Making a difference in minority health

The underground railroad / Chas. T. Webber

Making a difference in minority health SAN DIEGO, Oct. 27 – Experts from the Center for Minority Health (CMH) at the University of Pittsburgh Graduate School of Public Health will address the successes and challenges of reducing health disparities at the American Public Health Association 136th Annual Meeting and Exposition in San Diego,

Oct. 25 to 29. Faculty will present innovative programs that improve the health and well-being of racial and ethnic minorities.

Nurses and Barbers Work Together to Promote Prostate Cancer Prevention

Prostate cancer is the second-leading cause of death in African-American men, higher than any other racial or ethnic group. To create an opportunity for African-American men to learn about prostate cancer prevention in their own communities, CMH developed Health Advocates In Reach (HAIR). HAIR trains barbers to deliver accurate health information to peers and customers with the assistance of oncology nurses, public health professionals and prostate cancer survivors. Since 2005, CMH project director Mario Browne, M.P.H., has coordinated the efforts of HAIR, which has reached 275 men with prostate cancer information and screened 139 African-American men.

Abstract number 186259, scheduled for 8:30 a.m. PDT, Monday, Oct. 27

The Underground Railroad Bicycle Route: Exploring African-American History by Bicycle

To increase physical activity among African-Americans and diversify the cycling community, CMH partnered with Adventure Cycling Association in 2004 to create the Underground Railroad Bicycle Route, a 2,100 mile cycling route from Mobile, Ala. to Owen Sound, Ontario. In May 2007, 20 riders from across the U.S. launched the inaugural tour, spanning 53 days. Since that time, organizers have developed two maps for the route – a long distance and short distance tour to accommodate all types of cyclists. Led by the director of CMH, Stephen Thomas, Ph.D., Philip Hallen Professor of Community Health and Social Justice, and Mario Browne, M.P.H., CMH project director, the project combines history, culture and education to celebrate the courage and determination of freedom seekers and to engage people of all walks of life in physical activity. Hundreds of cyclists of all races, ethnicities and ages have cycled all or portions of the bike route since 2007.

Abstract number 181775, scheduled for 3:12 p.m. PDT, Monday, Oct. 27 ###

CMH was established in 1994 with a grant from the Richard King Mellon Foundation. CMH is committed to taking a lead role in the nation's prevention agenda to eliminate racial and ethnic health disparities as described in Healthy People 2010, a Department of Health and Human Services Initiative. For more information on CMH, visit http://www.cmh.pitt.edu.

Contact: Clare Collins collcx@upmc.edu 412-352-2886 University of Pittsburgh Schools of the Health Sciences

Race and insurance status associated with death from trauma

African American and Hispanic patients are more likely to die following trauma than white patients, and uninsured patients have a higher death risk when compared with those who have health insurance, according to a report in the October issue of Archives of Surgery, one of the JAMA/Archives journals.

Health disparities based on race, income and insurance status have previously been documented in patients with cancer and those undergoing surgery, among other treatments and conditions, according to background information in the article.

Adil H. Haider, M.D., M.P.H., of the Johns Hopkins University School of Medicine, Baltimore, and colleagues reviewed data from the National Trauma Data Bank for 429,751 patients age 18 to 64 years treated at approximately 700 trauma centers nationwide between 2001 and 2005. Of these, 72,249 were African American, 41,770 were Hispanic and 262,878 were white; 47 percent had health insurance.

Overall, death rates were higher among African American (8.2 percent) and Hispanic (9.1 percent) patients than among white patients (5.7 percent). Uninsured patients were also more likely to die than insured patients (8.6 percent vs. 4.4 percent). "Mortality rates were substantially higher for all uninsured patients, almost doubling for African American (4.9 percent to 11.4 percent) and Hispanic patients (6.3 percent to 11.3 percent) compared with white patients (4.2 percent to 7.9 percent)," the authors write. "The absence of health insurance increased a trauma patient's adjusted odds of death by almost 50 percent."

Patients in minority groups were much more likely to be uninsured than white patients—about one-third of white patients, two-thirds of African American patients and two-thirds of Hispanic patients lacked insurance. Lack of insurance is associated with poorer baseline health status; because pre-existing conditions are known to affect trauma outcomes, this could partially account for the higher death rates in the uninsured, the authors note.

However, insurance status alone could not explain all racial disparities in trauma death rates. "Of the insured patients, both Hispanic and African American patients had significantly higher odds of mortality compared with white patients," the authors note. Other issues that may contribute to racial differences include mistrust, subconscious bias and stereotyping, but further study is needed to explore these possibilities, they continue.

"Understanding insurance and race-dependent differences is a crucial first step toward ameliorating health care disparities," the authors conclude. "The next step will be to comprehend the underlying reasons for these differences, which will enable the development of interventions to close the gap between patients of different races and payer statuses." ###

(Arch Surg. 2008;143[10]:945-949. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by the Johns Hopkins University School of Medicine Department of Surgery New Faculty Academic Support Group. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Contact: Eric A. Vohr evohr1@jhmi.edu 410-955-8665 JAMA and Archives Journals

Racial disparities in cardiovascular health linked to birth weight, slavery

Evanston, Ill. - October 16, 2008 – Two new articles examine the theory of "fetal programming" and their effect on racial health disparities. The studies, published in American Journal of Human Biology, suggest that the higher rates of hypertension and cardiovascular disease present in African Americans may be a consequence of low birth weights, and that these low birth weights may be a result of social rather than genetic factors.

It is well-established that the nutritional and psychological state of a pregnant mother can influence whether her child will later develop cardiovascular disease as an adult.

Nutrients and hormones present in the womb shape a fetus's development, in part by silencing certain genes in the body. These influences can persist into later life to impact adult health. Researchers from Northwestern University argue that such intergenerational impacts of environmental factors could help explain black-white differences in cardiovascular health in the U.S.

Five generations on Smith's Plantation, Beaufort, South Carolina, Civil War Photograph Collection (Library of Congress).

"A pregnant African American mother's experience of well documented stressors, including social forces such as discrimination and racism, could have lingering effects on diseases like hypertension, diabetes and heart attacks in her children," says Christopher Kuzawa and Elizabeth Sweet, who co-authored this piece. By synthesizing this new evidence, they argue that social forces, rather than genes, may underlie the problem of racial inequity in heart attacks and strokes in the U.S. In a related editorial in the journal, Peter Ellison, Editor-in-Chief, explains that some of the most persistent health disparities in the United States occur between African Americans and European Americans.

The causes of those disparities are many and their roots are deep. They are entwined with the history of slavery and discrimination, with rural and inner city neglect, with differential wealth and differential access to health care, with cultural traditions and cultural biases, according to Ellison.

A second study in the Journal states that the average birth weight among African-American babies is approximately 250 grams lower than the average birth weight of whites, a difference that represents nearly 10 percent of an average infant's body weight. According to Grazyna Jasienska, co-author of the study, this may also be the result of conditions experienced by their ancestors during the period of slavery passed through epigenetic, rather than genetic, mechanisms.

Current socio-economic conditions which are, on average, worse for African-Americans, can explain only part of the observed birth weight variation, according to Jasienska. Nor is there reason to think that lower birth weight of African-Americans is due to original African genetic heritage. Prior studies have shown that contemporary black women who were born in African countries ancestral to slave populations, but who live in the U.S., give birth to children with significantly higher weight than black women in the U.S. who have slave ancestry.

