Atlanta's Mayoral Runoff: What to Expect

Emory political scientist Michael Leo Owens gives his views on the forthcoming Atlanta mayoral runoff set for Tuesday, Dec. 2:

Q: Will the voter turnout be any better? How much will GOTV matter on election day?

A: Atlanta is a city too busy or too listless to vote. Thus, voter turnout may or may not be any better for the runoff. On the one hand, many of the 75 percent of registered voters who stayed home during the last election did it because they anticipated a runoff. They bided their time. A good number of them will now vote in the runoff, and their numbers could be great enough to swing the election. Also, the policy differences and records of achievement and inaction between Norwood and Reed are clear and meaningful enough for greater numbers of registered voters to show up at the polls. On the other hand, turnout may be as low if not lower than before.

First, this is a runoff election. We should expect a drop in turnout, not an increase. Second, the length of the campaign has exhausted segments of the electorate. They voted once and they may not vote again. Third, there is a general dissatisfaction with both candidates, which contributed to the low turnout a few weeks ago. Fourth, neither campaign has an electoral machine capable of guaranteeing strong turnout.

At the end of the day, the winner will be the one who converts motivation into mobilization. The edge could go to Norwood.

Emory political scientist Michael Leo Owens

Her partisans are extremely motivated and mobilized to see her win and to send an array of messages to City Hall (e.g., stop raising taxes, provide more efficient services, be accessible, etc.). Reed’s supporters are as motivated as Norwood’s but it’s unclear if they are as mobilized. Unless he can figure out how to increase turnout for him, especially in working-class Black neighborhoods and racial-transition neighborhoods where he did poorly, all the motivation in the world may not matter. Q: What’s been most notable about each campaign this past month leading up to the run-off? A: Both campaigns have flipped the political script. One, Norwood was the first to go negative in the runoff, implying that Reed was a tax scofflaw. Front-runners are expected to remain on the high road.

Two, Norwood went underground for the first week after the election. Front-runners are supposed to be out in front, literally and always. Third, the White candidate is the “racial” candidate. Norwood has subtly racialized the campaign by reminding the electorate that the election is “not about race” while making clear and overt appeals to Black voters, especially through Black surrogates and web-based videos. Fourth, Reed has focused less on paid advertisements and more on free media. He’s used his almost daily announcements of key endorsements to generate publicity, interest and momentum.

Q: How much has race been a factor in this campaign and how much will it matter in determining the winner?

A: Race remains an element of Atlanta politics, even in 2009. This explains, for example, why some White voters saw Lisa Borders' endorsement of Reed after her third-place finish as a "racial" endorsement -- one Black person supporting another Black person to prevent the election of a White person. It also explains why some White voters have publicly expressed support for Norwood because she’s White and thus deemed essentially different from the Black candidate and a break from the legacy of black mayors. Plus, race matters when some voters make choices based on “qualifications” and “experience.” None of this is to suggest that race is the dominant attribute of Atlanta politics. Rather, it is an enduring one, especially in light of 36 years of Black control of the city government, dramatic increases in the number of Whites moving into the city, and the reality of racial inequalities that politics seems incapable of reducing.

Surprisingly, race has played a far smaller role than many pundits anticipated. They feared (or hoped for) racial ugliness. They did not get it. Neither Norwood nor Reed wished to get bogged down in debates over race, even if some of those debates are necessary to understand their policy stances (e.g., racialized poverty in the city, redevelopment of public housing, contracts to minority firms, etc.). Also, neither candidate wanted to be painted as "racist" or be caught appealing to narrow racial interests.

Q: What would be the significance of a Norwood win?

A: If Mary Norwood wins, it will be by winning the most votes in a majority-Black city without winning the majority of votes from Blacks. In that way, she’ll be like Obama, who won the most votes in a majority-White nation without winning the majority of votes from Whites. ###

Contact:

• Beverly Clark: 404.712.8780
• Elaine Justice: 404.727.0643

News Release: Law, Politics, Nov. 25, 2009

IU's Neal-Marshall Black Culture Center promotes community service through 'Kwanzaa-in-Action'

BLOOMINGTON, Ind. -- "Kwanzaa-in-Action," the Neal-Marshall Black Culture Center's Pre-Kwanzaa Celebration on Dec. 2 at Indiana University Bloomington, will focus on community service. The event is designed to incorporate the seven principles of Kwanzaa through friendly competition among IU student organizations to benefit the university and Bloomington communities.

The public is invited to the pageant-style presentation and reception, where a panel of IU faculty and staff will judge the participating organizations' service projects and award a $500 prize to the winning organization. The event will feature entertainment and food, and will begin at 6 p.m. in the Grand Hall of the Neal-Marshall Black Culture Center, 275 N. Jordan Ave.

Admission is free to the public, but everyone is encouraged to bring a canned good, which will be donated to the local food pantry.

Kwanzaa was first celebrated on Dec. 26, 1966, and is traditionally observed from Dec. 26 through Jan.1, with each day focused on Nguzo Saba, or the "seven principles." Derived from the Swahili phrase "matunda ya kwanza," which means "first fruits," Kwanzaa is rooted in the first harvest celebrations practiced in various cultures in Africa.

Kwanzaa seeks to reinforce a connectedness to African cultural identity, provide a focal point for the gathering of African peoples and to reflect upon the seven principles that have sustained them. The holiday has been observed at IU since the early 1990s.

Audrey McCluskey, director of the Neal-Marshall Black Culture Center, noted that previous Kwanzaa celebrations at IU have involved guest speakers, art exhibits, children's programs and even a food festival. However this year's planners wanted to do something more specific to the Kwanzaa principles, which include unity, faith, cooperative economics, and creative work and responsibility.

All student organizations at IU have been invited to enact one or more of these principles through a community service project. "This is an open and friendly competition," McCluskey said. "They all will win, in fact. Giving back is a valuable part of all students' education."

Examples of the projects that organizations have entered in the competition include fundraisers for African relief and the World Food Program, programs to help young people prepare for college and succeed as young adults, and a program to donate Thanksgiving baskets in the community.

The pre-Kwanzaa event also will feature entertainment by student performers and a gala reception.

FOR IMMEDIATE RELEASE Nov. 24, 2009

Key Findings: African Americans in Wisconsin *

Social and Demographic Characteristics

• African Americans are the largest racial/ethnic minority group in Wisconsin, and constituted 6.1 percent of the Wisconsin population in 2007. African Americans were estimated to number 344,658 of the 5,641,581 residents of Wisconsin.

• African Americans are a younger population than Wisconsin as a whole, with a median age of 25. A younger median age means larger proportions of children and young adults, and a lower proportion of older adults, than the state as a whole.

• In 2007, the rate of poverty among African Americans in Wisconsin was 48 percent, four times greater than the poverty rate in the total state population (12%).

• Nearly 50 percent of black children in Wisconsin were living in poverty in 2007.
Mother and Infant Health

• In 2005, the low birthweight rate among babies born to African American mothers in Wisconsin was 13.7 percent, nearly twice the rate for all Wisconsin births (7.0%). Low birthweight means a weight of less than 5.5 pounds or 2,500 grams at birth.

• Other risks occurring at higher rates among African American births include the percent of births to teenagers (23%), and the percent of births to women who have not graduated from high school (35%).

• During 2003-2005, the infant mortality rate among African American babies was 16.5 deaths per 1,000 births. This was higher than the total infant mortality rate for Wisconsin during those years (6.4) and higher than the African American infant mortality rate in 1992-1994 (14.5).
Mortality

• Based on age-adjusted total death rates (all causes combined), African Americans have higher rates of death than the total state population after taking differences in population age structure into account.

• During the years 2001-2005, the five leading causes of death among African Americans in Wisconsin were cancer, heart disease, unintentional injury, stroke, and homicide.

• Causes of death with the largest disparities, where the age-adjusted mortality rate among African Americans was at least twice the white rate, were diabetes (2.3 times the white rate) and homicide (14.7 times the white rate).
Chronic Diseases

• In 2001-2005, the age-adjusted mortality rate from heart disease was 252 deaths per 100,000 population among African Americans, higher than the rate in the total Wisconsin population (202). Heart disease hospitalization rates were also higher for African Americans.

• Age-adjusted mortality and hospitalization rates for cancer were higher in the African American population than the total Wisconsin population. The African American cancer mortality rate was 248 deaths per 100,000 population, compared to 184 per 100,000 in Wisconsin as a whole.

• Stroke death and hospitalization rates were higher in the African American population compared to the total state population. In 2001-2005, the age-adjusted mortality rate from stroke was 68 deaths per 100,000 among African Americans, and 53 per 100,000 among all Wisconsin residents.

