of punitive drug laws. “The consequences of the arrests follow these children for the rest of their lives. It was to avoid these consequences that marijuana possession was decriminalized in the first place. It is particularly perverse that black and Latino youth are being targeted for violating a law that was passed to reduce the likelihood that young people would acquire criminal records for possessing small amounts of marijuana.”

The majority of the nearly 400,000 people arrested for possessing marijuana were not carrying or smoking the drug in public. Most people simply had a small amount of marijuana in their possession, usually concealed in a pocket or backpack. New York State decriminalized marijuana possession in 1977, making it a violation like speeding or driving through a stop light. When police officers coerce or intimidate people into showing marijuana in the open, though, they are able to classify it as a misdemeanor and arrest for it.

“The criminal complaint always charges that they had it in open view,” Steinberg said of her clients in the Bronx. “That is preposterous. It’s obvious that everyone isn’t walking around carrying pot in open view.”

Police did not focus on marijuana arrests from 1977 through 1996, arresting around 30,000 people total in both decades for possessing less than an ounce of marijuana. But police equaled or topped that 10-year arrest total in nine of the next 11 years. In 2007 alone, police made 39,700 arrests for marijuana possession.

The NYPD, rarely shy about touting success, does not promote its record-breaking crackdown on small-time marijuana possession. The report identifies incentives for the NYPD to focus on marijuana arrests. For instance, the arrests provide police officers a relatively safe and easy way to demonstrate productivity, especially in an organization such as the NYPD that heavily relies on statistics to measure effectiveness. Among other benefits, the arrests also help officers accrue overtime pay. Supervisors use marijuana arrests to generate arrest records, facilitate supervision of police activities and show that their officers are productive.

The arrests also succeed in dramatically expanding the NYPD’s vast database of New Yorkers’ personal information. Each marijuana arrest brings a new set of fingerprints and photos into the NYPD’s extensive system.

Three former police chiefs of some of the nation’s largest cities have endorsed the report’s findings. All three of the former chiefs believe marijuana possession arrests are a waste of police resources that do not reduce violent crime.

“Illegal, trivial, meaningless arrests undermine confidence in the justice system and corrupt the enforcers,” said Anthony V. Bouza, a former NYPD commander in the Bronx who was chief of police in Minneapolis from 1980 to 1989. “New York’s marijuana arrests are counterproductive, a classic misapplication of police resources.”

Norm Stamper, Seattle’s police chief from 1994 to 2000, said the enormous spike in marijuana arrests negatively affects both law enforcement and the community.

“I do not believe the two New York City mayors and three police commissioners who have presided over these practices are motivated by personal racism,” Stamp said. “But the effects of these practices are deeply, undeniably discriminatory, as well as damaging to legitimate crime fighting, community relations and police morale.”

George Napper, Atlanta’s chief of police from 1990 to 1997, said the report reveals common policing patterns, including racially skewed stop-and-frisk searches, that are poorly understood by the general public.

“People who care about the fate of American cities and the incarceration of racial minorities should read this fine study,” Napper said. “As a New York City police officer quoted in the report says: ‘Welcome to the real world.’”

Among an extensive list of recommendations, the report urges policymakers to:

* Hold public hearings and thoroughly examine the costs, consequences, and racial, gender, age and class disparities of the NYPD’s marijuana arrest practices.
* Ensure that law enforcement of marijuana offenses is consistent with the intent of New York State law.
* Substantially increase the pay scale of police officers to reduce the need for overtime.
* Require the NYPD to provide the City Council and state detailed, accurate and timely data on its arrests, citations and other practices, and make that information public.

New York Civil Liberties Union. 125 Broad Street, New York, NY 10004 Phone 212-607-3300 Fax 212-607-3318 and 212-607-3329

Blacks more likely to be shot than whites even when holding harmless objects

ANTHONY G. GREENWALD, Present Position Professor of Psychology, University of Washington Adjunct Professor of Marketing and International Business, University of Washington Office Address: Department of Psychology, Box 351525, Univ. of Washington, Seattle, WA 98195-1525 Telephone: (206) 543-7227 ; FAX (206) 685-3157 Electronic mail: agg@u.washington.edu Home page: faculty.washington.edu

Given only a fraction of a second to respond to images of men popping out from behind a garbage Dumpster, people were more likely to shoot blacks than whites, even when the men were holding a harmless object such as a flashlight rather than a gun. The finding comes from a study that is was published in the Journal of Experimental Social Psychology. The research used a virtual reality simulation and was prompted by a number of mistaken shootings of unarmed blacks by police officers in recent years. It was directed by Anthony Greenwald, a University of Washington psychologist who examines the unconscious roots and levels of prejudice. Although the subjects in this study were college students, Greenwald said there is every reason to believe that police officers have the same prejudices or psychological perceptions about race as students. He bases that conclusion on data collected from hundreds of thousands of people who have taken versions of the Implicit Association Tests (IAT), including one that measures unconscious attitudes about people and weapons. The majority of people who have taken the tests exhibit some form of unconscious racial, ethnic, gender or age prejudice or stereotype.

The IAT was created by Greenwald, and developed in collaboration with Mahazarin Banaji, a Harvard University psychology professor and Brian Nosek, a University of Virginia assistant professor of psychology.

"Police receive training to make them more sensitive to weapons, but they don't get training to undo unconscious race stereotypes or biases," said Greenwald. "There are some very sophisticated simulators police officers can train on, but they are geared to weapons, not race. Bias awareness training could give officers the chance to discover and counteract automatic stereotypes that can interfere with the best performance of their duties."

In the study, more than a hundred college students, predominantly white or Asian, participated in two experiments in which they were asked to play the role of a plainclothes police officer. Their job was to take quick action in response to three categories of simulated potential targets: criminals, fellow officers and citizens. Students were given less than a second to respond -- eight-tenths of a second in experiment one and nine-tenths of a second in experiment two -- to figures that popped out from behind one of two Dumpsters. The subjects were instructed to "shoot" at criminals by pointing the mouse at them and then left clicking, to send a safety signal to fellow officers by pressing the spacebar, and to make no response to citizens.

All of the targets were dressed similarly in casual clothes. Subjects could distinguish police officers and criminals, both of whom held guns, from citizens, who carried harmless objects -- a camera, beer bottle or flashlight. The only feature that distinguished police officers from criminals was race. Each subject responded to two variations of the simulation. In one, white targets were criminals and blacks were police officers. In the other, the roles were reversed with blacks as criminals and whites as officers.

Greenwald said the time pressure subjects faced was comparable to conditions police officers sometimes encounter.

"Actually, police officers try to do whatever they can so as not to be forced to respond this quickly. But there are situations that do require them to respond this rapidly," he said

Data from the two experiments indicated that the subjects had greater difficulty distinguishing weapons from harmless objects in the hands of blacks than whites. They also were more likely to shoot when the target person was black, regardless of knowing what was in the person's hand. In the two experiments, whites were wrongly "shot" 26 percent of the time while blacks were wrongly "shot" 35 percent of the time, which is statistically significant.

The UW researchers looked at perceptual sensitivity or their subjects' abilities, in this case, to distinguish a weapon from a harmless object, and their response bias, or readiness to respond by shooting more readily at blacks than whites. Greenwald likened these processes to baseball, where perceptual sensitivity would be a batter's "eye" that tells a ball from a strike and response bias would be the readiness of the batter to swing at anything.

The study is the third in recent months to produce similar findings, but involved a task that may have come closer than the others to model the complexity of natural situations.

"The subjects were on edge because of the time pressure to respond quickly or do nothing in the case of civilians," said Greenwald. "The stress we created is like that of facing a weapon in a video game but it is not the same as the stress faced a by the police officer on the street. Ours is an analog of a high-stress situation of what an officer might encounter. In more realistic simulations for weapons training there are reports of officers with heart rates approaching 200 beats per minute.