"Slaves experienced poor nutrition during all stages of life, suffered from a heavy burden of infectious diseases and, in addition, experienced high energetic costs of hard physical labor," says Jasienska. "Even a short-term nutritional deprivation of pregnant women, when very severe, has been shown to have an intergenerational effect," says Jasienska. Dutch women exposed to famine as fetuses in mid- and late gestation have also been shown to have reduced birth weights, and the effect was detectable years later because birth weight of their children was also reduced.

The fetal programming concept suggests that physiology and metabolism, including growth and fat accumulation of the developing fetus, and, thus its birth weight, depend on intergenerational signal of environmental quality passed through generations of matrilinear ancestors.

A child's birth weight depends on the condition of his or her mother during pregnancy but also, recent research indicates, on the conditions the mother faced as a child and even as a fetus. As a result, a child's birth weight may be influenced by nutritional conditions of its grandmother and even great-grandmother. The resulting effects can be seen in both childhood and adulthood, and include a higher risk of hypertension, diabetes and cardiovascular disease.

Jasienska states that, in the U.S. , the condition of many slaves did not immediately improve after the abolition of slavery, so the causes are not as far removed in time from contemporary African Americans as it may seem. Census data from the year 1900 showed that African Americans continued to suffer higher mortality than whites from all major diseases except cancer. Even though several generations have passed since then, it may not have been enough time to eliminate the negative impact of slavery on the health of the contemporary African-American population. ###

Contact: Sean Wagner, swagner@wiley.com 781-388-8550 Wiley-Blackwell

Landmark study links sleep, memory problems in elderly African-Americans

Alyssa Gamaldo, North Carolina State University. Department of Psychology. Campus Box 7650. Raleigh, NC 27695, Phone: 919-515-6141, FAX: 919-515-1716. Email: aagamald@ncsu.edu

A landmark study led by North Carolina State University researchers shows that African-American seniors who have trouble falling asleep are at higher risk of having memory problems – raising the possibility that identifying and treating sleep difficulties in the elderly may help preserve their cognitive functioning. The study is the first to examine the link between sleep and cognitive functioning in older African-Americans.

The study, led by NC State psychology Ph.D. student Alyssa A. Gamaldo, shows that older African-Americans who reported having trouble falling asleep tended to do much worse on memory tests than those study participants who did not have trouble falling asleep. Gamaldo says that the difference was particularly apparent in tests related to "working memory," which is the ability to multitask or do two things at once. The study examined 174 subjects between the ages of 65 and 90.

Gamaldo says the findings raise additional questions, which will have to be addressed in future research. For example, Gamaldo says, "it is not clear if lack of sleep is the issue. Is it the quantity of sleep, the quality of sleep, or something else altogether?"

The study raises questions for future research on both sleep and cognitive functioning in the elderly. The findings indicate that sleep may need to be accounted for as a confounding variable in cognition studies targeting seniors. In addition, the findings show that sleep research may need to increase its focus on older adults in order to fully explore the impacts of sleep problems on cognition in seniors.

"If we can better understand how sleep quantity, as well as quality, influences general cognitive functioning, perhaps we could better maintain memory throughout life – including later in life," Gamaldo says. ###

The study, "The Relationship Between Reported Problems Falling Asleep and Cognition Among African American Elderly," will be published in the November issue of Research on Aging. The study's co-authors are Dr. Jason C. Allaire, assistant professor of psychology at NC State, and Dr. Keith E. Whitfield, professor of psychology and neuroscience at Duke University.

Note to editors: The study abstract follows.

"The Relationship Between Reported Problems Falling Asleep and Cognition Among African American Elderly" - Authors: Alyssa A. Gamaldo, Dr. Jason C. Allaire, North Carolina State University; Dr. Keith E. Whitfield, Duke University, Published: November 2008 in Research on Aging

Abstract: This study examined the relationship between elders' cognitive performance and self-reported trouble falling asleep. Analyses were conducted on 174 older independently living, community dwelling African Americans (M age = 72.74; range = 65 to 90). Cognitive performance was measured using the Mini-Mental State Examination, Forward Digit Span task, Backward Digit Span task, Alpha Span task, and California Verbal Learning Test.

Results suggested that individuals who reported trouble falling asleep tended to perform significantly worse than individuals who did not report trouble falling asleep on measures tapping short-term memory and working memory after controlling for age, education, gender, depression, and current health. These results demonstrate that a self-report of sleep difficulty may be a unique predictor of cognitive performance.

Contact: Matt Shipman matt_shipman@ncsu.edu 919-515-6386 North Carolina State University

Black patients with chronic pain less likely to be tested for obesity

Carmen R. Green, MD, Director, Pain Research Division. Associate Professor of Anesthesiology. Phone: 734-936-4240, Fax: 734-936-9091, Email: carmeng@umich.edu

ANN ARBOR, Mich. — At the intersection of two U.S. health epidemics – obesity and chronic pain – researchers from the University of Michigan Health System found black patients with chronic pain were less likely to have their weight or body mass index (BMI) recorded, even though they are at higher risk for having obesity when compared with their white counterparts. This new study also revealed that obesity is related to greater disability and poorer functioning, over and above the impact of a person’s pain level.

Obesity contributes to chronic pain and several other chronic conditions, leading to decreased health and quality of life. Chronic pain also leads to decreased health and quality of life, says senior author Carmen R. Green, M.D. Disparities in the chronic pain experience and obesity exist, with blacks more likely to be negatively impacted, she notes.

Black people also are more likely to experience disability and lower physical functioning than white people, when faced with chronic pain, says Green, associate professor of anesthesiology and health management and policy, and director of Pain Medicine Research at the U-M Medical School and School of Public Health. The study appears in the Journal of Pain.

“Assessing a patient’s weight and height is necessary to calculate BMI. Once assessed, a dialogue can begin between the patient and health care team to address obesity,” Green says. “These findings provide further evidence of the negative effect obesity, measured via BMI, can have on a person’s overall health and well-being in general and on chronic pain in particular.

“This is a reminder about the importance of assessing height and weight and measuring BMI in patients with chronic pain, especially minorities.”

However, the goal is made more difficult because black patients are less likely to have their BMI assessed, the study found. “Both chronic pain and obesity are reaching epidemic proportions. Considering their public health implications in terms of disability, BMI should be regularly assessed especially in populations who are at increased risk,” Green says.

It is not clear why it was less likely black patients would have their BMI measured, even though they may be at increased risk for higher BMI and obesity, researchers say. But they point out that the gap could indicate a lower quality of care than what is provided to white patients.

BMI is a measure of body fat based on height and weight. According to the National Institutes of Health, people with a BMI lower than 18.5 are considered underweight; people between 18.5 and 24.9 are normal weight; people between 25 and 29.9 are overweight; and those with a BMI of 30 or higher are obese. This table shows the BMI of people at various weights and heights.

By the numbers:

Researchers studied 183 people – 92 white and 91 black, 68 men and 115 women, ages 31 to 46. New black patients attending a pain clinic at U-M were asked to participate, and were matched with a white chronic pain patient of the same gender and similar age.

When the height and weight was available it was taken from the electronic medical record. Patients were asked to indicate on a diagram of the human body where they were in pain, how long they’ve been in pain and what caused it. They also were given the McGill Pain Questionnaire and the West Haven Yale Multidimensional Pain Inventory to evaluate the intensity of their pain and its impact on their life.

The BMI was notably higher for blacks than whites (31.6 vs. 27.6). Blacks were less likely to have complete height and weight data in their records than whites (73 percent vs. 84 percent). Those without BMI data had higher pain severity scores.

In addition to Green, Julia Caldwell, M.D. and Tamera Hart-Johnson, M.S. were co-authors of the paper.

AETNA Quality Care Foundation provided funding for the study.