• Diabetes deaths and hospitalizations also occurred at higher rates in the African American population. The age-adjusted mortality rate from diabetes was 49 deaths per 100,000 among African Americans, and 22 per 100,000 in the total state population. The age-adjusted rate of diabetes hospitalizations was 445 per 100,000 in the African American population, more than three times the rate in the total state population (125 per 100,000).
Injury

• In 2001-2005, the age-adjusted mortality rate for unintentional injuries (such as car crashes, falls, fires, and drowning) was 41 deaths per 100,000 population among African Americans, and 39 per 100,000 among the total Wisconsin population.

• The age-adjusted mortality rate from homicide was 26 deaths per 100,000 among African Americans, compared to 4 per 100,000 among the total state population. Among African Americans, the rate of death from homicide was 46 per 100,000 among males and 7 per 100,000 among females.

• The age-adjusted suicide death rate was lower in African Americans (7 per 100,000) than in the total state population (11 per 100,000).

Communicable Diseases

• In 2001-2005, African Americans accounted for 37.3 percent of new HIV infections in Wisconsin, while making up about 6 percent of the state’s population. The rate of new HIV infections in African Americans (46.9 cases per 100,000 population) was nearly nine times the rate in whites (5.3 per 100,000).

• For the years 2001-2005, African Americans accounted for 31.8 percent of reported Chlamydia cases, 51.2 percent of reported gonorrhea cases, and 45 percent of reported syphilis cases in Wisconsin.

• Between 2001 and 2005, the number of hepatitis C infections reported among African Americans declined annually (from 589 to 242), although the large number of cases with unknown race makes trends difficult to establish.

• The proportion of African American children aged 19-35 months who have had three or more doses of polio vaccine (92.5% in 2005) is similar to the proportion in all Wisconsin children of that age (94.9%). The proportion who have had three doses of hepatitis B vaccine is also similar.
Oral Health

• In 2001-2005, African Americans were less likely to have visited a dentist recently: 61 percent of African Americans had seen a dentist in the past year, compared to 73 percent of all Wisconsin residents.
Environmental Health

• An estimated 13 percent of African Americans in Wisconsin have been diagnosed with asthma; this is higher than the statewide percentage (9 percent).

• In 2005, 3.4 percent of Wisconsin children tested had elevated levels of lead in their blood. The proportion was higher among African American children tested (9.7%).
Behavioral Health Risks

• An estimated 29 percent of African American adults in Wisconsin smoke cigarettes, based on 2001-2005 survey results. This is higher than in the general Wisconsin population (22%).

• Binge drinking (five or more drinks on one occasion) occurred at a lower rate among African Americans in Wisconsin (16%) than in the total adult population of the state (24%).

• In 2001-2005, 59 percent of African Americans said they were physically inactive in the past month, compared to 45 percent of all Wisconsin adults.

• African Americans were also more likely to be overweight or obese: 70 percent, compared to 60 percent of the total population.
Access to Health Care

• In 2001-2005, the percent of people without health insurance at any point in time was more than twice as high among African Americans (13%) than in the total Wisconsin population (6%).

• Among women age 50 and older, the percentage who received a mammogram in the past year was higher among African American women (76%) than among all Wisconsin women (67%). Rates of other kinds of screening (cholesterol, Pap smear, clinical breast exam) were similar between the African American and total Wisconsin populations.

* Excerpted from: Wisconsin Department of Health and Family Services, Division of Public Health, Bureau of Health Information and Policy. Wisconsin Minority Health Report, 2001-2005 (PPH 5716). January 2008.

Justice Department Sues Chicago Area Landlord for Refusing to Rent to African Americans

WASHINGTON – The United States has filed a lawsuit against Terence Flanagan, a Chicago area property owner and rental agent, alleging that he refused to rent properties he owned or controlled to African-Americans, in violation of the federal Fair Housing Act, the Justice Department announced.

The lawsuit, filed today in federal court in Chicago, alleges that Flanagan refused to rent a single-family house he owns in Orland Park, Ill., to Kamal Alex Majeid, who is African-American, because of his race. The lawsuit also alleges that Flanagan asked a white tester employed by the Justice Department whether her husband was African-American and admitted to her that he did not want to rent to African-Americans. The suit further alleges that Flanagan told this tester that he had numerous other rental properties in the Chicago area.

Testers are individuals who pose as applicants for housing and report on their interactions with housing providers to determine the providers’ compliance with fair housing laws. Since 1991, the Department has operated a Fair Housing Testing Program whereby it uses federal employees or contractors as testers to identify violations of the Fair Housing Act.

"Racial discrimination has no place in this nation, particularly when it stands in the way of an individual satisfying a basic need like housing," said Thomas E. Perez, Assistant Attorney General of the Civil Rights Division. "This lawsuit makes clear that such discrimination will not be tolerated, and we will use all tools at our disposal to root out unlawful discrimination against racial and ethnic minorities."

"We are committed to seeking out discrimination and acting forcefully to eliminate it in all its forms from the Chicago-area housing market," said Patrick J. Fitzgerald, United States Attorney for the Northern District of Illinois.

This lawsuit resulted from a complaint submitted to the Justice Department by the South Suburban Housing Center, a private suburban Chicago fair housing organization, after it was contacted by Majeid. Majeid filed a lawsuit against Flanagan in August. That lawsuit is currently pending in federal court before the Honorable Samuel Der-Yeghiayan. The United States’ complaint seeks a court order prohibiting future discrimination by the defendant, monetary damages for those harmed by the defendant’s actions and a civil penalty.

Individuals who may have information related to this lawsuit should contact the Justice Department toll-free at 1-800-896-7743, mail box number 93, or email the Justice Department at fairhousing@usdoj.gov. Fighting illegal housing discrimination is a top priority of the Justice Department. The federal Fair Housing Act prohibits discrimination in housing based on race, color, religion, national origin, sex, disability and familial status. More information about the Civil Rights Division and the laws it enforces is available at http://www.justice.gov/crt. Individuals who believe that they may have been victims of housing discrimination can call the Housing Discrimination Tip Line at 1-800-896-7743, e-mail the Justice Department at fairhousing@usdoj.gov, or contact HUD at 1-800-669-9777.

The complaint is an allegation of unlawful conduct. The allegations must be proven in federal court.

09-1271 Civil Rights Division: Department of Justice Office of Public Affairs FOR IMMEDIATE RELEASE Monday, November 23, 2009

National Suburban Poll Examines Diversity, Race Relations, Impact of Economic Crisis in Suburbs VIDEO

First Comprehensive Data on Opinions, Attitudes of Minority Suburbanites.

Hofstra University, Hempstead, NY -- A new National Suburban Poll for the National Center for Suburban Studies at Hofstra University (NCSS) brings into sharp focus the profoundly personal impact of the economic crisis on suburbanites, with three-quarters saying they or someone they know has lost a job, suffered a cut in pay, work hours or benefits.

The findings, when compared to a National Suburban poll in October 2008, offer compelling evidence that America’s suburbs have been at the epicenter of the recession. In 2009, for example, 76 percent of suburbanites said either they or someone they knew had lost a job since October 2007, up from 51 percent last year.

“Our poll shows that job loss and foreclosure are both hitting close to home for suburbanites,” said NCSS Academic Director Christopher Niedt, Ph.D. “And when we dig a little deeper, we find that suburban people of color are feeling the economic pain even more acutely.”

This latest poll, the third issued by the NCSS, focuses on diversity and the economic crisis in the suburbs and comes as Hofstra prepares to host a ground-breaking conference Oct. 22-24, 2009 called “The Diverse Suburb: History, Politics and Prospects”. The conference will bring together academics, activists and policymakers to examine the impact of shifting demographics, and hash out the challenges and opportunities that lay ahead.

The poll oversampled minority suburban residents, making it the first poll of its size to provide reliable, projectable data about the opinions and attitudes of blacks and Hispanics in the suburbs. It was designed and conducted for the NCSS by Princeton Research Survey Associates.

“I know of no other national poll that has sought to shine a light as intensely on black and Hispanic residents of suburban communities that are undergoing dynamic demographic change,” said Lawrence C. Levy, NCCS executive director. “That the poll focuses on minorities in particular adds a whole extra dimension to the Diverse Suburbs conference, which itself will present new data and perspectives from experts and activists around the world.”

The poll also reveals that President Obama’s support among suburban residents, which was so critical to his historic election, is eroding as the economy sours. Just 47 percent of suburbanites gave him a positive job approval rating, while 31 percent – more than double the number from 2008 – said they believe the federal government’s response to the economic crisis has hurt their family finances.
Race and ethnicity also play a major role in Obama’s approval ratings among suburban residents: only 39 percent of white suburbanites gave him a positive rating, compared to 66 percent of Hispanics and 91 percent of African-Americans.