"The practical value of our work is for people who manage police on the beat. Our studies and the previous ones lead to the conclusion that we need to look at what kind of training officers are receiving and what kind of training is needed to eventually overcome race-influenced errors that have resulted in blacks being hugely over-represented among victims of mistaken shootings by police."

Co-authors of the study are Mark Oaks, a psychology doctoral student, and Hunter Hoffman, a research engineer in the UW's Human Interface Technology Laboratory where the virtual reality simulation was created. The National Institute of Mental Health funded the research.

People may take the IAT test that measures unconscious attitudes about people and weapons at a Web site operated by the Southern Poverty Law Center at: tolerance.org/hidden_bias. The site also offers a number of other tests measuring other unconscious attitudes. ###

For more information, contact Greenwald at (206) 543-7227 or agg@u.washington.edu. He will be in Santa Fe, N.M., July 15-22 and can be reached at (505) 984-1420.

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

Suicide attempt rate for blacks higher than previously reported

Sean Joe: Assistant Professor of Social Work, Assistant Professor of Psychiatry and Faculty Associate, RCGD, I Degrees * BA, Africana Studies, 1991, State University of New York, Stony Brook; * MSW, Social Welfare, 1994, State University of New York, Stony Brook; * PhD, Social Work, 1999, University of Illinois at Urbana-Champaign Sean Joe's current research, funded by the National Institute of Mental Health, focuses on developing father-focused, family-based interventions to prevent urban, Black American, adolescent males from engaging in multiple forms of self-destructive behaviors, including suicidal behavior. Dr. Joe has published in the areas of suicide, violence, and firearm-related violence. His seminal review paper on suicide among Black Americans for the first national conference on suicide prevention remains the most thorough and thoughtful review of the topic. This effort contributed to the increasing rates of suicide among young, Black American males being highlighted in the Surgeon General's "Call to Action to Prevent Suicide."

ANN ARBOR, Mich.— Research indicates that blacks in the United States have a lifetime prevalence of attempted suicide of about 4 percent, a rate comparable with the general population, but higher than previous estimates. The University of Michigan findings—the first known national study that provides information about the prevalence of attempted suicide among blacks—appeared in the Journal of the American Medical Association. Suicide is the 11th leading cause of death among all Americans and the rates range across specific demographic subgroups. In recent years, suicide and nonfatal suicidal behavior have emerged as crucial health issues for blacks, particularly among older adolescents and young adults. Sean Joe, assistant professor at the U-M School of Social Work, and colleagues sought to determine national estimates of the lifetime prevalence and risk factors for suicidal thoughts, plans and attempts among blacks of African American and Caribbean ethnicity in the United States. The researchers used data from the National Survey of American Life (NSAL), a national sample of 5,181 black respondents age 18 and older, conducted between February 2001 and June 2003. The NSAL study was conducted by the Program for Research on Black Americans at U-M's Institute for Social Research. The estimated lifetime prevalence of suicide attempts among blacks in the United States was 4.1 percent; for suicidal thoughts, 11.7 percent. By comparison, the most recent data from the National Institute of Mental Health's Epidemiologic Catchment Area study for the period 1980-1984 had the lifetime estimate of attempted suicide among blacks at 2.3 percent. In Joe's study, among those who reported suicidal thoughts, 34.6 percent made a suicide plan and 21 percent made an unplanned attempt. Significant differences were found based on gender, with suicide attempts more prevalent among women (4.9 percent) than men (3.1 percent). The prevalence of suicide attempts was highest for Caribbean black men (7.5 percent), followed by African American women (5 percent). Risk of a suicide attempt and risk of suicidal thoughts were significantly associated with being younger, having a low education level, residing in the Midwest region of the United States, and having one or more psychiatric disorders. The researchers indicate the study's results should influence clinicians who screen patients for risk of suicide. For instance, clinicians should focus on modifiable risk factors—such as anxiety or depression—and should engage blacks in aggressive treatment in the high-risk period of the first year after the initial ideas of suicide and continue to observe patients who attempt suicide.

Clinicians must also consider, when screening blacks, the strong association of psychiatric disorders with the risk for suicide attempts, the greater likelihood for young adults to be impulsive and for older adults to engage in planned suicide attempts. It is also important that black patients at risk for impulsive attempts do not have access to firearms or medications that can be used to attempt suicide.

Contact: Jared Wadley Phone: (734) 936-7819 U-M School of Social Work

Family History Influences Cancer Screening

A new study indicates that African Americans with a family history of colorectal cancer are less likely to be screened than African Americans at average risk for the disease. There is also some evidence to indicate that AA with a family history are less likely to be screened than their white counterparts. The study is published in the July 15, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

African Americans have the highest colorectal cancer (CRC) incidence and death rates of all racial groups in the United States. The reason for this is thought to be multifactorial but remains poorly understood. Overall, African Americans have low rates of colorectal cancer screening compared to most other racial groups. Early detection is especially important for those with family histories of CRC who are at higher risk of developing the disease. Factors associated with CRC screening are not well understood for African Americans, both those with and without family histories of CRC.

To investigate the factors associated with risk-appropriate CRC screening, Kathleen Griffith, Ph.D., CRNP, of the Johns Hopkins University School of Nursing and colleagues at the University of Maryland Baltimore analyzed data from the 2002 Maryland Cancer Survey, a telephone survey of more than 5,000 Maryland residents, performed under the Maryland Cigarette Restitution Fund Program, to identify predictors of screening among African Americans.

The researchers' analyses revealed that for African Americans, regardless of family history, a health care provider's recommendation for colorectal cancer screening was strongly correlated with a higher likelihood of screening. Furthermore, individuals who were more physically active were also more likely to have been screened for colorectal cancer. Surprisingly, though, having a family history of colorectal cancer did not predict a higher likelihood of screening. In fact, the researchers found that African Americans with a family history were less likely to have received risk-appropriate screening than those without a family history. Family history of colorectal cancer is often associated with increased rates of screening in whites.

The authors say it is difficult to explain why a perception of increased risk, which is significantly higher in African Americans with a family history of CRC than in those without, did not translate into screening. Their findings suggest that other unknown or unmeasured factors may play a role is screening decisions. Additional studies to determine what those factors might be could lead to culturally tailored interventions designed to increase screening rates, which in turn could ultimately improve early detection and reduce colorectal cancer deaths in African Americans. "This study suggests that African Americans would benefit from a primary care approach that evaluates their risk factors for colorectal cancer, and provides corresponding recommendations for appropriate screening tests," the authors write.

Regular colorectal cancer screening is one of the most powerful weapons in preventing colorectal cancer. It can, in many cases, prevent colorectal cancer altogether. Experts estimate adherence to national screening guidelines could prevent up to eight in ten deaths from the disease. The American Cancer Society recommends that people at average risk begin screening for colorectal cancer at age 50. Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, as well as the third leading cause of cancer-related death among both men and women in the United States. ###

Article: "Influence of family history and preventive health behaviors on colorectal cancer screening in African Americans." Kathleen A. Griffith, Deborah B. McGuire, Renee Royak-Schaler, Keith O. Plowden, and Eileen K. Steinberger. CANCER; Published Online: June 9, 2008 (DOI: 10.1002/cncr.23550); Print Issue Date: July 15, 2008.

Contact: David Sampson david.sampson@cancer.org 213-368-8523 American Cancer Society

U.S. African American Buying Power to Hit $1.1 trillion by 2012

NewswireToday - /newswire/ - London, United Kingdom, - ReportBuyer.com, the online destination for business intelligence for major industry sectors, added a new report which forecasts that the buying power of 39 million African Americans will hit $1.1 trillion by 2012.