Reference: Journal of Pain and doi:10.1016, Body Mass Index and Quality of Life: Examining Blacks and Whites With Chronic Pain. # # #

Contact: Katie Vloet kgazella@umich.edu 734-764-2220 University of Michigan Health System

Seeing race and seeming racist? Whites go out of their way to avoid talking about race

Evan P. Apfelbaum was born in Boston, Massachusetts and attended Newton North High School. He received a B.S. in Psychology and Music from Union College (2002) and a M.S. in Experimental Psychology from Tufts University (2007), where he expects to receive his Ph.D. in 2009. Department of Psychology • Tufts University 490 Boston Avenue • Medford MA 02155. 617.627.2524, E-Mail: Evan.Apfelbaum@Tufts.edu Personal website: Evan Apfelbaum

Efforts to appear unbiased lead to misunderstandings between the races, studies find. WASHINGTON – White people – including children as young as 10 -- may avoid talking about race so as not to appear prejudiced, according to new research. But that approach often backfires as blacks tend to view this "colorblind" approach as evidence of prejudice, especially when race is clearly relevant. These results are from two separate sets of experiments led by researchers from Tufts University and Harvard Business School. Their findings are reported in the October issue of the Journal of Personality and Social Psychology and the September issue of Developmental Psychology. Both journals are published by the American Psychological Association.

"Efforts to talk about race are fraught with the potential for misunderstandings," said the studies' lead author, Evan Apfelbaum, a PhD candidate at Tufts University. "One way that whites try to appear unbiased is to avoid talking about race altogether, a tendency we refer to as strategic colorblindness."

In one study, 101 white undergraduate students were paired with either a white or black female partner who pretended to be another participant. The pairs were presented with 30 photographs of faces that varied in race, gender and background color. Each white participant's objective was to guess which of the photographs the partner was holding by asking as few yes-or-no questions as possible.

Even though asking about the race of the person in the photograph was a sound strategy for completing the task, white participants were far less likely to do so with a black versus a white partner. Moreover, when the black partner was the first one to have a turn asking questions, whether she mentioned race had a dramatic effect. White participants whose black partner asked about race mentioned race on their own turn 95 percent of the time. When the black partner never asked about race, white participants only did so 10 percent of the time.

"There was clear evidence the white participants' behavior was influenced by the precedent set by their partner, but especially when that partner was black," said Samuel Sommers, assistant professor at Tufts and co-author of both papers. "Whites are strategically avoiding the topic of race because they're worried that they'll look bad if they admit they notice it in other people."

The researchers also wanted to see how outsiders interpreted such interactions. In another experiment, 74 black and white college students evaluated videos of whites engaging in the photo task. The results showed that whites' effort to appear colorblind backfired. Black observers rated whites' avoidance of asking about race as being evidence of prejudice. What's more, when the researchers showed silent video clips of whites from the study to another group of individuals, those whites who avoided asking about race were judged as less friendly, just on the basis of their nonverbal behavior.

"The findings suggest that when race is clearly relevant, whites who think that it is a wise social strategy to avoid talking about race should think again," said Apfelbaum.

Even children appear to adopt this strategically colorblind approach. In another set of experiments, 101 white children between the ages of 8 and 11 were asked to perform a similar photo task. The children were told that asking as few yes-or-no questions as possible would mean they would get a higher score on the task.

The results showed that the older children, ages 10 and 11, avoided asking about race more than the younger children, even though this led them to perform less efficiently than their younger counterparts on the task. In a control version where all the faces in the photos were white, the older children outperformed the younger children, as expected. "This result is fascinating because it shows that children as young as 10 feel the need to try to avoid appearing prejudiced, even if doing so leads them to perform poorly on a basic cognitive test," said Kristin Pauker, a PhD candidate at Tufts and co-author of this study.

The authors associated with both studies said their findings offer several important implications. "Our findings don't suggest that individuals who avoid talking about race are racists," Apfelbaum explained. "On the contrary, most are well-intentioned people who earnestly believe that colorblindness is the culturally sensitive way to interact. But, as we've shown, bending over backward to avoid even mentioning race sometimes creates more interpersonal problems than it solves." ###

Article: "Seeing Race and Seeming Racist? Evaluating Strategic Colorblindness in Social Interaction," Evan P. Apfelbaum, PhD candidate, and Samuel R. Sommers, PhD, Tufts University; Michael Norton, PhD, Harvard Business School; Journal of Personality and Social Psychology, Vol. 95, No. 4. (Full text of this article is available from the APA Public Affairs Office and at www.apa.org/journals/releases/) In PDF Format.

Article: "Learning (Not) to Talk About Race: When Older Children Underperform in Social Categorization," Evan P. Apfelbaum, PhD candidate, Kristin Pauker, PhD candidate, Nalini Ambady, PhD, and Samuel R. Sommers, PhD, Tufts University; Michael I. Norton, PhD, Harvard Business School; Developmental Psychology, Vol. 44, No. 5. (Full text of this article is available from the APA Public Affairs Office and at www.apa.org/journals/releases/) in PDF Format.

Contact Samuel Sommers by e-mail at sam.sommers@tufts.edu; his phone number is 617-627-5293.

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 148,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

Contact: Public Affairs Office public.affairs@apa.org 202-336-5700 American Psychological Association

African-Americans may be at higher risk of stroke-causing brain lesions

Specialties: Neurology, Title: Associate Professor, Department of Neurology; Medical Director of Georgetown Stroke Center. Medical Degree: University of Arizona, Tuscon, 1992. Internship: UCLA, Internal Medicine, 1993. Residency: UCLA, Neurology, 1996. Fellowship: Cerebrovascular Disease Fellowship, UCLA, 1998. Certification: Neurology; Vascular Neurology. Special Interests: Acute stroke therapies, Neuroimaging in stroke. Address: Georgetown University Hospital, 4000 Reservoir Rd., NW, Building D, Suite 207, Washington, DC 20007, Phone: (202) 877-3154

ST. PAUL, Minn. – Cerebral microbleeds, which are small bleeds within the brain, appear to be more common in African-Americans than in Caucasians, increasing the likelihood of having a stroke, according to a study published in the October 7, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology. These types of brain lesions can be an important indicator for stroke. For the study, 87 people from the Washington, DC, area who had suffered a certain type of stroke, called an intracerebral hemorrhage, underwent brain scans. This kind of stroke involves bleeding in the brain and makes up 10 to 15 percent of all strokes. Researchers also determined the group's risk factors for stroke such as age, hypertension and alcohol use. Forty-two of the people were African-American while 45 were Caucasian. The study found that African-Americans had 32 percent more microbleeds than Caucasians. African-Americans were also more likely to have these types of lesions in several different areas of the brain. While African-Americans had more lesions in the lower and middle parts of the brain, Caucasians had them most frequently near the surface of the brain. "Finding racial differences that could be linked with a higher prevalence for these brain lesions may lead to new methods for testing and treating people to prevent stroke," said study author Chelsea Kidwell, MD, with Georgetown University Medical Center in Washington, DC, and member of the American Academy of Neurology.

"Knowing if a person has a higher likelihood of having these brain lesions or bleeding in the brain is important for doctors and patients when caring for medically underserved groups of people and optimally treating their stroke risk factors," said Kidwell. Hemorrhagic stroke is two to three times more common in minority populations, including African-Americans. Microbleeds are found in 50 to 80 percent of this type of stroke. ###

The study was supported by the National Institute of Neurological Disorders and Stroke.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington's disease, and dementia. For more information about the American Academy of Neurology, visit www.aan.com.