“Obama has lost support in the suburbs, where his administration’s economic policies have been particularly unpopular,” Niedt said. “He has remained popular, though, among African-Americans and Hispanic residents – precisely the groups that are suffering most.”

And while the suburbs are more diverse than ever – large numbers of residents from all racial and ethnic groups now report living in mixed neighborhoods, suburbanites see less racial tension than those living in cities. Sixty percent of suburban residents say racial tension is not a problem, compared to 40 percent in urban areas.

Yet views about race relations vary by race and ethnicity, particularly among Hispanic suburbanites. About a third of whites and African-Americans in the suburbs believe racial tension is a problem, while 46 percent of Hispanics do. And Hispanics in the suburbs are less positive about how well they get along with African-Americans than their urban counterparts. While 63 percent of Hispanics living in cities agree that they generally get along with African-Americans, only 53 percent of Hispanics in the suburbs do.

“When President Obama was elected, we heard a lot about how America was entering a ‘post-racial’ era, and in the suburbs there are some hopeful signs,” Niedt said. “For example, whites and African-Americans said that they got along with each other and with Hispanics. But for many Hispanics, the perspective is quite different, and less optimistic. Almost half said that they did not generally get along with African-Americans.”

Among other findings of the poll:

--- More than a third of suburban residents – 36 percent – say they or someone they know has lost their home to foreclosure or because they could no longer afford their mortgage payments. That’s up from 28 percent in 2008.

--- Forty-seven percent of suburbanites say immigrants face some discrimination, but the same percentage believe state and local government treat illegal immigrants too leniently. Fifty-five percent say the federal government is too lenient.

The third national Suburban Poll is based on phone interviews in English and Spanish with 1,781 adults from Sept. 21 to Oct. 4, 2009. The margin of error for the total sample is plus or minus four percentage points. For results reflecting suburbanites, the margin is plus or minus five percentage points, and for urban and rural residents it is plus or minus six percentage points.

The National Center for Suburban Studies at Hofstra University is a non-partisan research institution dedicated to promoting objective, academically rigorous study of suburbia’s problems and promise. Rooted in the laboratory of Long Island’s diverse and aging suburbs, the National Center studies a broad range of local and national issues. The suburbs have emerged as the nexus of dynamic demographic, social, economic and environmental change. The tasks of identifying, analyzing and solving the problems of suburbia are key to the health of the country – and central to the Center’s mission.

Hofstra University is a dynamic private institution where students can choose from more than 140 undergraduate and 155 graduate programs in liberal arts and sciences, business, communication, education and allied health services, honor studies, as well as a School of Law, ###

Media Contact: Karla Schuster. University Relations Hofstra Hall 202 Phone: 516-463-6493 Fax: 516-463-5146 Send an E-mail

Investigation into Scam Targeting African American Churches

Brown Launches Investigation into Scam Targeting African American Churches

Los Angeles - Attorney General Edmund G. Brown Jr. announced today that his office has launched an investigation into whether four individuals defrauded more than 30 African American churches in Southern California by forcing them to pay up to $45,000 for shoddy computer kiosks originally presented as cost-free. These individuals-Michael Morris; Willie Perkins; Tonya Wilson; and Wayne Wilson-are also suspected of targeting dozens of churches in at least ten other states.

Additionally, Brown is investigating what role three national leasing companies-Balboa Capital Corporation; United Leasing Associates of America Ltd.; and Banc of America Leasing and Capital, LLC-may have played in facilitating this scam.

"These individuals sold the churches on the promise of free services and advertising revenues," said Brown. "Instead, the churches were enticed into expensive leases, which the leasing companies aggressively enforced, even after learning of the alleged scam."

Since 2000, Morris, Perkins, Wilson and Wilson have operated two companies-Urban Interfaith Network and Television Broadcasting Online-that peddled computer kiosks to African American churches throughout the country. In California, these individuals targeted neighborhood churches in Compton, Los Angeles, Long Beach, Moreno Valley, Murrieta, Pasadena, Perris, Pomona, Rialto, Riverside and San Bernardino.

These individuals purportedly pitched the kiosks to church leaders as cost-free, high-tech devices that could serve as electronic message boards, print retail coupons from local businesses and generate advertising revenue.

Once a church agreed to house a kiosk, the individuals presented it with a lease agreement from United Leasing Associates of America Ltd. or Balboa Capital Corp (who later sold some of its leases to Banc of America Leasing and Capital, LLC). The individuals repeatedly assured church leaders that Urban Interfaith Network, Television Broadcasting Online or other church-friendly corporate sponsors would cover all leasing costs.

Instead, churches were left with leases as high as $45,000 per year for what amounted to little more than desktop computers and printers housed in podium-sized wooden boxes. Many of the kiosks did not function.

Even after learning of the alleged scam, leasing companies continued to aggressively enforce the terms of the leases, filing lawsuits against churches to collect payment, interest and late fees. For example:

- Los Angeles-based Bryant Temple AME Church was sued by Balboa Capital Corp. to collect on a kiosk lease even after the church informed the company that it had been defrauded into signing the lease. For months, the church pooled funds together to pay down the lease and avoid the cost of litigation, however, it has recently decided to stop making payments to Balboa.

- Los Angeles-based True Way Missionary Baptist Church contends in its own lawsuit against United Leasing Associates of America, Ltd. that even after learning of the alleged scam, the leasing company collected payments on the lease by debiting the church's bank account without authorization. The lawsuit further contends that United obtained a default judgment in Wisconsin for over $30,000 for a kiosk that the leasing company knew was worth only $2,000.

- San Bernardino-based Ecclesia Christian Fellowship Church was sued by Balboa Capital Corp. and Banc of America Leasing and Capital, LLC to collect on two separate kiosk leases. The two leasing companies continue to aggressively pursue their lawsuits.

- San Bernardino-based New Hope Missionary Baptist Church was sued by Banc of America to collect payment on two leases it purchased from Balboa Leasing. The church filed a countersuit contending that Balboa, working with Urban Interfaith Network and Television Broadcasting Online, defrauded the church. Balboa's motion to dismiss the church's countersuit was overruled in court.

Brown has served investigative subpoenas on the three leasing companies: United Leasing Associates of America Ltd.; Balboa Capital Corporation; and Banc of America Leasing and Capital, LLC; and the two companies operated by Morris, Perkins, Wilson and Wilson: Urban Interfaith Network and Television Broadcasting Online.

Last month, Michigan Attorney General Mike Cox filed criminal charges against Morris and Perkins, including: one count of racketeering, one count of conspiracy to commit false pretenses over $20,000, four counts of false pretenses over $20,000 and four counts of fraudulently obtaining a signature. # # #

News Release November 20, 2009 For Immediate Release Contact: (916) 324-5500

Health reform gaps for ethnic elders

Press briefing: Health reform gaps for ethnic elders

Event:

The Gerontological Society of America (GSA) — in cooperation with New America Media and the Journalists Network on Generations — invites reporters to "Health Reform Gaps for Ethnic Elders," a press briefing taking place at GSA's upcoming Annual Scientific Meeting in Atlanta, GA.

Date and Time:

Wednesday, November 18, 5 to 6 p.m. EST. (A journalists' reception will follow.)

Location and Call-in Information:

The briefing will be held in Room 212 of the Hilton Atlanta, located at 255 Courtland Street NE. Journalists can apply for a complimentary media registration online www.geron.org/ampress.

Reporters who cannot attend in person can listen and ask questions by toll-free conference line. Please dial in at least ten minutes before the start of the briefing. The call-in numbers are as follows:
U.S. toll free: 888-299-4099
Canadian toll free: 866-682-1172
International toll: 302-709-8337
Passcode (to be given to the operator): VK44448

Focus:

Closing the gap of health disparities for elders — no matter what happens on Capitol Hill with regard to health care reform — is at the center of the nation's unfinished business. The critical link to that is bridging the knowledge gap between health scientists and policy makers.

The populations of ethnic elders are growing at two to three times the rate of older non-Hispanic whites. The proportion of ethnic elders in the U.S. will double by 2050 to make up 40 percent of all people aged 65 and over. National experts presenting new information at the GSA conference will focus on going beyond the current health care debate to meet the needs of our rapidly growing and increasingly diverse boomer and senior populations.

Multicultural and language issues range from better medical and pain management for African American elders to improving nutrition and exercise among low-income Mexican Americans. Without more serious attention to multicultural seniors, ethnic older Americans and the families will increasingly endure a growing burden of disease and disability, while the U.S. will face billions in unnecessary health costs and billions more in lost productivity gains.