Report Buyer, has now added a new report which forecasts that the buying power of 39 million African Americans will hit $1.1 trillion by 2012. This buying power offers opportunities to marketers of a wide range of products and services.

“The African-American Market in the U.S” reports that in the U.S. there are 2.4 million affluent African-American households with household incomes of $75,000 or more. They account for 17% of all African-American households but 45% of total African-American buying power.

Data shows that companies offering luxury items and financial services are at a particular advantage, because affluent African Americans are even more likely than other affluent cohorts to spend money on luxury items such as cruise-ship holidays, new cars, designer clothes, as well as investing in life insurance.

Authors of the report note that the African-American cohort continues to be a significant consumer segment that in some ways exercises more economic clout than the ever popular Hispanic one. They say African Americans' purchasing behaviours can differ in many ways, ranging from what is bought at the grocery store to clothing style and magazine preferences. The authors argue that marketers should pay attention to these differences to execute marketing campaigns that target the many segments of this important demographic cohort.

”The African-American Market in the U.S.” provides a demographic analysis of the African-American population and an assessment of social and economic trends affecting African Americans today and in the future. A full assessment of African-American buying power presents their behaviours across a variety of areas. This data-rich report also analyses how African Americans spend their leisure time and money offering solid support to marketers targeting African-American consumers.

“The African-American Market in the U.S” is available from Report Buyer. For more information, see website.

Report Buyer product ID: PKF00090

About Report Buyer: Report Buyer is a UK-based independent online store supplying business information. The website now carries over 70,000 business information products, including market reports, studies, books and events. Subscribers receive a free monthly newsletter and email alerts on new titles in their areas of interest. A regularly updated blog provides information on the latest market trends.

IMAGE LICENCE: Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation license, Version 1.2 or any later version published by the Free Software Foundation; with no Invariant Sections, no Front-Cover Texts, and no Back-Cover Texts. A copy of the license is included in the section entitled "GNU Free Documentation license".

Known genetic risk for Alzheimer's in whites also places blacks at risk

Dr. Natalie Sachs-Ericsson. Phone Number: 644-4576 Email : sachs@psy.fsu.edu, Dr. Natalie J. Sachs-Ericsson HomePage

A commonly recognized gene that places one at risk for Alzheimer's disease does not discriminate between blacks and whites, according to new research led by Florida State University. FSU Psychology Professor Natalie Sachs-Ericsson and graduate student Kathryn Sawyer have found that the gene APOE epsilon 4 allele is a risk factor for African-Americans as well as whites. Until now, it has been a mainstream belief that the gene is only a risk factor for whites.

"The results of our study have clear implications for research and treatment of Alzheimer's disease," Sachs-Ericsson said. "The APOE test might be used as one tool in identifying people who are at risk for Alzheimer's. We now know that African-Americans and Caucasians alike need to be considered for such risk assessments."

Sachs-Ericsson and Sawyer collaborated with Kristopher Preacher of the University of Kansas and Dan Blazer of Duke University Medical Center on the study. The study has been published online in the journal Gerontology.

The researchers' findings underscore the importance of including both blacks and whites in future studies that explore why the APOE genotype is a risk factor for Alzheimer's disease, a progressive and fatal brain disease that causes problems with memory, thinking and behavior. By understanding the mechanism by which the genotype confers risk, scientists could potentially develop medicines that slow the progress of Alzheimer's or even prevent it, according to Sachs-Ericsson.

Sachs-Ericsson's team theorized that small sample sizes coupled with possible racial bias in measuring cognitive functioning may explain why some studies have failed to detect the effect of the APOE epsilon 4 allele on cognitive decline among blacks.

In addition, false-positive rates for dementia on standardized screening tests are higher for blacks than for whites when compared to neurologists' ratings of cognitive status, Sachs-Ericsson said, and those false positives may have obscured the influence of the gene on dementia. Alzheimer's disease is the most common form of dementia.

Alleles are different variants of a gene. Everyone has the APOE gene, but what differs across people is which variant they happen to have: epsilon 2, epsilon 3 or epsilon 4. In addition, each person has two alleles of the gene—one from the mother and one from the father. Having at least one APOE epsilon 4 allele is a risk factor for Alzheimer's, but not everyone who has it will develop the disease, Sachs-Ericsson said. And some people who develop Alzheimer's do not have the allele.

"While having the APOE epsilon 4 allele increases the risk of developing Alzheimer's disease, APOE genotype alone is not enough to predict the disease," she said. "We don't understand why the allele predicts Alzheimer's in some but not others. There may be other biological or genetic causes or even environmental factors, such as diet, that determine whether the allele will lead to Alzheimer's. We need a better understanding of what these factors are and whether they affect African Americans and Caucasians equally."

The researchers used data from the Duke Established Populations for Epidemiologic Studies of the Elderly. To determine genotype, DNA samples were collected through blood or cheek swabs from 2,076 people 65 or older.

In the study, participants were divided into two groups: those who had at least one APOE epsilon 4 allele and those who had no epsilon 4 allele. Cognitive errors on a standardized test were measured in four in-person interviews over a 10-year period ending in 1997. Those with the gene—both blacks and whites—made increasingly more cognitive errors over time on a questionnaire that assessed knowledge of items such as the day, date and current president than those without the gene.

To view the article, "Racial Differences in the Influence of the APOE Epsilon 4 Allele on Cognitive Decline in a Sample of Community-Dwelling Older Adults," visit Gerontology.

Contact: Natalie Sachs-Ericsson sachs@psy.fsu.edu 850-644-4576 Florida State University

Tight blood pressure control not enough to temper kidney disease in African-Americans

Lawrence J. Appel Professor of Medicine; Core Faculty, Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University. Joint Departmental Affiliations: Epidemiology and International Health, Bloomberg School of Public Health. Academic Degrees: AB, Dartmouth College, 1977; MD, New York University School of Medicine, 1981; MPH, Johns Hopkins University, 1989. Contact: E-mail: lappel@jhmi.edu Phone: (410) 955-4156, Fax: (410) 955-0476. Research and Professional Interests: Clinical investigation in cardiovascular disease, Hypertension. Link to Dr. Appel's publications: PubMed database

Other unknown factors at play in worsening this condition Even when their blood pressure is kept strictly under control with the best available medicine, African-American patients with chronic kidney disease (CKD) continue to lose their kidney function over time, research led by a Johns Hopkins team shows. The finding suggests that treating CKD in this population may be vastly more complex than researchers had previously thought, with blood pressure control being only one piece of the therapeutic puzzle. The study, called AASK (African-American Study of Kidney Disease and Hypertension), is the longest to date focusing on blood pressure in patients with CKD. AASK followed 1,094 African-American patients with this condition for up to 11 years. Through a combination of medications, most of these patients kept their blood pressure in the recommended range for CKD, lower than 130/80. However, the vast majority still went on to develop steadily worsening kidney function, often leading to dialysis, kidney transplantation, or death. “Kidney disease still progressed at an alarming rate, even when our participants received outstanding medical care for their high blood pressure,” says study leader Lawrence Appel, M.D., professor of medicine at the Johns Hopkins School of Medicine. “Blood pressure is important, but it’s not the whole picture. We still have a long way to go in figuring out the best way to treat patients with CKD.”

Appel and his colleagues at 21 clinical centers across the country chose to focus their study on African Americans, who suffer disproportionately from kidney disease associated with high blood pressure. In whites, high blood pressure causes about 19 percent of all end-stage renal disease cases, in which kidneys have essentially lost their function. In African-Americans, the corresponding figure is about 37 percent.