Contact: Rachel Seroka rseroka@aan.com 651-695-2738 American Academy of Neurology

Newly found gene variants account for kidney diseases among African-Americans

Director, Elias A. Zerhouni, M.D. in front of NIH headquarters, Bethesda, MD

For the first time, researchers have identified variations in a single gene that are strongly associated with kidney diseases disproportionately affecting African-Americans. This work was conducted by researchers at the National Institutes of Health (NIH) and by NIH-funded investigators at the Johns Hopkins University. The findings are published online today in two papers in Nature Genetics and will be published in the October print issue.

"These two breakthrough genomic studies on kidney disease illustrate the importance of collaborations between scientists at NIH and NIH-funded investigators at Johns Hopkins," said NIH Director Elias A. Zerhouni, M.D. "This type of government-academic collaboration moves translational research forward and provides the knowledge base for developing new therapies for these chronic health disorders."

The researchers studied nondiabetic kidney diseases that can lead to chronic kidney disease and, in severe cases, to kidney failure requiring long-term dialysis or a kidney transplant. One of these diseases, focal segmental glomerulosclerosis (FSGS), is a kidney disease that leads to kidney failure in more than half of those with the disease over a period of about 10 years. Chronic kidney disease is caused by many different diseases and conditions and affects 26 million Americans. More than 106,000 individuals develop kidney failure and more than 485,000 receive dialysis or transplantation in the United States each year.

Using a type of genome association that relies on differences in the frequency of gene variants between populations, the NIH researchers identified several variations in the MYH9 gene as major contributors to excess risk of kidney disease among African-Americans. The NIH researchers shared their discovery with the Johns Hopkins scientists, who replicated the findings in participants from earlier studies of kidney disease.

Both research teams found statistically significant associations of MYH9 variants with FSGS, HIV-associated FSGS, and all nondiabetic kidney failure. They also found that these variants were much more frequent among people of African ancestry than among whites. The increased risk among African-Americans with these variants is more than 300 percent for FSGS, more than 500 percent for HIV-associated FSGS, and more than 100 percent for all nondiabetic kidney failure. Sixty percent of African-Americans carry the risk variants in contrast to 4 percent of whites.

Though FSGS affects African-Americans more than whites, the rate of progression to kidney failure is believed to the same for both populations. FSGS associated with HIV infection is almost exclusively found in individuals of African descent and, without treatment, progresses more rapidly to kidney failure compared to other forms of kidney disease. FSGS often affects adolescents and young adults as well as older individuals.

In the NIH study, the researchers scanned the genome of 190 African-Americans known to have FSGS, including the form associated with HIV infection, and 222 who did not have FSGS and replicated these findings in additional cases. The Johns Hopkins researchers, members of the Family Investigation of Nephropathy and Diabetes (FIND) consortium, studied more than 2,100 participants of the FIND study and the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) study. FIND, one of the largest multi-center genetic studies of kidney disease ever conducted, has been funded by the NIDDK since 1999.

"MYH9 genetic variations account for some of the excess risk of kidney disease due to hypertension, and much of the excess risk due to FSGS, and HIV-associated FSGS in African-Americans," said Jeffrey B. Kopp, M.D., a kidney specialist and lead author of the NIH study. "We hope this finding will lead to personalized medical therapy that will reduce the burden of chronic kidney disease."

Though diabetes is one of the leading causes of kidney failure, both research teams found no association between the MYH9 variants and diabetes-related kidney failure in African-Americans. "This finding suggests that the mechanisms leading from onset of chronic kidney disease to kidney failure may differ based on the inciting cause," said W.H. Linda Kao, M.H.S., Ph.D., and Rulan S. Parekh, M.D., M.S., the lead and senior authors of the Hopkins study. "Therefore, understanding the role that MYH9 plays in kidney failure may ultimately lead to development of drug therapies that target more specific, rather than common, genetic pathways to prevent kidney disease progression more effectively."

"These two studies are important not only because the MYH9 risk variants account for nearly all the excess burden of FSGS and HIV-associated kidney disease in African-Americans, but also because MYH9 is the first kidney disease gene identified that explains an important health disparity and involves common forms of kidney disease," said Cheryl Winkler, Ph.D., principal scientist with the National Cancer Institute, senior author of the NIH intramural study, and a co-author of the Johns Hopkins study. "In addition, the MYH9 gene's estimated relative risk is higher than that observed for nearly all genetic factors discovered by genome-wide scans, including those for prostate cancer, diabetes, cardiovascular disease, breast cancer, and hypertension."

The different frequencies of genetic variants between African Americans and European Americans have potential implications for future screening strategies for African-Americans with hypertension. It remains unclear whether hypertension is particularly likely to damage the kidney in individuals with these MYH9 variants, and further research will be needed to determine whether individuals identified as having hypertensive kidney disease actually have undiagnosed FSGS.

The variants found in these studies are markers indicating that the MYH9 gene is the location of the disease-causing variations, but the specific variants have not yet been definitively identified. Further studies will be needed to identify the specific causal variants. Most individuals with the gene variants do not develop kidney disease, suggesting that additional genetic or environmental factors contribute to causing kidney disease in particular individuals with the MYH9 variants. ###

This research also was supported by the National Cancer Institute, the National Heart Lung and Blood Institute, the Agency for Healthcare Research and Quality, and by the National Center for Research Resources through its General Clinical Research Centers.

Kopp, J.B. et al. "MYH9 is major-effect risk gene for focal segmental glomerulosclerosis," Nature Genetics, September 14, 2008.

Kao, W.H. Linda et al. "MYH9 is associated with nondiabetic end-stage renal disease in African-Americans," Nature Genetics, September 14, 2008.

For more information on FSGS and kidney failure, visit kidney.niddk.nih.gov/kudiseases/pubs/glomerular/.

For more technical information on glomerular disease, visit intramural.niddk.nih.gov/research/glomerular_diseases/normal_kidney.asp

NIDDK conducts and supports research in diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans. For more information about NIDDK and its programs, see www.niddk.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Contact: Arthur Stone niddkmedia@mail.nih.gov 301-496-3583 NIH/National Institute of Diabetes and Digestive and Kidney Diseases

African-American blogs offer key health communications tool

Blogs allow African Americans to discuss HIV and AIDS in an unfiltered way that is both public and private, according to a Penn State researcher, and this exploration may lead to another way to distribute health messages to the African American community.

Lynette Kvasny, Associate Professor of Information Sciences and Technology lkvasnyist.psu.edu 814-865-6458, 329 C Information Sciences and Technology Building. Education: Ph.D., Computer Information Systems Georgia State University 2002, M.S., Computer and Information Systems Georgia State University 1996, B.S., Computer and Information Systems Mercy College 1988. Web Sites: ist.psu.edu/lkvasny

Lynette Kvasny, associate professor of information sciences and technology (IST), an avid blog reader, noticed an interesting conversation on a blog following an August 2006 ABC News story, "Out of Control: AIDS in Black America." "I was really surprised by some of the things I was reading … these were things that I'd never seen discussed in a public forum before," Kvasny said. Kvasny and C. Frank Igwe, a recent IST Ph.D. recipient, analyzed 128 responses to the ABC News story posted from Aug. 24 to Aug. 26, 2006. They separated the comments into themes, including ineffective Black community leadership; the influence of prison and hip-hop cultures; religion; sexual taboos; and African Americans in the media. These categories provided a basis to analyze how ethnic identities are conveyed through technology. The television show pointed to five reasons why AIDS is out of control in Black America, including, those in charge do not see the problem; the government fails to control street drugs and the large African American prison population; the skewed ratio of men to women in the African American community lead to multiple partners for men; a hidden African American homosexual population on the "down low;" and the failure of leadership in the Black community to make AIDS a priority.