In an unusual show of unity, members of the research community in aging will come together to call for closing the gulf between America's scientific and social science know-how and its policymakers.

Speakers will examine unaddressed issues for ethnic elders and how new findings presented at the conference can help to recast the national debate from the costs of health care to comprehensive, continuity of care that will maximize the wellness and productive capacity of older adults and their families.

Participants:

Sara E. Espinoza, MD, is an assistant professor of medicine in the Division of Geriatrics and Gerontology within the Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center at San Antonio. At the conference, she will be presenting 10-year data from the San Antonio Longitudinal Study of Aging (SALSA), partly showing that lower socio-economic status impedes access to the means of healthy aging among frail Mexican elders and those with diabetes. She also focuses on the under-representation of ethnic elders in academic medicine and scientific research.

Carmen R. Green, MD, is a professor of anesthesiology and obstetrics and gynecology, and an associate professor of health management and policy at University Hospital within the Department of Anesthesiology at the University of Michigan, Ann Arbor. Green's health services research agenda focuses on pain management outcomes for African Americans, physician decision-making, and access to care. She is the principal investigator for the Michigan Pain Outcomes Study Team. Her scrutiny of disparities due to age, race, gender, and class has revealed a "health care bubble," which she defines as structural barriers to health, physician decision-making, and health policy. Green is also the director for the Dissemination and Health Policy Core for the Michigan Center for Urban African American Aging Research.

Toni P. Miles, MD, PhD, is a professor of family and geriatric medicine and the Wise-Nelson Endowed Chair in Clinical Geriatrics Research at the University of Louisville. In 2009 she was a Health and Aging Policy Fellow in the Obama administration, where she served on the health care team of the Senate Finance Committee — working on policies related to geographic disparities in healthcare. Her chapter in a new book, "Life Course Perspectives on Late Life Inequalities," proposes a new way to measure the impact of health reform on disparities in mortality and access to health care. ###

Online Press Kit:

A special online press kit for this briefing will be posted at www.geron.org/ampress. It will include full-length participant biographies with contact information and high resolution photos; background papers from the participants, and fact sheets about the host organizations.

The Gerontological Society of America (GSA) is the nation's oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society — and its 5,200+ members — is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA's structure also includes a policy institute, the National Academy on an Aging Society, and an educational branch, the Association of Gerontology in Higher Education.

Awareness of racism affects how children do socially and academically

Most children actively notice and think about race. A new study has found that children develop an awareness about racial stereotypes early, and that those biases can be damaging.

The study, by researchers at Rush University and Yale University, appears in the November/December 2009 issue of the journal Child Development.

This study looked at more than 120 elementary school children from an ethnically and socioeconomically diverse area of the United States. Children were asked questions to determine their ability to understand another person's stereotypical beliefs as well as their own comprehension of broadly held stereotypes. They were also asked about their own experiences with discrimination. In addition, the children's parents completed questionnaires asking about their parenting.

Between ages 5 and 11, the researchers found, children become aware that many people believe stereotypes, including stereotypes about academic ability (for example, how intelligent certain racial and ethnic groups are). When children become aware of these types of bias about their own racial or ethnic group, it can affect how they respond to everyday situations, ranging from interacting with others to taking tests. For example, African American and Latino youths who were aware of broadly held stereotypes about their groups performed poorly on a standardized test, confirming the negative stereotype in a self-fulfilling prophecy.

"These results have important implications for social policy," according to Clark McKown, assistant professor of pediatrics and behavioral sciences at Rush University Medical Center, who led the study. "Specifically, they suggest the need for educational policies and comprehensive programs to reduce stereotypes and their consequences early in children's school careers." ###

The study was funded by the William T. Grant Foundation.

Summarized from Child Development, Vol. 80, Issue 6, Developmental Antecedents and Social and Academic Consequences of Stereotype-Consciousness in Middle Childhood by McKown, C (Rush University Medical Center), and Strambler, MJ (Yale University Medical Center). Copyright 2009 The Society for Research in Child Development, Inc. All rights reserved.

Contact: Sarah Hutcheon shutcheon@srcd.org 202-289-7905 Society for Research in Child Development

Ethnic pride may boost African-American teens' mental health

Most adolescents who belong to an ethnic minority group wrestle not only with their self-esteem (like most teens), but also with identity issues unique to their ethnic group, such as dealing with social stigma. A new study tells us that young people's ethnic pride may affect their mental health.

The study, carried out by researchers at Northwestern University, Loyola University Chicago, and Walden University, appears in the November/December 2009 issue of the journal Child Development.

The researchers studied more than 250 African American youths from urban, low-income families in an effort to assess the unique effects of racial identity and self esteem on mental health.

Dr. Jelani Mandara Associate Professor, Human Development and Social Policy

They found that when young people's feelings of ethnic pride rose between 7th and 8th grades, their mental health also improved over that period, regardless of their self-esteem. Even for those with low self-esteem, the investigators found, a sense of pride in their ethnic group served as a buffer to some mental health problems. Racial identity was a stronger buffer against symptoms of depression for boys than for girls.

"These findings imply that ethnic pride is important to African American adolescents' mental health for other reasons than it simply makes them feel better about themselves as individuals," according to Jelani Mandara, associate professor of human development and social policy at Northwestern University, who was the study's lead author. "The findings also imply that ethnic pride may be as important as self-esteem to the mental health of African American adolescents. Parents, schools, and therapists should expose young people to material and environments that help foster a sense of ethnic pride." ###

The study was supported by the National Institute of Mental Health.

Summarized from Child Development, Vol. 80, Issue 6, The Effects of Changes in Racial Identity and Self-Esteem on Changes in African American Adolescents' Mental Health by Mandara, J (Northwestern University), Gaylord-Harden, NK, and Richards, MH (Loyola University Chicago), and Ragsdale, BL (Walden University). Copyright 2009 The Society for Research in Child Development, Inc. All rights reserved.

Contact: Sarah Hutcheon shutcheon@srcd.org 202-289-7905 Society for Research in Child Development

African-Americans with colorectal cancer have poorer outcomes, lower survival rates

New study in Journal of the American College of Surgeons finds racial disparities in screening and treatment for several cancers

CHICAGO (November 12, 2009) – New research published in the November issue of the Journal of the American College of Surgeons shows that African-American patients with colorectal cancer are more likely to be diagnosed with advanced disease and are less likely to undergo surgical procedures compared with Caucasians, suggesting that improvements in screening and rates of operation may reduce differences in colorectal cancer outcomes for African-Americans.

Racial disparities previously have been demonstrated in numerous studies for a number of cancers, typically due to unequal access to care. As a result, the identification and elimination of these disparities has become a national public health priority.

Timothy Louis Fitzgerald, MD, FACS, Associate Professor.

"Colorectal cancer is the only gastrointestinal cancer that is routinely screened for and can be effectively treated, yet African-Americans still have a profoundly lower survival rate than Caucasians," said Timothy L. Fitzgerald, MD, FACS, associate professor, department of surgery, division of surgical oncology, East Carolina University in Greenville, NC. "Our analysis suggests that these disparities may be attributable to a lack of access to or use of care. It is imperative that screening and treatment are delivered equally to all patients."

East Carolina researchers used four years of population-based Medicare and Medicaid administrative claims merged with the Michigan Tumor Registry and identified data for 18,260 patients (≥66 years) with colorectal (n=13,001; 11.31 percent African-American), pancreatic (n=2,427; 14.38 percent African-American), gastric (n=1,739; 17.49 percent African-American) and esophageal (n=1,093; 13.50 percent African-American) cancer. Key data used in the analysis included likelihood of late-stage diagnosis, likelihood of surgical treatment after diagnosis, and survival.

In evaluating an unadjusted analyses, researchers discovered that African-American patients with colorectal cancer were more likely to present with metastatic disease (23.17 percent versus 14.75 percent Caucasians; p(0.05) and less likely to undergo operations (71.25 percent versus 79.05 percent; p(0.05), regardless of socioeconomic factors. This finding was the case even when the analysis was confined to patients with localized, surgically treatable diseases.

The median survival of African-Americans with colorectal cancer (39 months versus 56 months) and esophageal cancer (5 months versus 9 months) in the study was significantly less than that for Caucasians (p ( 0.05). Survival was similarly poor for pancreatic and gastric cancer patients regardless of race.