Researchers aren’t sure why high blood pressure often leads to CKD. The prevailing theory is that high pressure strains delicate tufts of capillaries known as glomeruli, which filter blood and create urine in kidneys.

To investigate whether keeping blood pressure low would slow or possibly stop CKD progression, the researchers designed their study in two phases; the first would take place between February 1995 and September 2001, and the second between October 2001 and June 2007.

In the first phase, the researchers randomly assigned all 1,094 patients to one of three drugs commonly used to lower blood pressure-an ACE inhibitor, a ?-blocker, or a calcium channel blocker. Each patient was also assigned to one of two blood pressure goals-a standard goal (about 140/90 or lower), and a more aggressive goal (130/80 or lower). The researchers tracked each patient’s blood pressure and kidney function, determined through blood and urine tests, as well as their overall health.

At the end of the first phase, the researchers found that about a third of the patients had lost at least half their kidney function, developed end-stage renal disease, or died, even though almost all of the patients were well within their blood pressure goals. Of the remaining patients, the scientists recruited 759 to continue on to the study’s next phase, in which they capitalized on what they’d learned so far. Early findings from the first phase showed that the ACE inhibitor worked better than the other treatments, so the remaining patients began taking that drug. They were also given the more aggressive blood pressure goal of 130/80.

“Kidney disease still progressed at an alarming rate, even when our participants received outstanding medical care for their high blood pressure,” says study leader Lawrence Appel, M.D., professor of medicine at the Johns Hopkins School of Medicine. “Blood pressure is important, but it’s not the whole picture. We still have a long way to go in figuring out the best way to treat patients with CKD.”

Appel and his colleagues at 21 clinical centers across the country chose to focus their study on African Americans, who suffer disproportionately from kidney disease associated with high blood pressure. In whites, high blood pressure causes about 19 percent of all end-stage renal disease cases, in which kidneys have essentially lost their function. In African-Americans, the corresponding figure is about 37 percent.

Researchers aren’t sure why high blood pressure often leads to CKD. The prevailing theory is that high pressure strains delicate tufts of capillaries known as glomeruli, which filter blood and create urine in kidneys.

To investigate whether keeping blood pressure low would slow or possibly stop CKD progression, the researchers designed their study in two phases; the first would take place between February 1995 and September 2001, and the second between October 2001 and June 2007.

In the first phase, the researchers randomly assigned all 1,094 patients to one of three drugs commonly used to lower blood pressure-an ACE inhibitor, a â-blocker, or a calcium channel blocker. Each patient was also assigned to one of two blood pressure goals-a standard goal (about 140/90 or lower), and a more aggressive goal (130/80 or lower). The researchers tracked each patient’s blood pressure and kidney function, determined through blood and urine tests, as well as their overall health.

At the end of the first phase, the researchers found that about a third of the patients had lost at least half their kidney function, developed end-stage renal disease, or died, even though almost all of the patients were well within their blood pressure goals. Of the remaining patients, the scientists recruited 759 to continue on to the study’s next phase, in which they capitalized on what they’d learned so far. Early findings from the first phase showed that the ACE inhibitor worked better than the other treatments, so the remaining patients began taking that drug. They were also given the more aggressive blood pressure goal of 130/80.

Over the next five years, the researchers again tracked patients’ blood pressure, kidney function, and overall health. However, regardless of their new and improved treatment, a third of these patients still lost at least half their kidney function, developed end-stage renal disease, or died.

These results, published in the April 28 Archives of Internal Medicine, shouldn’t discourage patients with CKD from continuing their blood pressure therapy, says Appel. “Outcomes would certainly be worse if they didn’t control their blood pressure,” he explains. However, he adds that the findings suggest that other factors beyond just blood pressure may be at play in worsening CKD. Blood pressure spikes at night, high salt intake, or exposure to heavy metals like lead or mercury may influence kidney disease progression. “Lots of different factors need examining,” says Appel.

He and his colleagues plan to investigate these additional factors in future studies. ###

This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center for Minority Health and Health Disparities, and King Pharmaceuticals Company.

Another Hopkins researcher contributing to the study was Jeanne Charleston, R.N.

For more information, go to::

• hopkinsmedicine.org/gim/faculty/
• hopkinsmedicine.org/gim/

Johns Hopkins Medical Institutions Media Relations and Public Affairs Media Contact: Christen Brownlee 410-955-7832; cbrownlee@jhmi.edu

Rising Up a documentary on the civil rights era

Rising Up a documentary on the civil rights era Produced by William G. Thomas, Bill Reifenberger, and the University of Virginia (50 minutes)

Rising Up is a documentary film of the African American experience in the civil rights era. The film broadly covers the South, but concentrates on Virginia and follows major events with close, personal stories, including: Samuel W. Tucker's 1939 library sit-in, Irene Morgan's 1946 busing case before the Supreme Court, the school desegregation crisis in 1958-59, the 1960 sit-ins, the violence of Danville and Birmingham in 1963, and the resurgence of black voting and politics in 1965.

What made everyday people decide to take a stand in a time of transition and cultural conflict? This is the question at the heart of Rising Up. In asking it and answering it, the film hopes to bring a fresh perspective to the civil rights struggle.

These images from Rising Up are for press materials and use in print publications about the film. The images feature the confrontation on the court house steps in Danville, Virginia in the summer of 1963 between civil rights demonstrators and Danville police. All images courtesy of the Library of Virginia.

What makes this documentary fresh is that it includes recently uncovered local television news coverage of the events combined with interviews of participants seen in these old films. Rare footage from WDBJ and WSLS in Roanoke, Virginia, feature not only local participants but also such regional and national figures as Rev. Dr. Martin Luther King, Jr., Rev. Fred Shuttlesworth, John F. Kennedy, James J. Kilpatrick, Oliver Hill, Robert Zellner, and Roy Wilkins. It includes a rarely seen and remarkable NBC News debate between James J. Kilpatrick, Jr., a leading news editor in the South, and Rev. Dr. Martin Luther King, Jr., on whether the sit-ins were justified.

It features, as well, a rarely seen speech from Rev. Dr. King on the violence at Danville in 1963. This film is also different because it is created from the perspectives of young people today. Rising Up is written, directed, narrated, filmed, and edited by a talented group of undergraduate students at the University of Virginia. Their remarkable approach to this history is evident in the visual storytelling and powerful images they assembled. The score includes original works by University of Virginia students and music from Sweet Honey and the Rock™. Rising Up takes viewers through a series of stories about how everyday Americans were moved to take a stand.

These images from Rising Up are for press materials and use in print publications about the film. The images feature the confrontation on the court house steps in Danville, Virginia in the summer of 1963 between civil rights demonstrators and Danville police. All images courtesy of the Library of Virginia.

Along the way it tells a stirring story of the history of the civil rights struggle, one that will inform, appeal to, and inspire viewers.

Rising Up:

• Virginia’s Civil Rights Movement - the African American experience in the civil rights era.
• Television News of the Civil Rights Era 1950-1970 - aims to collect, digitize, and present in streaming video format over the World Wide Web television news footage from the period.

For Program Broadcast Information Contact: Mr. John Felton Vice-President and General Manager WCVE Richmond PBS, The Community Ideas Stations 23 Sesame Street Richmond, VA 23235 jfelton@ideastations.org 804-560-8120

SCLC Places Archive at Emory

Participants, some carrying American flags, marching in the civil rights march from Selma to Montgomery, Alabama in 1965

Historical Records to Become Destination for Civil Rights Research Emory University and the Southern Christian Leadership Conference (SCLC) announced March 6 that the SCLC has placed its archive with Emory's Manuscript, Archives, and Rare Book Library (MARBL).