"Online conversations provide an opportunity to examine how this community uses language to express their unique position as subjects in HIV/AIDS discourse," the researchers note in "An African-American Weblog Community's Reading of AIDS in Black America," published recently in the Journal of Computer-Mediated Communication. "The relationships among identity, language and computer mediated communication are not straightforward."

Kvasny also noted the varying levels of community that exist within the blog, saying that while individual users are anonymous, they are all united by a common language and a desire to speak out about HIV/AIDS and other issues affecting the Black community. Blogs and message boards also allow people to voice their own opinions, rather than being spoken for by one or several people in the mass media. "Communities like this give people a place to talk about things they couldn't talk about elsewhere," Kvasny said. "The affordances of technology allow people to become members of a virtual community while still remaining anonymous and being able to freely express their thoughts." The researchers looked at two aspects of the online conversation. First are the factors that the blog members thought contributed to the spread of AIDS in the African American population. Included in this were members' presentation of opposing, alternative views to the television report and how they presented those views. Second, the researchers looked for indications of Black communication styles including signifying, emotional intensity and computer-mediated communication techniques like emoticons and turn taking. An analysis of the blog suggested that three things -- ineffective leadership, Black cultural practices and individual behaviors -- were the risk factors for the Black community. Also, analysis of how ideas were expressed showed communication interaction used call-and-response conventions such as acknowledging prior comments by naming the speaker or co-signing the previous comments.

C. Frank Igwe, His expertise includes computer-mediated communications, the digital divide, virtual third places, and electronic online reverse auction exchanges. Frank’s dissertation focused on examining how African Americans utilize weblogs to create virtual “third places” as a means to rebuild aspects of community that are lacking in their “real-world” communities. Frank receive his Ph.D. in IST, and his M.S. in Business Administration, both from Penn State. He also received his M.G.A. from the University of Pennsylvania, and his M.B.A. and B.S. in Environmental Engineering from the University of Oklahoma

The community of bloggers developed shorthand terms for AIDS that were used by the group and emotion, in the form of capitalized comments and other verbal scolding, appeared frequently.

The use of screen names and family terms showed communal support. The acts of advising, consoling and testifying through stories create a community of support through the discussion. The final style element of this African American blogging community involves movement, if only virtual. These include describing actions that would normally be acted out, describing dances, singing lyrics and laughter.

The researchers suggest that African Americans form virtual communities with ethnic identity through the use of language, noting "These self avowed identities suggest that ethnicity is an essential characteristic that finds expression in a public realm."

While realizing that the online community does not reach the entire African-American community, the researchers believe discussions online may impact the larger community as well through interactions with friends and relative who are not online and provide an alternative approach to community health education.

Kvasny said she hopes to continue this research and examine whether blogs are an effective medium for medical practitioners to distribute messages about HIV/AIDS prevention and education. ###

Contact: A'ndrea Elyse Messer aem1@psu.edu 814-865-9481 Penn State

Television viewing and aggression: Some alternative perspectives

Image Credit: SAMHSA is an Agency of the U.S. Department of Health & Human Services

The effect of media violence on behavior is not only an interesting psychological question but is also a relevant public policy and public health issue. Although many studies have been conducted examining the link between violence on TV and aggressive behavior, most of these studies have overlooked several other potentially significant factors, including the dramatic context of the violence and the type of violence depicted as well as the race and ethnicity of the viewers.

In a new study appearing in the September issue of Perspectives on Psychological Science, a journal of the Association for Psychological Science, psychologists Seymour Feshbach from the University of California, Los Angeles and June Tangney from George Mason University investigated the effect that exposure to violent TV programs has on negative behavior in children from different ethnic backgrounds. To investigate this connection, the psychologists conducted a study that evaluated TV viewing habits, intelligence, and behavior in 4th, 5th and 6th grade children. To assess these qualities, the children's parents and teachers completed behavioral questionnaires detailing the children's aggression, delinquency and cruelty. The children took IQ tests and completed surveys indicating the TV programs (which were later categorized as violent or non-violent by the researchers) they had watched during a seven day time period.

The results showed a positive relationship between the amount of violent TV watched and negative personality attributes among white males and females and African-American females. Interestingly though, while there was a correlation between watching violent TV and lower academic performance in African-America males, these boys did not exhibit increased aggression or lower IQ.

The authors speculate that perhaps for African-American males, viewing TV (including violent programs) may play a different role than for white males and African-American and white females. The researchers noted, "The data raise the possibility that processes competing with or overriding the aggression stimulating or aggression modeling effects of viewing violence on television may be more salient for African-American males." For example, viewing TV shows where violent behavior is punished may inhibit feelings of aggression to a greater degree in African-American males. In any case, additional research is required to assess the effects on African-American males of viewing TV aggression.

The authors also suggest that when studying the effect of TV violence on aggression, researchers and policy makers must recognize "the need for a more general conceptualization of the effects of exposure to TV violence, one that takes into account personality differences, ethnic differences, the social context in which TV is viewed, variations in the dramatic context, and other potentially significant moderating factors." ###

Author Contact: Seymour Feshbach at sfeshbac@ucla.edu

Perspectives on Psychological Science is a journal of the Association for Psychological Science. It publishes an eclectic mix of thought-provoking articles on the latest important advances in psychology. For a copy of the article "Television Viewing and Aggression: Some Alternative Perspectives" and access to other Perspectives on Psychological Science research findings, please contact Barbara Isanski at 202-293-9300 or bisanski@psychologicalscience.org.

Contact: Barbara Isanski bisanski@psychologicalscience.org WEB: Association for Psychological Science

Study shows how African-American Ph.D. chemists overcame discrimination to build careers

Willie Pearson, Jr. Photographer: Gary Meek.

A national study of career experiences among African-American Ph.D. chemists shows how these scientists dealt with discriminatory practices and attitudes to build careers in academia, industry and government. While seven out of ten respondents felt they had been hindered by discrimination, less than a handful regretted choosing a career in chemistry.

"Regardless of the experiences they had, these people had remarkably positive feelings about chemistry," said Willie Pearson, Jr., the study's author and chair of the School of History, Technology and Society at the Georgia Institute of Technology. "If they had it to do all over again, they would still see chemistry as an attractive field."

Results of the study, "Beyond Small Numbers: Voices of African-American Ph.D. Chemists," will be presented February 15 at the annual meeting of the American Association for the Advancement of Science (AAAS). The study explores the divergent career experiences of 44 randomly-chosen African-American Ph.D. chemists who received degrees prior to 1994.

"The opportunity structure differed dramatically in many cases over time," said Pearson, who conducted face-to-face interviews with all but one of the scientists. "Most felt that race was an issue, and that it had impacted them in certain ways. But they didn't let that cripple them or stifle their achievement. Racism was just part of the reality that confronted them."

Most respondents began their careers in the academic world, with slightly more than half taking positions at historically black colleges and universities. The Ph.D. chemists choosing academic careers were attracted to institutions similar to the ones where they obtained their undergraduate degrees.

Their experiences changed dramatically over time, affected by federal legislation such as the Civil Rights Act of 1964 and court decisions such as Brown v. Board of Education.