In conducting a multivariate analysis, the research team found that African-American patients had a higher likelihood of dying from colorectal cancer than Caucasian patients did. However, this difference did not persist when adjustments were made for disease stage and presence or absence of a surgical procedure (hazard ratio = 1.15, 95% CI = 1.06 – 1.24). There was no association between survival and race for patients with esophagus, gastric or pancreatic cancer. Other variables of interest and statistical significance were median household income below $35,000, a dual eligibility insurance status and older age, all of which were negatively associated with colorectal cancer survival. ###

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 77,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

Contact: Sally Garneski pressinquiry@facs.org 312-202-5409 Weber Shandwick Worldwide

Physician bias might keep life-saving transplants from black and Hispanic patients

(Washington, DC) Physician bias might be the reason why African Americans are not receiving kidney/pancreas transplants at the same rate as similar patients in other racial groups. Dr. Keith Melancon, director of kidney and pancreas transplantation at Georgetown University Hospital and associate professor of surgery at Georgetown University Medical Center, and colleagues explore this phenomenon in the November issue of the American Journal of Transplantation.

Medicare coverage for people needing a simultaneous kidney/pancreas transplant has increased in the past decade. In July 1999 Medicare made the changes as a conscious effort by the government intended to address racial and economic disparities that existed. But increased Medicare dollars have not translated into more access for African Americans or Hispanics.

J. Keith Melancon, M.D.

"Our research raised the possibility of racial bias on the part of physicians who might incorrectly assume that African Americans are type 2 diabetics when in fact, they would metabolically meet the criteria for type 1 diabetes," said Dr. Melancon. "Since this is a transplant that is most often performed in type 1 diabetics, their doctors might not even raise the possibility with their black patients. Also, health care providers might incorrectly predict worse outcomes for black patients, despite research that shows they do about as well as other racial groups."

Dr. Melancon's group took a look at the national transplant list before and after the Medicare changes in July 1999. Of the patients already listed for transplant, African Americans were 27% less likely to be recommended for a kidney pancreas transplant than Caucasians. Hispanics were 25% less likely to be recommended. After the Medicare changes African Americans were 28% less likely to be recommended for kidney/pancreas transplant and Hispanics were 31% less likely to be recommended.

"So, the situation for African Americans and Hispanics actually got worse instead of better," said Dr. Melancon.

The benefits of a kidney pancreas transplant are the list is much shorter; 2200 compared with over 80,000 for a kidney alone, according to the United Network of Organ Sharing (www.unos.org). Patient survival and kidney graft survival are better in kidney pancreas transplants.

"I don't think the medical community has been aggressive enough about kidney/pancreas transplant, especially in African Americans who are assumed to have type 2 diabetes. When a person has type 2 diabetes and they are obese, the benefit of a kidney/pancreas transplant is often outweighed by the risks of surgery which are higher in an obese person. So they are not offered the transplant. There is also a population of people with diabetes who are sort of between type 1 and type 2. This procedure would work for them too. But I think the medical community is, in some cases, making assumptions about the African American and Hispanic population that they are not making with other racial groups."

A kidney/pancreas transplant is the only current, reliable way to give diabetics normal glucose and insulin levels 24 hours a day. It's not technically a cure, but it does eliminate the medical problems associated with diabetes. ###

About Georgetown University Medical Center

Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through Georgetown's affiliation with MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university's sponsored research funding.

About Georgetown University Hospital

Georgetown University Hospital is a not-for-profit, acute care teaching and research hospital with 609 beds located in Northwest Washington, D.C. Founded in the Jesuit principle of cura personalis - caring for the whole person - Georgetown is committed to offering a variety of innovative diagnostic and treatment options within a trusting and compassionate environment.

Georgetown's centers of excellence include cancer, neurosciences, gastroenterology, transplant and vascular diseases. Along with Magnet nurses, internationally recognized physicians, advanced research and cutting-edge technologies, Georgetown's healthcare professionals have a reputation of medical excellence and leadership. Georgetown University Hospital is a proud member of MedStar Health.

Contact: Marianne Worley worleym@gunet.georgetown.edu 202-444-4659 Georgetown University Medical Center

Regional variations in rhinosinusitis shows southerners, women most frequent outpatients

New research released at world's largest ENT meeting

San Diego, CA – A four year study of the regional impact of chronic rhinosinusitis (CRS) indicates that African-Americans living in southern states account for the highest proportion of CRS outpatient treatment, according to new research presented at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO, in San Diego, CA.

The NIH-supported study, which included 4,617 patient visits for CRS, found that the prevalence of female outpatients was significantly higher than that of men in all regions. Primary care specialties (which include internal medicine, general, family practice, and pediatrics) were most frequently visited, although approximately 20 percent of visits for CRS took place in the emergency room.

The study's authors also found that Northeast-based care providers ordered significantly fewer diagnostic services, and prescribed or continued fewer medications at the patient visit for all demographics. The authors believe this indicates that further research is warranted into regional differences of diagnosis and treatment of CRS, and how this impacts management of the disease.

Rhinosinusitis is estimated to affect approximately 14 percent of the U.S. adult population annually; the patient visits chronicled in this study represent approximately 91.2 million national outpatient visits for CRS. However, CRS accounts for only 2 percent of all outpatient visits in the U.S. ###

About the AAO-HNS

The American Academy of Otolaryngology – Head and Neck Surgery (http://www.entnet.org), one of the oldest medical associations in the nation, represents more than 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization's vision: "Empowering otolaryngologist-head and neck surgeons to deliver the best patient care."

Contact: Matt Daigle newsroom@entnet.org 703-535-3754 American Academy of Otolaryngology -- Head and Neck Surgery

Higher risk of GI diseases may mean more vigilance, earlier screenings for minorities

San Diego, CA (October 26, 2009) – Three studies presented this week at the American College of Gastroenterology's 74th Annual Scientific meeting in San Diego underscore the growing disparities in gastrointestinal disease, particularly colon cancer and Barrett's Esophagus, among certain ethnic and gender populations, including African Americans, Latinos and women. These race- and gender-specific disparities underscore the need for education and vigilance among these populations and perhaps more aggressive screening tactics than the population in general.

Using data from more than 500,000 cases of colorectal cancer contained the National Cancer Institute's Surveillance, Epidemiology and End Results Registry, Dr. Robert Wong of California Pacific Medical Center, preformed a retrospective cohort study to analyze the race and gender- specific disparities in colorectal cancer epidemiology.

Dr Robert Wong

Dr. Wong's analysis indicates that from 1973 through 2004, there has been a shift of newly diagnosed cancers to the proximal, or right side colon among the population in general. Females, however, have the greatest proportion of proximal cancers and female Hispanics in particular, show the greatest gender disparity versus Hispanic males (47.7 percent vs 28.2 percent). In addition, while advanced stage colorectal cancers showed a steady decline during the study period, African Americans have the greatest proportion of advanced cancers among all racial and ethnic group.

In fact, between 2001 and 2004, a full quarter (25.2 percent) of all colorectal cancers found in black males were advanced-stage cancers, the highest proportion of any ethnic group.

"The significantly higher rates of proximal cancers among women and advanced cancers in the African American population is concerning," reports Dr. Wong. "While we still must consider whether environmental and genetic factors play a role in these disparities, potential gaps in access to health care resources and education may also contribute to these differences. We should use this information to make improvements to cancer screening and prevention programs."

Proximal Cancers in African Americans

In another study of racial disparities in the prevalence and location of colon adenomas conducted at the University of Illinois at Chicago Medical Center, Dr. Amit Gajera and a team of researchers performed a retrospective analysis of 3220 patient records collected between 2005 and 2007 to determine whether the distribution and number of adenomas could be correlated to ethnic or racial group.

The study found that African American patients not only were more likely than other racial groups to have multiple polyps, but that those polyps were more often located on the proximal side of the colon as compared to other racial groups. The team also assessed whether these disparities could be the result of environmental factors such as alcohol or tobacco use, but found no correlation.

"Understanding that African American patients have a propensity for developing multiple polyps located on the all important right side of the colon is a critical factor for choosing an appropriate screening method," explains Dr. Gajera. "In these cases, we must consider whether flexible sigmoidoscopy is as effective as colonoscopy for examining the proximal colon where these polyps and adenomas are often lurking."

About Colorectal Cancer Screening in African Americans

Because of the high incidence of colorectal cancer and a greater prevalence of proximal or right-sided polyps and cancerous lesions in African Americans, in 2009, the American College of Gastroenterology updated its colorectal cancer screening guideline to include a recommendation for African Americans to begin colorectal cancer screening earlier, at age 45, rather than at age 50 as recommended to average risk patients. According to the ACG guideline, colonoscopy is the preferred strategy for colorectal cancer screening.