"Emory is delighted to care for, catalog and share this unique intellectual resource with visitors from around the city and the world," says Emory Provost Earl Lewis. "SCLC played a signal role in the nation's struggles over civil rights. By helping to preserve that legacy we honor the past by connecting it to the present and the future."

"Placing the SCLC archive with Emory ensures that the organization's materials will enrich understanding of history, culture and non-violence for generations to come," says SCLC President Charles Steele.

The SCLC was co-founded in New Orleans, La., on Feb. 14, 1957, by Martin Luther King, Jr. and other African American leaders from across the South with the purpose of advancing the cause of racial equality. Its archive, contained in 1,100 boxes, is the second-largest collection placed with MARBL, surpassed in size only by the Sam Nunn congressional archive. The bulk of the SCLC materials date from 1968 to 1977, during the terms of SCLC's two longest-serving presidents: Ralph David Abernathy and Joseph Lowery.

The civil rights march from Selma to Montgomery, Alabama in 1965. Photograph shows some participants in the civil rights march sitting on a wall resting, one holds a placard which reads, "We march together, Catholics, Jews, Protestant, for dignity and brotherhood of all men under God, Now!"

SCLC Archive Photos Document Civil Rights Movement

Included in the archive are correspondence; press releases, speeches and other SCLC staff writings; SCLC publications; membership records; clippings and other collected print materials; photographs; audio cassette tapes; and videotapes.

Some highlights of the collection include:

• Photographs documenting aspects of the Civil Rights movement such as voter registration workshops, Freedom Summer and the Freedom Schools.

• A number of drafts of speeches by Ralph Abernathy and others, many heavily annotated in the hands of their authors.

• Thousands of sympathy cards and letters expressing grief and outrage at the assassination of Martin Luther King Jr.

• Letters from individuals and organizations from across the nation seeking assistance in local political organization or help in dealing with violations of civil rights.

The archive will complement the SCLC papers, most pre-1968, that are held by the King Library and Archives at the King Center in Atlanta. They also will enhance the holdings of African American and civil rights collections throughout Atlanta.

SCLC and Emory Announce Archive Acquisition at Press Conference

• Video - Press Conference: Presentations
• Video - Press Conference: Q&A ###

The SCLC is nonprofit, non-sectarian, inter-faith, advocacy organization that is committed to non-violent action to achieve social, economic and political justice. The SCLC consists of local chapters and affiliates from around the world that supports the mission of the international organization, and work in their own communities to implement programs such as conflict resolution, voter registration, improvement of education and direct action against racial injustice. Established in 1957 by Dr. Martin Luther King, Jr. and others, the SCLC is dedicated to promoting human rights throughout the United States and abroad.

The Emory University Libraries (www.web.library.emory.edu) in Atlanta and Oxford, Ga., are the intellectual commons of their campuses and their communities. They are dedicated to fostering courageous inquiry among students and scholars at Emory University, Oxford College and around the world. The nine libraries' holdings include more than 3.1 million print and electronic volumes, 40,000-plus electronic journals, and internationally renowned special collections.

Emory University (www.emory.edu) is one of the nation’s leading private research universities and a member of the Association of American Universities. Known for its demanding academics, outstanding undergraduate college of arts and sciences, highly ranked professional schools and state-of-the-art research facilities, Emory is ranked as one of the country's top 20 national universities by U.S. News & World Report. In addition to its nine schools, the university encompasses The Carter Center, Yerkes National Primate Research Center and Emory Healthcare, the state's largest and most comprehensive health care system.

Contact: Elaine Justice of Emory University, 404-727-0643, elaine.justice@emory.edu. Contact: Keisha Ray of SCLC, 404-522-1420 ext. 23, keisharay_ray@yahoo.com

The papers of Annie Bethel Spencer go to the University of Virginia

The UVa Library's latest building, showing the Harrison Institute and skylights over the below-ground Small Special Collections Library. Alderman Library is on the right.

The papers of Annie Bethel Spencer (Lynchburg, Virginia) better known as Anne Spencer (1882-1975) one of the most important voices of the Harlem Renaissance literary period go to the University of Virginia's Small Special Collections Library. Anne Spencer acquisition

Ms. Spencer was an Black American poet and participant of the New Negro Movement.

She was the first Virginian and African-American to have poetry included in the Norton Anthology of American Poetry and is remembered as an activist for equality and educational opportunities.

During her long and productive life, Anne Spencer was recognized as a lyric poet of considerable talent. Since her death, she has attained fame not only as a writer, but as a cultural leader. Given that she was both black and female, her achievement of recognition from her intellectual peers was a remarkable feat.

Anne Spencer was born in February 1882 on a plantation in Henry County, Virginia. Her
father was a former slave, and her mother was the daughter of a former slave and a wealthy Virginia aristocrat. In 1886 she and her mother moved to Bramwell, West Virginia, where she lived until entering the Virginia Seminary and Normal School in Lynchburg in 1893. At the age of 17, she graduated as valedictorian of her class. In 1901 she married Edward Alexander Spencer, and the couple moved to the house on Pierce Street in Lynchburg.

Anne Spencer's devotion to the cause of cultural enlightenment for African Americans
was expressed in her local activities as librarian and educator and in the lively rapport she maintained with many of the nation's most noted black leaders. Among the prominent visitors to the house were Langston Hughes, Countee Cullen, Georgia Douglas Johnston, W. E. B. Du Bois, Dr. Martin Luther King, Jr., Thurgood Marshall, and Adam Clayton Powell, Jr.

Anne Spencer House, Study, 1313 Pierce Street, Lynchburg, VA. Historic American Buildings Survey, Historic American Engineering Record.

The house and the small study in the garden where she worked were built largely by Edward Spencer. Both remain virtually undisturbed, containing original decorations, furniture, books, and personal belongings in place as Anne Spencer kept them. [B 12/6/76 NHL, 76002224] Anne Spencer House 1313 Pierce Street Lynchburg Listed: 1976-12-06 in PDFformat

• Lynchburg icon, poet Anne Spencer’s works turned over to UVa - VIDEO, Anne Spencer is considered one of the most important voices of the Harlem Renaissance literary period, from 1925-1935
• Modern American Poetry - Anne Spencer (1882-1975
• Anne Bethel Spencer - Once the world was young, For I was twenty and very old, And you and I knew all the answers

University of Virginia Library Acquires Papers of Civil Rights Leader Julian Bond

The University of Virginia Library has acquired the personal papers of civil rights activist, former Georgia state senator and representative, National Association for the Advancement of Colored People (NAACP) chairman, and university professor Julian Bond.

One of the first African Americans to reach national prominence in politics, Bond began his political career in as a founder of the Student Nonviolent Coordinating Committee (SNCC), known for its voter registration drives in the South.

The collection holds 47,000 items, including photographs, recordings, and drafts of more than three hundred speeches. It contains Bond’s correspondence with influential civil rights activists, and memorabilia from the many organizations, schools, and events that he supported. The collection also chronicles Bond’s service in the Georgia General Assembly, and documents his 1976 presidential run and leadership of the NAACP. The papers complement the Library’s existing collection of records of the Southern Elections Fund, an early political action committee that Bond founded to aid the election of rural Southern black candidates.

“The Bond Papers give us a fascinating picture of an extraordinary life,” said Karin Wittenborg, University Librarian. “The collection is a wonderful addition to the study of history and the civil rights movement here at U.Va., and I look forward to seeing them used by students and faculty.”

“I am overjoyed that my papers have found a home at the University of Virginia Library,” said Mr. Bond. “The University is where I’ve spent the bulk of my academic career and where scholarship of the civil rights era is valued. I hope scholars and students will find the Bond papers a useful resource in helping shape future thinking about the civil rights era.”