Other key findings include:

• The respondents often found themselves torn between the research they were trained to do and administrative roles that provided salary and advancement opportunities beyond what they could achieve as practicing chemists. For industrial chemists, these administrative positions were often in Equal Employment Opportunity, human resources or community outreach areas with little impact on company decision-making.
• Many of the respondents reported that good work overcame discrimination. "It's difficult not to reward excellence," said Pearson. "While there may be discriminatory practices, by and large the system tended to work for those who did good work."
• In academia as well as industry, experiences varied among departments even within the same institution. "While there might be a company culture, there are also individual unit cultures," he explained. "At one company, chemists reported different career advancement experiences depending on the division in which they worked. For example, in one unit, a chemist had filed racial discrimination complaints, while chemists in two separate units reported supportive and welcoming environments."
• African-American women often had to also confront gender discrimination and were expected to meet a higher standard than their male counterparts. "But I think you would find the same thing with women in general, because chemistry is still largely a male-dominated field," Pearson said.
• If they were the only persons of color in their organizations, African-American chemists sometimes suffered feelings of isolation, which caused stress and depression. In academia, isolated chemists often had difficulty attracting graduate students, which hurt their research and therefore their stature in the field.
• Among industrial chemists, eight of 13 respondents (62 percent) said they were satisfied or very satisfied with their jobs. Among the academic chemists, 16 of the 22 (72 percent) reported that level of satisfaction – while five said they were very dissatisfied.
• Segregation in the South contributed to a 'brain drain' in which African-Americans pursuing chemistry doctorates entered universities outside the region. Most never returned

Daryl Chubin, senior vice president at the National Action Council for Minorities in Education (NACME), said the study is unusual in using interviews to provide an in-depth look at complex issues.

"The value of the analysis is that it looks across a half-century of experience on the part of these minority chemists," he said. "Because of the interviews, the study puts a human face on their experiences. There is a great deal of commonality in what these Ph.D. chemists are saying."

Chubin noted that the experiences reported by the chemists parallel those of today's minority science and engineering students, who often suffer from lack of access, isolation, tokenism, lack of acceptance from others at the institution and limited mentoring opportunities.

"The good news is that they prevailed," he added. "Some of them had very distinguished careers despite this. But it points out the climate in which they had to work, and which still confronts faculty of color."

The qualitative study highlights the importance of mentoring, Chubin and Pearson agree. To be successful in academia, scientists must not only teach and do research, but also write papers, submit grant applications, make professional presentations, compete for graduate students and manage their laboratories. That knowledge isn't taught in the classroom, but comes from working with top faculty.

"Many in the first generation of Ph.D.s didn't have a sense that the degree is only the beginning," Pearson said. "Finishing at a top academic institution is a great achievement, but in the research community, the degree is only the key to get in. Those who did not have a rich publishing experience and knowledge of how to write a grant had a very difficult time."

A shortage of African-American faculty poses a threat to the modest diversity at U.S. colleges and universities as today's full professors look toward retirement. "When we are only producing 30 or so African-American Ph.D.s a year and a number of African-American chemists are at or near retirement age, we risk losing ground, especially in academia," Pearson warned. ###

Technical contact: Willie Pearson (404-385-2265) or e-mail: (willie.pearsonjr@hts.gatech.edu).

Contact: John Toon john.toon@edi.gatech.edu 404-894-6986 Georgia Institute of Technology Research News

Project to Save the Lives of Malnourished Children Voted Top 5 in American Express Members Project

International Medical Corps (IMC) has been voted into the Top 5 as part of the American Express Members Project. After more than 87,000 votes, the project, “Saving the Lives of Malnourished Children,” now enters the final round of voting, which ends October 13. Card members will be able to cast their votes a second and final time to decide how the $2.5 million in funding is divided among the five finalists. The project with the most votes receives $1.5 million; the second-place finisher receives $500,000; third place, $300,000; and fourth and fifth place, $100,000.

“While my children go to bed with full stomachs each night, it is deeply troubling to consider that 5 million children younger than five die each year because they do not have the nutrients their little bodies need to survive,” says Paige Strackman, of Brooklyn, N.Y., who submitted the project to American Express. “We can solve this problem with nutrient-rich, ready-to-eat food. The number of votes during this round determines how many lives will be saved. Every vote makes a difference.”

Hunger and malnutrition kill more people in the world than HIV, tuberculosis, and malaria combined. As food prices rise, millions are being driven deeper into poverty everyday while trying to afford basic staples. Many are at risk of having nothing to eat at all.

“International Medical Corps is deeply grateful for the opportunity to work with Paige on a project that she feels so passionately about,” said Rebecca Milner, Vice President of Institutional Advancement. “We also thank all those who rallied behind this cause to support our life-saving work. Their continued support is going to be critical as we vie for the top Members Project prize.”

Through nutrition programs that provide relief while creating sustainable solutions, International Medical Corps brings nutrition-rich, ready-to-eat food to some of world’s most food-insecure environments, including Ethiopia, Somalia, Chad, and Sudan. With a mission that focuses on training, International Medical Corps works to empower individuals and communities, providing education on how to treat malnutrition, identify warnings signs, and intervene before malnutrition worsens.

Contacts: For Press Inquiries, Stephanie Bowen. Communications Manager. International Medical Corps, 1919 Santa Monica Blvd., Suite 400, Santa Monica, CA 90404. 310-826-7800. sbowen@imcworldwide.org

Most ethnic minority teens don't hang out with ethnic school crowds

Dr. Bradford Brown, is Professor of Human Development and former Chair of the Department of Educational Psychology at the University of Wisconsin-Madison. He received an A.B. in sociology from Princeton University and Ph.D. in human development from the University of Chicago. Before joining the faculty of the University of Wisconsin in 1979. Dr. Brown’s research has focused on adolescent peer relations. He is especially well known for his work on teenage peer groups and peer pressure and their influence on school achievement and social adjustment. WEB: Peer Relations Study Group

Peer relationships are an important part of adolescence for most American adolescents. As teens find their places in the peer system in most high schools, crowds define most students’ status and reputation. Today, schools and communities are growing more ethnically diverse and types of crowds have expanded to include ethnically oriented groups. A new study finds that ethnic minority teens tend not to hang out with crowds made up of their ethnic peers. The study also found that being part of an ethnically oriented crowd at school is, for most Asian students, associated with mostly positive characteristics (such as pride in one’s ethnic background). For most Latino students, being part of an ethnically oriented crowd is associated with a mixed group of characteristics (some pride, but also some feelings of discrimination and stereotyping). The study was conducted by researchers at the University of Wisconsin-Madison, Dartmouth College, and the University of North Carolina-Chapel Hill. It is published in the May/June 2008 issue of the journal Child Development.

The researchers sought to determine what factors explain whether ethnic minority teens are associated with ethnically oriented school crowds (for example, Blacks, Asians, or Mexicans) or with crowds based on individual abilities and interests (such as so-called jocks, druggies, populars, Goths, brains, loners, and nerds). In addition, they sought to understand whether crowds foster discrimination and stereotyping, or affirm young people’s positive ties to their ethnic background.

Researchers polled 2,465 African American, Asian American, and Latino teenagers ages 14 to 19 attending seven public high schools in the midwestern and western United States. The students were given a list of the crowds most commonly mentioned by other teens at their school and asked to indicate the one they identified with most closely. In addition, a group of students placed all their classmates (including those initially polled) into crowds; the researchers then looked for characteristics that distinguished adolescents who were part of ethnically oriented crowds from adolescents who were part of non-ethnic crowds.

The study found that ethnic crowd affiliation was not widespread, particularly among biracial youth. Only about 30% of the teenagers were placed by peers in ethnically oriented crowds, and only half that number associated themselves with such crowds. Teens in the ethnic categories studied were more likely to be placed by peers—and to place themselves—in crowds that were not defined ethnically.

However, since ethnicity is an important factor in the self-image and peer reputation of many youths, the study also sought to determine why some ethnic minorities do associate themselves with ethnic crowds at school. For all three ethnic groups studied, teenagers were more likely to be part of an ethnically oriented crowd if most of their friends came from the same ethnic background and if the students were doing poorly in school. Moreover, Latino and Asian American teens who had positive feelings about their ethnic background were more likely to associate themselves with a crowd made up of other teens from their ethnic group.