Largest Cohort Study to-Date Examines Barrett's Esophagus Prevalence Among Latinos

Historically, middle-aged white males with chronic gastroesophogeal reflux (GERD) have displayed the highest incidence of Barrett's Esophagus (BE). Given that Latinos are the largest and fastest-growing minority ethnic group in the United States, researchers at The University of Southern California conducted a study to determine the prevalence of BE in the Latino population compared to Non-Latino Whites, as well as identify risk factors associated with BE in Latinos.

The research team, led by Dr. Kian Keyashian and Dr. John Kim, reviewed the records of 627 patients, taken from the Los Angeles County and University of Southern California Medical Center who underwent endoscopy for primary symptoms of GERD between March 2005 and January 2009. There were no significant differences between the Latinos and non-Latino Whites in the prevalence of BE or long-segment BE and no difference in the average length of BE. In addition to established risk factors for BE, insulin resistance was also associated with BE among the Latino population.

"Previous studies to compare the prevalence of Barrett's Esophagus in Latinos and non-Latino whites have been inconclusive," explains Dr. Keyashian. "With this large cohort, we have demonstrated that Latino race may confer a higher risk for Barrett's Esophagus than previously described in the literature and, therefore, should be considered in screening Latinos for this potentially dangerous condition." ###

About the American College of Gastroenterology

Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 11,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients. www.acg.gi.org/

View releases on other research breaking at the ACG meeting at www.acg.gi.org/media/press

Contact: Jennifer Burke Labriola burkepr@gmail.com 203-405-1479 American College of Gastroenterology

Low vitamin D levels explains most ESRD risk in African-Americans

Future studies will tell whether raising vitamin D Levels can slow kidney disease

Low levels of vitamin D may account for nearly 60 percent of the elevated risk of end-stage renal disease (ESRD) in African Americans, according to a report in the December Journal of the American Society of Nephrology (JASN). "Our study adds to previous evidence linking vitamin D deficiency to the progression of kidney disease and the need for dialysis," comments Michal L. Melamed, MD, of Albert Einstein College of Medicine (Bronx, NY). "It also explains a fair amount of the increased risk of ESRD in African Americans." Vitamin D is obtained from sun exposure, food and food supplements.

Michal L. Melamed, MD

Melamed and colleagues analyzed a nationwide sample of 13,000 Americans, including measurements of the vitamin D metabolite 25(OH)D. Medicare data were used to identify participants who eventually required dialysis therapy for ESRD. "We found that the participants with the lowest 25(OH)D levels were 2.6 times as likely to end up on dialysis compared to those with higher levels," says Melamed.

The researchers then tested whether 25(OH)D levels could contribute to the higher risk of ESRD in African Americans, compared to whites. "African Americans have lower 25(OH)D levels and a higher risk of ESRD," Melamed explains. "We found that 25(OH)D deficiency was responsible for about 58 percent of the excess risk for ESRD experienced by African Americans."

Vitamin D deficiency is a very common problem in the United States. In recent years, studies have linked low vitamin D to many different health problems, including diabetes, high blood pressure, cancers, and heart disease. The new results add to previous evidence that low 25(OH)D levels are an important risk factor for ESRD. "This is another good reason to make sure that people get enough vitamin D," Melamed adds.

Although it can't prove any cause-and-effect relationship, the study also suggests that vitamin D deficiency is a key contributor to the high risk of ESRD in African Americans. More research is needed to confirm these findings, and to determine whether treatment to raise low vitamin D levels can help to preserve kidney function. "We are currently in the process of enrolling for a clinical trial of vitamin D repletion in patients with chronic kidney disease to further test these hypotheses," says Melamed. ###

Dr. Melamed's research will also be presented as part of a Poster Session during ASN Renal Week on October 30, 2009. This poster presentation is entitled, "25-Hydroxyvitamin D Levels and Progressive Kidney Disease: Contribution to the Excess Risk of ESRD in Non-Hispanic Blacks" (F-PO1101).

Other authors included Paul Muntner, PhD (University of Alabama at Birmingham); Thomas Hostetter, MD (also of Albert Einstein College of Medicine); Erin Michos, MD; Brad Astor, PhD (Johns Hopkins School of Medicine); and Neil R. Powe, MD, MBA, FASN (University of California- San Francisco). Dr Hostetter has consulted for Bristol Myers Squibb, Eli Lilly, and Wyeth. None of the other co-authors reported financial disclosures.

The study entitled, "25-Hydroxyvitamin D Levels, Race, and the Progression of Kidney Disease," will appear in an upcoming issue of JASN, and online at //jasn.asnjournals.org/ on October 29, 2009, doi 10.1681/ASN.2009030283.

The American Society of Nephrology (ASN) does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

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

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

Study finds delay in follow-up among African-American women receiving abnormal breast finding

A new analysis has identified a significant delay in follow-up times among African-American women after the finding of a suspicious breast abnormality. Published in the December 15, 2009 issue of Cancer, a peer-reviewed journal of the American Cancer Society, the study indicates that African-American women may face obstacles to receiving appropriate breast cancer–related care.

In the United States, and particularly South Carolina, African-American women suffer disproportionately higher mortality rates from breast cancer compared to white women. Studies have indicated that African-American women experience significantly longer time intervals from an abnormal mammogram to diagnostic testing or are less likely to comply with recommended diagnostic follow-up exams within six months of an abnormal mammogram.

Swann Arp Adams, MS, PhD, of the University of South Carolina in Columbia,

To investigate further, Swann Arp Adams, MS, PhD, of the University of South Carolina in Columbia, and her colleagues studied medical data from participants of the Best Chance Network, a state-wide service program that provides free mammography screenings to economically disadvantaged and medically underserved women. The program is part of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Dr. Adams and her team analyzed tumor characteristics and patients' adherence to recommended tests following abnormal mammograms.

While African-American women were just as likely as white women to complete diagnostic procedures after abnormal mammography findings, there was a significantly longer time between the first clinical exam and to complete a diagnostic follow-up (median time = 44 days for African Americans and 40 days for European Americans). When time was measured in the number of days between the mammogram and the date of final status, a significant effect of race was no longer evident. Because the clinical breast examination typically precedes the diagnostic mammogram, these findings suggest that the racial differences may occur early in the process. While the reasons for the delay are unknown, they may result from poor communication between patient and doctor, lack of patient trust in her doctor, lack of transportation, proximity of clinics to the patient, and other factors.

The researchers say evidence indicates delayed follow-up of breast abnormalities can result in detecting the breast cancer at a later stage, pointing to one study that found a delayed diagnosis of breast cancer of as little as three months is associated with lower survival than those with prompt follow-up.

The researchers add that the finding of no disparities existing in the overall completion of the follow-up is an encouraging evaluation of the NBCCEDP, as it suggests that the program is making progress toward eliminating racial disparities in breast cancer and offer areas for strengthening.

"Programs specially aimed at providing breast cancer screening to economically disadvantaged women like the National Breast and Cervical Cancer Early Detection Program are successful in eliminating some of the racial disparities seen in breast cancer," said Dr. Adams. "There are still improvements that could be made in the program to help identify and eliminate barriers to timely completion of testing procedures," she added. ###

Article: "Racial differences in follow-up of abnormal mammography findings among economically disadvantaged women." Swann Arp Adams, Emily Rose Smith, James Hardin, Irene Prabhu Das, Jeanette Fulton, and James R. Hebert. Cancer; Published Online: October 26, 2009 (DOI: 10.1002/cncr.24633); Print Issue Date: December 15, 2009.

Contact: David Sampson david.sampson@cancer.org WEB: american cancer society

Partners in weight loss success may help African-Americans shed more pounds

Enrolling in a weight loss program with a family member or friend appears to enhance weight loss among African Americans, but only if the involved partner attends sessions frequently or also loses weight, according to a report in the October 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Obesity and its cardiovascular complications affect many African Americans, according to background information in the article. Standard behavioral treatments for obesity appear to be less successful in African Americans than in whites. Cultural modifications to these standard programs—such as the inclusion of family members and support networks—may enhance their effectiveness.

Shiriki Kumanyika, PhD, MPH, a Professor in the Department of Biostatistics and Epidemiology at the University of Pennsylvania School of Medicine.

Shiriki K. Kumanyika, Ph.D., M.P.H., and colleagues at the University of Pennsylvania School of Medicine, Philadelphia, conducted a two-year trial of a culturally specific weight loss program among 344 African American men and women. The goal was to achieve and maintain a 5 percent to 10 percent weight loss. Components of the program included counseling that encouraged self-monitoring of food intake and physical activity, distribution of pedometers, group sessions involving weight and activity checks and skill building, and community-based field workshops such as cooking demonstrations and gym visits.