The holder of twenty-five honorary degrees, Bond is a Professor in the Corcoran Department of History at the University of Virginia and a Distinguished Scholar in Residence at American University in Washington, D.C. In 2002, he received the Freedom Award from the National Civil Rights Museum. The Bond Papers are described in the Library’s online catalog and can be viewed in the Albert and Small Special Collections Library on U.Va.’s central Grounds. ###

RELATED:

• Descriptions of the Julian Bond Papers in the Library’s online catalog (search on “Julian Bond Papers”): virgo.lib.virginia.edu/
• Information on the Albert and Shirley Small Special Collections Library: lib.virginia.edu/small/
• Library Hours: lib.virginia.edu/hours/

Press Contact: Charlotte Morford, Dir. of Communications, U.Va. Library 434) 924-7041, cwm6z@virginia.edu

Mother's obesity a factor in newborn deaths for blacks, not whites, new study reports

Hamisu M. Salihu, MD, PhD, Associate Professor. Epidemiology & Biostatistics Dr. Hamisu Salihu received his MD from University of Saarland in Germany in 1995. He earned his PhD from University of Saarland in Perinatology in 1996 and then got his PhD from University of South Florida in Epidemiology 2001. He came to us from the University of Alabama at Birmingham where he served as Associate Professor in the Department of Obstetrics & Gynecology.

A study led by the University of South Florida sheds new light on obesity’s role in the black-white gap in infant mortality. While maternal obesity appears to have no impact on the early survival of infants born to white women, the situation is different for black women, researchers report in the June 2008 issue of the journal Obstetrics & Gynecology. Infants of obese black mothers had a higher risk of death in the first 27 days following birth than newborns of obese white mothers, the researchers found. Furthermore, this black disadvantage in neonatal infant mortality widened with an increase in the body mass index (BMI). “Even if the infant of an obese black woman survives pregnancy, labor and delivery, that baby is at greater risk of dying than a baby born to an obese white woman,” said the study’s lead author Hamisu Salihu, MD, PhD, associate professor of epidemiology at the USF College of Public Health.

The researchers analyzed more than 1.4 million births recorded from Missouri’s vital records database, covering the period 1978 through 1997. The database linked black and white mother-infant pairs. Among all women, the likelihood of neonatal death (up to 27 days following death) and early neonatal death (up to six days following death) was 20 percent greater than for nonobese women, the researcher found.

Further analysis revealed that the higher risk of neonatal deaths among newborns of obese mothers was confined to blacks only. The rate of neonatal deaths increased significantly with rising BMIs of black women (ranging from 50 to 100-percent increments). However, the offspring of obese white mothers, regardless of the severity of maternal obesity, had no greater risk of neonatal death than the newborns of nonobese women.

The black-white disparity in infant mortality persisted even when the researchers adjusted for certain obesity-associated medical complications more prevalent in black women — high blood pressure, diabetes and preeclampsia.

“This further confirms our findings that high BMI is an independent risk factor for neonatal mortality among blacks but not whites,” Dr. Salihu said.

The researchers also controlled for the amount of prenatal care received since another possible explanation for the black-white disparity may be that obese white women have better access to prenatal care than black women. Their results suggested otherwise, but Dr. Salihu cautions that more study is needed. “We cannot dismiss access to care as a factor because the quantity of prenatal care does not take into account the quality of care received,” he said.

Dr. Salihu suggests that differences in the way fat is distributed in white and black women may play a role in their newborns’ survival. Studies have shown that fat tucked deep inside the waistline may be worse for adults’ health than fat padding the rest of the body. “If we can understand more about the potential association between fat distribution in mothers and likelihood of death in their babies, we might have an avenue for prevention and narrowing the persistent black-white gap in infant mortality,” he said.

The latest study builds on another published last year by Dr. Salihu and colleagues, which reported that the risk for obesity-associated stillbirth was 50 percent greater among blacks than whites.

Dr. Salihu is director of the Center for Research and Evaluation at the Chiles Center for Healthy Mothers and Babies at USF. The study was supported by a young clinical scientist award to Dr. Salihu by the Flight Attendant Medical Research Institute. Researchers from UMDNJ School of Public Health in New Jersey and the University of Alabama in Birmingham were coauthors of the study.

USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With $308 million in research funding last year, USF is one of the nation’s top 63 public research universities and one of Florida’s top three research universities.

Contact: Anne DeLotto Baier abaier@health.usf.edu 813-974-3300 University of South Florida Health

Black patients with terminal cancer more likely to choose aggressive care at end of life

Holly Gwen Prigerson, PhD. Dana-Farber Cancer Institute. 44 Binney Street. Shields Warren 440A. Boston, MA 02115. Office phone: (617) 632-2369. Appointment phone: (617) 632-2369. Fax: (617) 582-8017, E-mail: Holly_Prigerson@dfci.harvard.edu Dr. Prigerson has studied psychosocial factors that influence the quality of life and care received by terminally ill patients and factors influencing caregiver adjustment both before and after the death of a loved one since her dissertation work at Stanford in the late 1980s. She completed a postdoctoral fellowship in the Epidemiology of Aging at Yale University and then was funded by the NIMH for a K-award to study psychosocial factors in bereavement-related depression while an Assistant Professor of Psychiatry at Western Psychiatric Institute and Clinic in Pittsburgh. Dr. Prigerson moved to Dana-Farber Cancer Institute to assume leadership of the Center for Psychooncology and Palliative Care Research, with an academic appointment as Associate Professor of Psychiatry at Brigham and Women's Hospital, Harvard Medical School. She is now involved with a wide variety of research projects including intervention studies for Complicated Grief, a study to improve the cardiovascular health of recently bereaved cancer patient caregivers, and the factors influencing equanimity in the acknowledgement of terminal illness.

CHICAGO—Black patients with advanced cancer were more likely than whites to die in a hospital intensive care unit, reflecting a greater preference among blacks for life-extending treatment even in the face of a terminal prognosis, according to a study led by researchers at Dana-Farber Cancer Institute in Boston. The findings (abstract 6506) will be presented at the annual meeting of the American Society of Clinical Oncology in Chicago on Monday, June 2, 3 - 6 p.m. CT, South Building, Hall100B. The report included interview data showing that blacks more often answered yes to questions such as, "Would you want the doctors here to do everything they can to keep you alive, even if you were going to die in a day or two?" "This is the first study focused on black/white differences that prospectively asked [terminal cancer patients] what kind of care they wanted at the end of life, and then documented the kind of care they actually received and the place of their death," said Elizabeth Trice, MD, PhD, of Dana-Farber, lead author. Although they ruled out a number of possible explanations for the black/white differences, the investigators weren't able to identify precisely why blacks tended to prefer more-aggressive care. "There is something different about the way black patients and white patients approach the end of life," Trice said, which may be based in cultural attitudes, religious beliefs, and how thoroughly they have been informed about and comprehend their prognosis, among other things. Data on the preferences was obtained from the Coping with Cancer study led by Holly Prigerson, PhD, director of the Center for Psycho-social Oncology and Palliative Care Research at Dana-Farber and an associate professor of psychiatry at Harvard Medical School. That study is recruiting 800 cancer patients and their informal caregivers, such as family members. The researchers recorded the location of death for 231 white and 61 black patients who had stage IV metastatic cancer, and who had been interviewed when they entered the study. Black patients were over four times more likely to die in a hospital ICU than white patients, they found.

The researchers, using multivariable models, found that the increased likelihood of dying in the ICU for black compared to white patients was not explained by differences in education, physical or mental health, insurance, social support, doctor-patient communication, or advance care planning, when taking into account the patient's own preference for more-aggressive care. It was clear that a patient's preference for aggressive care was the strongest factor in predicting death in an ICU.