Furthermore, Latino students were more likely to be part of an ethnically oriented crowd if they came from lower-income homes and had experienced a lot of ethnic discrimination, perhaps because associating with a Latino crowd served as a defense against negative experiences with other peers at school.

“Adolescent crowds are often disparaged as instruments of peer pressure and stereotyping that interfere with healthy identity development,” notes Bradford Brown, professor of human development and educational psychology at the University of Wisconsin-Madison and the study’s lead author. “Our findings suggest that this might be true for ethnically oriented crowds in multi-ethnic American high schools, at least among Latino youth. In other respects, however our findings suggest that ethnically oriented crowd affiliations can reflect and contribute to healthy identity and social development, particularly among adolescents of Asian backgrounds.” ###

The study was funded, in part, by the U.S. Department of Education.

Summarized from Child Development, Vol. 79, Issue 3, Ethnicity and Image: Correlates of Crowd Affiliation Among Ethnic Minority Youth, by Brown, BB (University of Wisconsin-Madison), Herman, M (Dartmouth College), Hamm, JV (University of North Carolina-Chapel Hill), and Heck, DJ (Horizon Research, Inc.). Copyright 2008 The Society for Research in Child Development, Inc. All rights reserved.

Contact: Andrea Browning abrowning@srcd.org 202-289-7905 Society for Research in Child Development

Racial disparities decline for cancer in Missouri

Sept. 23, 2008 -- Cancer death rates in the United States are highest among African Americans, but a new report shows that in Missouri the disparity in cancer incidence and death between African Americans and whites is declining. As a result, cancer incidence (the rate of newly diagnosed cases) between the races is equal, although the death rate will probably remain higher for African Americans for some time.

The report will be published in an upcoming issue of Missouri Medicine. The lead author is Mario Schootman, Ph.D., co-leader of the Prevention and Control Program at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital.

"A lot of effort has been made to reduce cancer racial disparity in Missouri," says Schootman, also chief of the Division of Health Behavior Research and associate professor of epidemiology and medicine. "But there is still work to be done, especially in decreasing cancer mortality. Ideally, cancer will become just another bump in the road — an illness that people will be able to live with for many decades and keep under control."

The report shows that in 1996, the rate of new cancer cases was 18 percent higher for African-American Missourians but declined to six percent higher by 2003, the last year for which the data were analyzed. If this downward trend continues, the disparity in new cancer cases between African-American and white Missourians will have disappeared when 2006 data is analyzed, Schootman says.

On average, the overall Missouri cancer incidence rate decreased by 0.8 percent per year, possibly reflecting a drop in smoking rates and other preventive measures. The disparity in incidence between African Americans and whites might have arisen from such factors as differences in physical activity, weight, vitamin D deficiency, diabetes, diet and occupational exposure to pollutants, according to the report.

On the other hand, racial disparity in overall cancer death rates remains. In 2005, the last year for which the data were analyzed, the cancer death rate was 28 percent higher for Missouri's African Americans than for whites. This was down from a 48 percent higher cancer death rate for African Americans in 1990, but the slow pace of the decrease means that racial disparity in cancer deaths will probably continue for several more decades unless more aggressive interventions are used, Schootman says.

Schootman also individually analyzed four major cancers — colorectal, breast, prostate and lung — and found some trends contrary to the overall cancer trends. Instead of decreasing, the gap between African Americans and whites for colorectal cancer death rates remained as large as ever. The death rate for this cancer declined among members of both groups during the study period of 1990 to 2005, but it remained about 42 percent higher for African-American than white Missourians.

"In Missouri, African Americans were more likely to be screened for colorectal cancer than whites during the timeframe of our statistical analysis," Schootman says. "But that doesn't appear to have made enough of a difference in the rate of death yet. The racial disparity in colorectal cancer death rate is one of the most serious concerns raised by this study."

Schootman explains that there are four possible reasons for the higher colorectal cancer death rate: less aggressive treatment, more advanced cancer at time of diagnosis, less patient engagement in lifestyles that reduce risk of dying after diagnosis — such as exercise and weight loss — and more physical characteristics that increase risk of dying — such as a higher body fat percentage.

Racial disparity in breast cancer deaths increased during the study period. African American women in Missouri had a nine percent lower incidence of breast cancer than did white Missourians at the end of the study period but had a 46 percent higher breast cancer death rate. Schootman says that other studies suggest that lack of insurance, fear of testing, delay in seeking care and unfavorable tumor characteristics all contribute to this disparity.

Another major concern raised by the study was the much higher death rate from prostate cancer among African Americans. Despite a decline in racial disparity, African-American Missourians died at a 116 percent higher rate from prostate cancer than white Missourians. Schootman says that a possible explanation is that African Americans adopted prostate cancer screening and new therapies later than did white Missourians.

Racial disparity in lung cancer deaths decreased during the study period, but remained 15 percent higher for African-American Missourians. Other research suggests several reasons for the disparity: differences in referral to specialists, less patient acceptance of therapy due to distrust or misunderstanding and differences in availability of treatment.

To further reduce disparities in cancer incidence and death, state and local health departments, primary care associations, medical and community-based organizations, large employers and health care companies need to focus on providing equal access to preventive and treatment services.

The Siteman Cancer Center's PECaD (Program for the Elimination of Cancer Disparities addresses racial disparities in cancer in the St. Louis region.

"PECaD's efforts to reduce breast cancer disparities in the region include promoting mammography through outreach and our mobile mammography van, together with access to diagnostic and treatment services," says PECaD director, Graham Colditz, M.D., Dr.P.H., the Niess-Gain Professor and associate director of Prevention and Control at the Siteman Cancer Center. "Similar multilevel approaches will be necessary to reduce disparities."

###

Schootman conducted the analysis in collaboration with the Missouri Department of Health and Senior Services, and the Missouri health department has published a more detailed version of this report, Cancer in Missouri: Trends in Disparities Between African Americans and Whites, which is available in PDF format at: dhss.mo.gov/CancerinMissouri/CancerDisparityReport. Information on cancer incidence and deaths for the report came from the Missouri Cancer Registry and the Bureau of Health Informatics.

Eliminating racial disparities in cancer is a key goal of national organizations and agencies such as the American Cancer Society, the National Cancer Institute and the U.S. Department of Health and Human Services. It is also a key goal of the Missouri cancer control plan developed by the Missouri Cancer Consortium.

Schootman M, Yun S. Trends in cancer disparities between African Americans and whites in Missouri. Missouri Medicine, upcoming issue.

Funding from the Centers for Disease Control and Prevention and the National Cancer Institute supported this research.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

Siteman Cancer Center is the only federally designated Comprehensive Cancer Center within a 240-mile radius of St. Louis. Siteman Cancer Center is composed of the combined cancer research and treatment programs of Barnes-Jewish Hospital and Washington University School of Medicine. Siteman has satellite locations in West County and St. Peters, in addition to its full-service facility at Washington University Medical Center on South Kingshighway.

Contact: Gwen Ericson ericsong@wustl.edu 314-286-0141 Washington University in St. Louis

Hip hop and linguistics: You ain't heard no research like it!

Unique source material furthers research on African American vernacular English It's rare to use the words 'hip hop' and 'serious academic research' in the same sentence,

but a University of Calgary linguistics professor has relied on rap music as source material for a study of African American vernacular English.