A total of 63 individuals enrolled in the program alone and 281 enrolled with a friend or family member (130 of whom were designated as the main, or index, participants and 151 as partners). Of the participants with partners, 65 (and 78 partners) were randomly assigned to a high-support group in which both individuals were expected to attend and participate fully in all treatment sessions. The remaining 65 (and 73 partners) were assigned to a low-support group, in which some portions of the program were restricted to the main participants. All participants' progress was measured at six, 12, 18 and 24 months.

After 24 months, main participants had lost an average of 2.4 kilograms (about 5.3 pounds). Participants in the two family groups initially had better attendance and greater weight loss than those in the individual group, but these changes were not statistically significant and decreased over time.

However, participants whose partners attended more personally tailored counseling sessions had lost more weight at six months in the high-support group and at six, 12 and 24 months in the low-support group. In addition, those in both family groups whose partner lost at least 5 percent of their body weight had greater weight loss at six months than those whose partner lost less than 5 percent (6.1 percent vs. 2.9 percent of body weight lost in the high-support group and 6.1 percent vs. 3.1 percent in the low-support group).

"We evaluated family and friend social support as a specific cultural adaptation strategy, which was added to an ethnic-specific program that was also adapted in other respects," the authors conclude. "Beneficial effects on weight loss were linked to actual rather than assigned partner participation and to partner success in losing weight. Further studies may elucidate ways to facilitate effective family or friend participation and to improve absolute weight losses." ###

(Arch Intern Med. 2009;169[19]:1795-1804. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was funded by a grant from the National Heart, Lung, and Blood Institute. Laboratory analyses were provided through a General Clinical Research Center Grant from the National Institutes of Health/National Center for Research Resources. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Contact: Karen Kreeger karen.kreeger@uphs.upenn.edu 215-349-5658 JAMA and Archives Journals

Higher risk of GI diseases may mean more vigilance, earlier screenings for minorities

San Diego, CA (October 26, 2009) – Three studies presented this week at the American College of Gastroenterology's 74th Annual Scientific meeting in San Diego underscore the growing disparities in gastrointestinal disease, particularly colon cancer and Barrett's Esophagus, among certain ethnic and gender populations, including African Americans, Latinos and women. These race- and gender-specific disparities underscore the need for education and vigilance among these populations and perhaps more aggressive screening tactics than the population in general.

Using data from more than 500,000 cases of colorectal cancer contained the National Cancer Institute's Surveillance, Epidemiology and End Results Registry, Dr. Robert Wong of California Pacific Medical Center, preformed a retrospective cohort study to analyze the race and gender- specific disparities in colorectal cancer epidemiology.

Dr. Wong's analysis indicates that from 1973 through 2004, there has been a shift of newly diagnosed cancers to the proximal, or right side colon among the population in general. Females, however, have the greatest proportion of proximal cancers and female Hispanics in particular, show the greatest gender disparity versus Hispanic males (47.7 percent vs 28.2 percent).

In addition, while advanced stage colorectal cancers showed a steady decline during the study period, African Americans have the greatest proportion of advanced cancers among all racial and ethnic group. In fact, between 2001 and 2004, a full quarter (25.2 percent) of all colorectal cancers found in black males were advanced-stage cancers, the highest proportion of any ethnic group.

"The significantly higher rates of proximal cancers among women and advanced cancers in the African American population is concerning," reports Dr. Wong. "While we still must consider whether environmental and genetic factors play a role in these disparities, potential gaps in access to health care resources and education may also contribute to these differences. We should use this information to make improvements to cancer screening and prevention programs."

Proximal Cancers in African Americans

In another study of racial disparities in the prevalence and location of colon adenomas conducted at the University of Illinois at Chicago Medical Center, Dr. Amit Gajera and a team of researchers performed a retrospective analysis of 3220 patient records collected between 2005 and 2007 to determine whether the distribution and number of adenomas could be correlated to ethnic or racial group.

The study found that African American patients not only were more likely than other racial groups to have multiple polyps, but that those polyps were more often located on the proximal side of the colon as compared to other racial groups. The team also assessed whether these disparities could be the result of environmental factors such as alcohol or tobacco use, but found no correlation.

"Understanding that African American patients have a propensity for developing multiple polyps located on the all important right side of the colon is a critical factor for choosing an appropriate screening method," explains Dr. Gajera. "In these cases, we must consider whether flexible sigmoidoscopy is as effective as colonoscopy for examining the proximal colon where these polyps and adenomas are often lurking."

About Colorectal Cancer Screening in African Americans

Because of the high incidence of colorectal cancer and a greater prevalence of proximal or right-sided polyps and cancerous lesions in African Americans, in 2009, the American College of Gastroenterology updated its colorectal cancer screening guideline to include a recommendation for African Americans to begin colorectal cancer screening earlier, at age 45, rather than at age 50 as recommended to average risk patients. According to the ACG guideline, colonoscopy is the preferred strategy for colorectal cancer screening.

Largest Cohort Study to-Date Examines Barrett's Esophagus Prevalence Among Latinos

Historically, middle-aged white males with chronic gastroesophogeal reflux (GERD) have displayed the highest incidence of Barrett's Esophagus (BE). Given that Latinos are the largest and fastest-growing minority ethnic group in the United States, researchers at The University of Southern California conducted a study to determine the prevalence of BE in the Latino population compared to Non-Latino Whites, as well as identify risk factors associated with BE in Latinos.

The research team, led by Dr. Kian Keyashian and Dr. John Kim, reviewed the records of 627 patients, taken from the Los Angeles County and University of Southern California Medical Center who underwent endoscopy for primary symptoms of GERD between March 2005 and January 2009. There were no significant differences between the Latinos and non-Latino Whites in the prevalence of BE or long-segment BE and no difference in the average length of BE. In addition to established risk factors for BE, insulin resistance was also associated with BE among the Latino population.

"Previous studies to compare the prevalence of Barrett's Esophagus in Latinos and non-Latino whites have been inconclusive," explains Dr. Keyashian. "With this large cohort, we have demonstrated that Latino race may confer a higher risk for Barrett's Esophagus than previously described in the literature and, therefore, should be considered in screening Latinos for this potentially dangerous condition." ###

About the American College of Gastroenterology

Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 11,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients. www.acg.gi.org/

View releases on other research breaking at the ACG meeting at www.acg.gi.org/media/press

Contact: Jennifer Burke Labriola burkepr@gmail.com 203-405-1479 American College of Gastroenterology

Study finds racial segregation a strong factor in learning disparities

Racial segregation in the schools is fueling the learning disparity between young black and white children, while out-of-school factors are more important to the growth of social class gaps, according to a study by Emory University sociologist Dennis Condron.

His findings were published in the October issue of the American Sociological Review.

Condron was perplexed by prior research showing that schools narrow the achievement gap among students of varying social classes while widening the gap between black and white students. To tease out possible reasons for this difference, he analyzed data from the Kindergarten Cohort of the Early Childhood Longitudinal Study.

Dennis Condron

He found that between the fall and spring of first grade, black students' reading and math skills fall almost two months behind those of white students. After controlling for other factors, the data suggested that segregation of schools was a primary driver of this early black-white learning disparity. In contrast, out-of-school factors explained the growth of social class gaps.

"This research adds an important piece to the puzzle of when and why social class and black-white inequalities in academic achievement emerge," says Condron, assistant professor of sociology. "And I hope it raises awareness that social class and black-white achievement gaps come from different sources to some extent. We tend to speak of 'the' achievement gap, but in reality different gaps probably have different sources and require different solutions."

His research also indicated that regardless of social class, black students are less often taught by certified teachers than are white students, and black students are far more likely than white students to attend predominantly minority schools, high-poverty schools and schools located in disadvantaged neighborhoods.

The findings are "a reminder of a persistent problem," Condron says, decades after the 1954 U.S. Supreme Court decision in Brown v. the Board of Education of Topeka struck down state laws establishing separate schools for black and white students.

"De facto segregation remains high these days, with important implications for education," he says. "When it comes to both housing and schools, race trumps class as the central axis upon which blacks and whites are segregated. Real solutions to the black-white achievement gap lie far beyond schools and require changes to society more broadly." ###

Condron's study is the lead article in the October issue of the American Sociological Review, which also features two other studies of educational inequality.

A specialist in educational disparities, Condron is currently analyzing data on more than 80 countries to research the impact of economic inequality on countries' average achievement levels.

Contact: Beverly Clark beverly.clark@emory.edu 404-712-8780 Emory University

African-American lung cancer patients may have different response to new cancer-fighting drugs

UH Case Medical Center study in JCO reinforces focus on personalized treatment for patients based on ethnicity

Clinical research out of University Hospitals Case Medical Center has found that African Americans with a common form of lung cancer have a lower frequency of drug-sensitizing genetic mutations, which may impact response to new cancer-fighting drugs. Published online in the Journal of Clinical Oncology, the study by Rom Leidner, MD, and colleagues report that ethnicity plays a significant role in non-small cell lung cancer (NSCLC) genetics and more personalized treatments may be beneficial to cancer patients.