In their initial interviews, black patients reported having a higher quality of life than their white counterparts and appeared more at peace, Trice said, which could be a factor in opting for a treatment plan aimed at extending life.

Prigerson, the senior author of the study, said the crucial question to be explored is whether the treatment preferences that explain the black/white disparities in ICU death are informed preferences or not. Toward that end, Trice has developed a research tool for assessing patients' knowledge of risks and benefits of life-extending therapies. If further research determines that blacks and whites are not equally well-informed about these risks and benefits, interventions aimed at eliminating this disparity should be considered, said the scientists. ###

The study's co-authors are Matthew Nilsson, Alexi Wright, MD, Tracy Balboni, MD, K. "Vish" Viswanath, PhD, and Karen Emmons, PhD, of Dana-Farber; Susan DeSanto-Madeya, RN, DNS, of the University of Massachusetts, Boston; and M. Elizabeth Paulk, MD, and Heather Stieglitz, PhD, of the University of Texas Southwestern Medical Center, Dallas.

Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.

Contact: Bill Schaller william_schaller@dfci.harvard.edu 617-632-5357 Dana-Farber Cancer Institute

African-American veterans are less likely to adhere to CPAP than caucasian or Asian veterans

"Above and Beyond the Call of Duty." Dorie Miller with his Navy Cross at Pearl Harbor, May 27, 1942. Color-offset poster. Prints and Photographs Division. Reproduction Number: LC-USZC4-2328 (8-10)

WESTCHESTER, Ill. – African-American war veterans are significantly less likely to adhere to continuous positive airway pressure (CPAP) than Caucasian or Asian veterans, according to a research abstract that will be presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies(APSS). The study, authored by Skai W. Schwartz, of the University of South Florida, focused on 1,486 patients who were prescribed and tried CPAP between 2003-2007. Adherence information was captured on a data card by a CPAP micro-recording device. Patients were asked to return cards by mail at one month, one year and two years. Adherence was defined as percentage of days that the device was used for four or more hours.

According to the results, African-Americans were significantly less likely to use CPAP than Caucasians at all time points, as well as Asians.

“Given the importance of CPAP adherence, research into physical characteristics (e.g., anatomical versus obese etiology) or cultural differences may be warranted to explain the disparity,” said Schwartz.

First introduced as a treatment option for sleep apnea in 1981, CPAP is the most common and effective treatment for obstructive sleep apnea (OSA). CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.

On average, most adults need seven to eight hours of nightly sleep to feel alert and well-rested.

The American Academy of Sleep Medicine AASM) offers the following tips on how to get a good night’s sleep:

* Follow a consistent bedtime routine.
* Establish a relaxing setting at bedtime.
* Get a full night’s sleep every night.
* Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
* Do not go to bed hungry, but don’t eat a big meal before bedtime either.
* Avoid any rigorous exercise within six hours of your bedtime.
* Make your bedroom quiet, dark and a little bit cool.
* Get up at the same time every morning.

Those who think they might have OSA, or another sleep disorder, are urged to consult with their primary care physician or a sleep specialist.

CPAP Central (www.SleepEducation.com/CPAPCentral), a Web site created by the AASM, provides the public with comprehensive, accurate and reliable information about CPAP. CPAP Central includes expanded information about OSA and CPAP, including how OSA is diagnosed, the function of CPAP, the benefits of CPAP and an overview of what to expect when beginning CPAP, the position of experts on CPAP, and tools for success. CPAP Central also features an interactive slide set that educates the public about the warning signs of OSA.

The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.

More than 1,150 research abstracts will be presented at the SLEEP meeting, a joint venture of the AASM and the Sleep Research Society. The three-and-a-half-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

SleepEducation.com, a patient education Web site created by the AASM, provides information about various sleep disorders, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.

Abstract Title: Demographic Predictors of CPAP Adherence Among Veterans. Presentation Date: Monday, June 9. Category: Sleep Related Breathing Disorders. Abstract ID: 0556
Lead Author: Skai Schwartz. Contact: W. McDowell Anderson, MD. Phone: Cell - (813) 972-7543. E-mail: william.anderson@med.va.gov # # #

Contact: Kathleen McCann kmccann@aasmnet.org 708-492-0930 American Academy of Sleep Medicine

Racial disparities exist among diabetes patients treated by the same physician

Harvard Medical School. Department of Health Care Policy. 180 Longwood Avenue, Boston, MA 02115-5899, E-mail Thomas D. Sequist, MD, MPH. Phone: 1 617-432-3447, Fax: 1 617-432-3696. Thomas D. Sequist, MD, MPH, is an assistant professor of medicine and of health care policy at Harvard Medical School and Brigham and Women’s Hospital. He currently practices general internal medicine at Harvard Vanguard Medical Associates. Thomas D. Sequist, MD, MPH

Black patients with diabetes are less likely than white patients to achieve long-term control of their blood glucose, blood cholesterol and blood pressure levels, even when they are treated by the same physician, according to a report in the June 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Racial disparities in the quality of diabetes care have been previously documented, according to background information in the article. Black patients with diabetes are less likely to receive recommended components of care, including hemoglobin A1C testing (HbA1C, a measure of blood glucose control over time) and lipid testing, and to achieve treatment goals, such as controlled blood pressure, cholesterol and blood glucose levels. In addition, black patients are more likely than white patients to develop diabetes-related eye and kidney disease and to have amputations of their lower extremities. "Identifying the underlying reasons and potential solutions for these differences in quality of care and outcomes is a high priority," the authors write. Thomas D. Sequist, M.D., M.P.H., of Harvard Vanguard Medical Associates, Boston, and colleagues analyzed electronic medical records from 4,556 white patients and 2,258 black patients with diabetes treated by 90 primary care physicians in eastern Massachusetts.

Each physician treated at least five black patients and five white patients; all patients were age 18 or older and had visited the physician within the last two years.

Black patients and white patients received tests of low-density lipoprotein (LDL or "bad") cholesterol and HbA1C at similar rates. However, white patients were more likely than black patients to reach commonly accepted benchmarks for controlled levels of HbA1C (47 percent vs. 39 percent), LDL cholesterol (57 percent vs. 45 percent) and blood pressure (30 percent vs. 24 percent).

"Patient sociodemographic factors explained 13 percent to 38 percent of the racial differences in these measures, whereas within-physician effects accounted for 66 percent to 75 percent of the differences," the authors write. "Thus, racial differences in outcomes were not related to black patients differentially receiving care from physicians who provide a lower quality of care, but rather that black patients experienced less ideal or even adequate outcomes than white patients within the same physician panel."

The variation in diabetes care was not related to overall performance or the volume of black patients treated by individual physicians, the authors note. "Our data suggest that the problem of racial disparities is not characterized by only a few physicians providing markedly unequal care, but that such differences in care are spread across the entire system, requiring the implementation of system-wide solutions," they write. "Efforts to eliminate these disparities, including race-stratified performance reports and programs to enhance care for minority patients, should be addressed to all physicians."

Editor's Note: This study was funded by the Robert Wood Johnson Foundation Finding Answers: Disparities Research for Change National Program. Dr. Sequist serves as a consultant on the Aetna External Advisory Committee for Racial and Ethnic Equality. Co-author Dr. Ayanian serves as a consultant to RTI International and DxCG Inc. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Results Offer Opportunity for Physician Leadership

"The findings presented by Sequist et al build nicely on prior work and are important and provocative," writes Carolyn Clancy, M.D., of the Agency for Healthcare Research and Quality, Rockville, Md., in an accompanying editorial.

"They now have an opportunity to examine physicians' reactions and how care changes when physicians are provided feedback on their performance," Dr. Clancy writes. "Eliminating disparities in health care will require that all patients have access to care, as well as physician leadership to assure that the care provided is evidence-based, patient-centered, effective, consistent and equitable."