Dr. Darin Howe recently contributed a book chapter that focuses on how black Americans use the negative in informal speech, citing examples from hip hop artists such as Phonte, Jay Z and Method Man. Howe is believed to be the only academic in Canada and one of the few in the world to take a scholarly look at the language of hip hop.

"There is still a lot of prejudice against black vernacular English," Howe says. "People tend to assume it's illogical and ungrammatical, but there is a system there and a grammar that you can describe. Rap music may be ear torture for many people, but for linguists, this is what makes us really excited."

Howe specifically focused on the use of the word 'ain't' and on other negative constructions – or, as it's called in linguistics, negation. "When you have multiple negation it seems really confusing, and what happens in black English is that the negation extends across multiple clauses."

For example, the book chapter quotes Tupac Shakur as saying, "It's like can't nobody never get confused and think I'm like Mike Tyson;" in other words, no one could confuse Tupac with Mike Tyson.

In another example, black English commonly substitutes the word 'ain't' for 'didn't.' So 'I didn't see him' could become, 'I aint see him.' "However, black English speakers know that you should only do this for about half the time," Howe says. "White hip hop artists try to imitate black speech, and for the most part they do a decent job, but when they don't have the rules down it becomes noticeable."

One of the intriguing conclusions that Howe draws is that there is an accelerating divergence in the speech dialects of whites and blacks, a subject that surfaced in the late 1990s with the debate on Ebonics.

Howe's focus was purely on the mechanics of the language and not on the culture of hip hop, which some have criticized as violent and misogynistic. He was assisted by an undergraduate linguistics student, Jeff Long, who is keenly interested in hip hop music and who found many of the examples cited in the research. "It's not often that you can combine your own interests with school work, so it was a real joy for me to work on this," Long says. ###

Howe did his master's thesis on African Nova Scotian English but has since specialized at U of C in native languages and phonology, or speech sounds. His chapter, "Negation in African American Vernacular English," appears in the book, Aspects of English Negation, edited by Yoko Iyeiri and published by John Benjamins Publishing Company / Yushodo Press. To arrange an interview with Dr. Howe, contact his office at (403) 220-6110, or phone Greg Harris, (403) 220-3506 or cell, 540-7306. Phone Harris to request a copy of the chapter.

Contact: Gregory Harris gharris@ucalgary.ca 403-220-3506 University of Calgary

Inage Licensing: This image was originally posted to Flickr by Defame. This file is licensed under Creative Commons Attribution 2.0 License.

No longer an issue of black and white?

Ronald E. Hall, Title: Associate Professor. Office Location: 224 Baker Hall. Phone: 517/432-3729. Fax: 517/353-3038. E-mail: hallr@msu.edu WEB: socialwork.msu.edu Education: Ph.D, Atlanta University, MSW, University of Michigan, MCS, University of Detroit

Skin color, more than race, is important cause of racism, according to new book Racism in the 21st Century The color of a person's skin, more than a person's race, is becoming a key cause of racism, according to a new book Racism in the 21st Century co-written and edited by Ronald Hall, associate professor of social work at Michigan State University. In an era when Barack Obama, the first African-American U.S. presidential candidate nominated by a major political party, is running for president, many people still struggle against prejudice and racism. Lighter-skinned blacks, Hispanics, Asians and other minorities often receive preferential treatment over their darker-skinned counterparts in education, housing, employment, and other areas, Hall and his fellow authors argue.

Immigrant workers with lighter skin color make more money on average than those with darker complexions, according to the research of contributor and Vanderbilt University professor Joni Hersch. In addition, the number of Equal Employment Opportunity Commission (EEOC) complaints on skin-color based discrimination are increasing, the book notes. In 2002, the EEOC successfully sued the owners of a Mexican restaurant in San Antonio, Texas, after the restaurant directed the white manager to hire only light-skinned staff to work in the dining room.

Colorism, discrimination based on skin color, is a centuries-old legacy of Western colonialism, according to Hall.

"Racism is no longer an issue of black and white," said Hall who has researched skin color discrimination for 25 years. "As we move further into the 21st century, with increased levels of interracial marriage, we won't be able to make racial differentiations. You're going to have people, for example, with Asian facial features, African hair texture, and Caucasian skin tones – and that's unprecedented. But the way we'll continue to assess one another, unfortunately, is going to be based on the manifestations of skin color. ###

Ronald Hall (Ed.) Racism in the 21st Century, An Empirical Analysis of Skin Color. XIV, 260 p. 9 illus., 2 in color., Hardcover $49.95, €34.95, £26.50, ISBN 978-0-387-79097-8

Contact: Joan Robinson joan.robinson@springer.com 49-622-148-78130 Springer

International Medical Corps, Saving the Lives of Malnourished Children

International Medical Corps has been matched to one of the Top 25 in American Express’ Members Projects, ‘Saving the Lives of Malnourished Children.’

Chosen out of 1,190 projects, “Saving the Lives of Malnourished Children” is now eligible to receive up to $1.5 million in funding. The project with the most votes receives $1.5 million, 2nd receives $500,000, 3rd $300,000, and 4th and 5th $100,000. The funding – made possible by your votes – would bring a vital lifeline to hungry and malnourished children around the world.

We need your help between now and September 29th. Voting is easy and doesn’t cost a thing!

In just a click, you can save the lives of thousands of malnourished children.

For severely malnourished children, we offer a step-by-step treatment program that gives them what they need to recover, including nutrient-dense food supplements like the peanut-based product, Plumpy'Nut. Our comprehensive monitoring system saves more than 90 percent of children being treated in our feeding centers. Being one of the Top 5 would mean our nutrition could reach more children around the world who need our help.

Hunger and malnutrition kill more people in the world than HIV, tuberculosis, and malaria combined. As food prices rise, this funding is even more critical. More people are being driven deeper into poverty trying to afford basic staples. Many have nothing to eat at all. Your vote makes it possible for fewer young lives to be lost because they do not have enough to eat.

Getting the word out to your friends and family makes a huge difference! Forward this link to a friend and you bring us that much closer to the $1.5 million to help malnourished children around the world!

About International Medical Corps

International Medical Corps (IMC) is a global, humanitarian, nonprofit organization dedicated to saving lives and relieving suffering through health care training and relief and development programs.

Established in 1984 by volunteer doctors and nurses, IMC is a private, voluntary, nonpolitical, nonsectarian organization. Its mission is to improve the quality of life through health interventions and related activities that build local capacity in underserved communities worldwide.

By offering training and health care to local populations and medical assistance to people at highest risk, and with the flexibility to respond rapidly to emergency situations, IMC rehabilitates devastated health care systems and helps bring them back to self-reliance.

Help International Medical Corps

Double your impact. Donate today. Your gift is matched before October 31st.

International Medical Corps has received a pledge of $100,000 in matching funds to provide vital health care to millions of children and families suffering in the global food crisis and other emergencies around the world. Every donation made before October 31st will be matched, dollar for dollar, up to $100,000. That means that we can double every dollar you provide, multiplying your gift and reaching more children and families who so desperately need our help.

Did you know that hunger and malnutrition kill more people than HIV/AIDS, tuberculosis, and malaria combined? As food prices soar, billions of people around the world are more vulnerable to malnutrition and severe food insecurity. Malnutrition often puts children at risk for malaria, diarrhea and respiratory infections – creating a vicious cycle. We see the impact of this emergency at our feeding sites and clinics everyday. By making a donation, you provide a lifeline for children and families who desperately need our help.

Contacts: For Press Inquiries: Stephanie Bowen, Communications Manager, International Medical Corps, 1919 Santa Monica Blvd., Suite 400, Santa Monica, CA 90404, 310-826-7800 sbowen@imcworldwide.org