African American patients with NSCLC are significantly less likely than Caucasian counterparts to harbor activating mutations of the epidermal growth factor receptor (EGFR) gene in their cancers, which suggests that common oral EGFR inhibitor drugs, such as Tarceva® (erlotinib), are unlikely to yield dramatic remissions.

Lung cancer US distribution

Additionally, cancer biopsy testing revealed that African American patients with NSCLC are significantly more likely to have increased copies of the EGFR gene than Caucasians. Detection of increased copies of the Her2 gene in breast cancer, a gene closely related to EGFR, has been the basis for major advances in therapy using drugs which target Her2.

"We are finding that ethnicity may play a significant role in a variety of cancers," says Dr. Leidner, an oncologist with Ireland Cancer Center of University Hospitals Case Medical Center and Visiting Instructor at Case Western Reserve University School of Medicine. "It was already known that a higher proportion of East Asian NSCLC patients harbor mutations of the EGFR gene than Caucasians, and that these mutations are associated with a higher likelihood of major responses to EGFR inhibitors. Before our study, however, surprisingly little data existed for African American patients with this common type of lung cancer."

These findings add to a growing body of evidence demonstrating genetic variation in genetic pathways between ethnic groups, and underscores the need for incorporation of these differences into the design of future clinical trials with agents targeting the EGFR pathway.

Epidemiologic studies have suggested that African Americans have a higher risk of NSCLC and have poorer outcomes with treatment. Ethnic background and genetic make-up are linked, and consequently, may impact the likelihood of major responses to oral EGFR inhibiting drugs. For example, in large international lung cancer trials a higher percentage of East Asian NSCLC patients were found to carry drug-sensitizing mutations of the EGFR gene than Caucasians, and as predicted the highest rates of response to EGFR inhibitor drugs were found in the East Asian patients.

The recently published findings have led the researchers to initiate a follow-up study. This multi-center effort will review the overall rates of response, or lack thereof, among African American patients with NSCLC treated at the Case Comprehensive Cancer Center with EGFR inhibitor drugs during the course of their illness.

"In the future, this may lead clinical cancer researchers to be able to take advantage of these findings for a 'smart-design approach' to clinical trials in lung cancer, with novel treatments and biomarkers employed among different patient populations or even individuals," says Stanton Gerson, MD, Director of the University Hospitals Ireland Cancer Center as well as the Case Comprehensive Cancer Center. "Targeted treatments for patients based on a myriad of genetic and ethnic factors are the wave of the future and may lead the way to improved cure rates for our cancer patients." ###

About University Hospitals

University Hospitals serves the needs of patients through an integrated network of hospitals, outpatient centers and primary care physicians. At the core of our health system is University Hospitals Case Medical Center. The primary affiliate of Case Western Reserve University School of Medicine, University Hospitals Case Medical Center is home to some of the most prestigious clinical and research centers of excellence in the nation and the world, including cancer, pediatrics, women's health, orthopedics and spine, radiology and radiation oncology, neurosurgery and neuroscience, cardiology and cardiovascular surgery, organ transplantation and human genetics.

Its main campus includes the internationally celebrated UH Rainbow Babies & Children's Hospital, ranked second in the nation for the care of critically ill newborns; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Ireland Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. For more information, go to www.uhhospitals.org

Contact: Alicia Reale alicia.reale@UHhospitals.org 216-844-5158 University Hospitals Case Medical Center

Inequalities in Education

News briefs from the American Sociological Review: Inequalities in education
October issue of flagship journal reports on the black-white achievement gap, socioeconomic desegregation in schools and class inequality in higher education

WASHINGTON, DC — Research published in the October issue of the American Sociological Review puts a spotlight on inequalities in education. The following briefs highlight selected sociological findings.

Racial Segregation Fuels Early Black-White Achievement Gap, Data Suggest

Racial segregation of schools, and thereby segregated neighborhoods, appears to be a leading source of academic achievement disparities between young black and white children, according to research by sociologist Dennis J. Condron of Emory University.

Analyzing data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), Condron examines the perplexing role of schools in narrowing the achievement gap among students of varying social classes while widening the gap between black and white students. He finds that between the fall and spring of first grade, black students' reading and math skills fall almost two months behind those of white students.

The data suggest that school factors—especially racial segregation—primarily fuel this early black-white learning disparity, which stands in contrast to the primary role of non-school circumstances (e.g., family, health, social resources) in fueling achievement gaps by social class.

The research also indicates that regardless of social class, black students are less often taught by certified teachers than are white students, and black students are far more likely than white students to attend predominantly minority schools, high-poverty schools and schools located in disadvantaged neighborhoods.

Condron suggests that "real solutions to the black-white achievement gap lie far beyond schools and require changes to society more broadly," such as reducing residential segregation and income and wealth inequality between blacks and whites. He also highlights the need for more studies with both fall and spring data, which would help researchers better understand when and how achievement gaps emerge.

("Social Class, School and Non-School Environments, and Black/White Inequalities in Children's Learning," by Dennis J. Condron, Emory University, in the American Sociological Review, October 2009)

Socioeconomic Desegregation Alone Is Not Effective in Improving Classroom Performance

Although past research has linked academic achievement gains to socioeconomic desegregation in schools, a new analysis reveals some hidden academic and psychological risks of integrating low-income students in schools with predominantly middle- and upper-class student populations that might undercut such achievement gains.

Sociologist Robert Crosnoe of the University of Texas at Austin finds that low-income students were more likely to be enrolled in lower-level math and science courses when they attended schools with mostly middle- and upper-class students, versus schools with low-income student bodies. Likewise, low-income students who attended schools with wealthier student populations were more likely to feel isolated and have negative feelings about themselves. These results were even more pronounced for black and Hispanic students.

Using a sample of low-income public high school students from the National Longitudinal Study of Adolescent Health, Crosnoe finds support for the theory that students' academic success is a function of how they view themselves and how others evaluate them relative to the academic skills and performance of their peers.

Crosnoe argues that achieving statistical representation in schools in not sufficient. He asserts that "desegregation efforts must attend to the social integration of students with lower socioeconomic status, as well as their distribution across courses."

("Low-Income Students and the Socioeconomic Composition of Public High Schools," by Robert Crosnoe, University of Texas at Austin, in the American Sociological Review, October 2009)

Competition for College Admissions Perpetuates Class Divide in Higher Education

Increased competition for college admissions combined with the heightened emphasis on test scores in recent decades has fueled the growth of class inequality in American higher education, according to sociologist Sigal Alon of Tel-Aviv University.

Using data from three nationally representative surveys (National Longitudinal Study of the High School Class of 1972, High School and Beyond, National Education Longitudinal Survey), Alon examines how social class affects college admissions of the high school graduating classes of 1972, 1982 and 1992.

Students from low socioeconomic strata in all three graduating classes were at a marked disadvantage in access to postsecondary education, and this disadvantage increased with college selectivity. Alon finds that the class divide grows during times of high competition in college admissions because privileged high school students are able to adapt to the tightening admissions requirements (i.e., the greater emphasis on test scores), while their underprivileged counterparts are unable to follow suit. This leads to a class-based polarization of test scores, restricting the opportunities of talented underprivileged seniors the most. During periods of declining competition in admissions, Alon finds a convergence in test scores among students of various socioeconomic statuses, leading to a smaller class divide in college enrollment.

"Strides toward equal opportunity in higher education will only be made when the screening tool used in college admissions becomes impervious to training or preparation," said Alon. She predicts that the momentum for going SAT-optional among liberal arts colleges will fall short of equalizing opportunity as long as privileged youth can adapt to the new screening tool used by institutions to sort the influx of applicants. She suggests that class-based affirmative action is one solution to reduce inequality in admissions to four-year colleges.

("The Evolution of Class Inequality in Higher Education: Competition, Exclusion, and Adaptation," by Sigal Alon, Tel-Aviv University, in the American Sociological Review, October 2009) ###

The research articles described above are available by request for members of the media. Contact ASA's Public Information Office at pubinfo@asanet.org or (202) 247-9871.

The American Sociological Review is the flagship journal of the American Sociological Association.

About the American Sociological Association

The American Sociological Association (www.asanet.org), founded in 1905, is a non-profit membership association dedicated to serving sociologists in their work, advancing sociology as a science and profession, and promoting the contributions to and use of sociology by society.

Contact: Johanna Olexy pubinfo@asanet.org 202-383-9005 American Sociological Association