(Arch Intern Med. 2008;168[11]:1145-1151. Available pre-embargo to the media at www.jamamedia.org.) ###

Contact: Leah Gourley 617-695-9555 JAMA and Archives Journals

Aaron Douglas: African American Modernist

Smithsonian American Art Museum Presents the First Major Retrospective of African American Modernist Aaron Douglas

“Aaron Douglas: African American Modernist,” on view at the Smithsonian American Art Museum May 9 through Aug. 3, presents the first nationally touring retrospective of Aaron Douglas (1899–1979), one of the most influential visual artists of the Harlem Renaissance. Douglas vividly captured the spirit of his time and established a new black aesthetic and vision. Preview Images and Captions (Adobe Acrobat PDF file, 73K)

Douglas’ forceful ideas about social change and distinctive artistic forms produced a powerful visual legacy through paintings, murals and illustrations for books and progressive journals and made a lasting impact on American modernism.

Aaron Douglas, Aspiration, 1936, Oil on canvas, Fine Arts Museums of San Francisco, Museum. purchase from the estate of Thurlow E. Tibbs Jr., the Museum Auxiliary, American Art Trust Fund, Unrestricted Art Trust Fund, and private donations from the people of the Bay Area

This exhibition brings together more than 80 rarely seen works by the artist, including paintings, prints, drawings and illustrations. Susan Earle, curator of European and American art at the Spencer Museum of Art, organized the exhibition; Virginia Mecklenburg, senior curator at the Smithsonian American Art Museum, is the coordinating curator.

Aaron Douglas, Noah’s Ark, 1935, Oil on Masonite, Fisk University Galleries, Nashville

“Aaron Douglas was an extraordinarily influential figure who was one of the first artists to place African American culture at the center of modern art,” said Elizabeth Broun, The Margaret and Terry Stent Director at the Smithsonian American Art Museum. “It is a great privilege to host this important exhibition at the Smithsonian American Art Museum, which has one of the largest pioneering collections of African American art in the United States.” The exhibition is presented in Washington, D.C., under the gracious patronage of Mayor Adrian M. Fenty and first lady Michelle Fenty.

“It is fitting that this nationally touring examination of Aaron Douglas’ career and his legacy is on view in Washington, D.C.,” said Fenty, mayor of the District of Columbia. “This city also played an important role in the renaissance of African American culture, with such legendary figures as Duke Ellington calling it home.”

Aaron Douglas, The Negro Speaks of Rivers (for Langston Hughes), 1941, Pen/ink on paper, Courtesy of the Walter O. Evans Collection/SCAD Museum of Art

Douglas arrived in New York City at a time when avant-garde artists, writers, intellectuals and activists were redefining culture. This New Negro movement, also known as the Harlem Renaissance, energized Douglas,

and he became one of its most influential members. Douglas and his fellow artists were inspired by the progressive professor of philosophy Alain Locke, a leading figure who taught at historic Howard University in Washington, D.C.

Douglas combined angular cubist rhythms and a seductive Art Deco dynamism with traditional African and African American imagery to develop a radically new visual vocabulary. His distinctive style with silhouetted forms and fractured space expressed both the harsh realities of African American life and hope for a better future.

Some of the artist’s most important works were mural commissions. He received his first major commission in 1930 for a series of murals for the new library at Fisk University in Nashville, Tenn. He chose subjects that he hoped would promote black identity and a sense of dignity among the students. In 1934, he was commissioned by the Public Works of Art Project to create a mural at the 135th Street branch of the New York Public Library. The four panels of “Aspects of Negro Life” reveal the bold modernist risks Douglas was willing to take when regionalism was the norm. His unique visual style, which drew from African, cubist and constructivist motifs, presented an allegorical representation of issues central to African American history and contemporary life.

“Aaron Douglas’ legacy is not only the body of work he left for future generations of artists and scholars to study,” said Mecklenburg. “His belief that artistic expression could be a bridge between African American and white culture, his courage to promote social change and his dedication to education truly make him ‘the father of black American art.’”

Born to laborer parents in Topeka, Kan., Douglas (1899–1979) overcame many obstacles to pursue his passion for art and ideas. After earning a bachelor’s degree in fine arts from the University of Nebraska in 1922, Douglas taught art at Lincoln High School in Kansas City, Mo. In 1925, he decided to move to New York City, inspired in part by an article in the magazine Survey Graphic, titled “Harlem: Mecca of the New Negro,” to join the flourishing cultural scene known as the Harlem Renaissance. During this exciting period, he met Alain Locke, a literary critic and philosopher who is considered the architect of the Harlem Renaissance; writer Zora Neale Hurston; photographer Carl Van Vechten; and prominent intellectual leader and activist W. E. B. Du Bois. He was a frequent contributor in the 1920s to the National Urban League’s journal Opportunity and to the NAACP’s journal the Crisis. Noted writers, such as Countee Cullen and Langston Hughes, collaborated with Douglas. In 1935, Douglas, who was politically active, became the first president of the Harlem Artists Guild. In 1938, he returned to Fisk as an assistant professor and began teaching full time in 1940. He received a master’s degree in art from the Teachers College at Columbia University in 1944. Douglas continued to teach at Fisk until his retirement in 1966. He died in 1979.

A major symposium was scheduled for Friday, May 9, from 1 to 5 p.m. Participating scholars were Richard Powell, professor of art and art history at Duke University; Amy Kirschke, associate professor of art history at the University of North Carolina, Wilmington; Renée Ater, assistant professor at the University of Maryland; and Earle. Kinshasha Holman Conwill, deputy director of the Smithsonian’s National Museum of African American History and Culture, will moderate, and University of Maryland Professor Emeritus David Driskell will deliver the keynote address.

A wide array of free public programs is being offered at the museum in conjunction with the exhibition, including gallery talks, films, performances, family programs and lectures. Details and complete program descriptions are available online at americanart.si.edu and in a separate press release.

A major monograph on Douglas accompanies the exhibition with an introduction by Conwill; essays by a number of prominent scholars, including Ater, Driskell, Earle, Kirscheke and Powell; and a chronology of Douglas’ life. It is available for $45 (softcover) in the museum store.

The final venue for the national tour is the Schomburg Center for Research in Black Culture in New York City (Aug. 30 – Nov. 30).

“Aaron Douglas: African American Modernist” was organized by the Spencer Museum of Art at the University of Kansas in Lawrence. The exhibition and accompanying catalog are made possible, in part, with support from the Henry Luce Foundation and the National Endowment for the Arts. The Diane and Norman Bernstein Foundation Inc. and PEPCO are proud to partner with the Smithsonian American Art Museum on the exhibition in Washington, D.C.

The Smithsonian American Art Museum celebrates the vision and creativity of Americans with approximately 41,000 artworks in all media spanning more than three centuries. Its National Historic Landmark building, a dazzling showcase for American art and portraiture, is located at Eighth and F streets N.W. in the heart of a revitalized downtown arts district. Museum hours are 11:30 a.m. to 7 p.m. daily, except Dec. 25. Admission is free. Metrorail station: Gallery Place/Chinatown (Red, Yellow and Green lines). Smithsonian Information: (202) 633-1000; (202) 633-5285 (TTY). Museum information (recorded): (202) 633-7970. Web site: americanart.si.edu. # # #

Note to editors: Selected high-resolution images for publicity only may be downloaded from ftp://saam-press@ftp.si.edu. Call (202) 633-8530 for the password. Additional information about the exhibition is available from the museum’s online press room at americanart.si.edu/press.

Media only: Laura Baptiste (202) 633-8494, Amy Hutchins (202) 633-8497 Media Web site: americanart.si.edu/press