Oakland School District passes vaccine mandate for students 12 and up

The Oakland Unified School District passed a Covid-19 vaccine mandate for students 12 and older Wednesday, despite a lack of full approval from the FDA that it is safe for children. 

The measure makes it one of the first districts, with its student population of nearly 50,000, in Northern California to pass such a vaccine requirement and follows a similar decision made by the Los Angeles school district – the second largest in the US – earlier this month. 

The Piedmont and Hayward districts also passed similar measures Wednesday.  

The resolution, which passed 5-1 with one abstention, did not include enforcement details or indicate a date for the mandate to take effect.

It was met with concern and some outrage, among parents, students and the school board members themselves. 

A teenager received a Covid-19 vaccine in Los Angeles over the summer. Its school district became the first in the state earlier this month to mandate students 12 and older get vaccinated. On Wednesday, the Oakland School District followed suit, making it one of the first in Northern California to do so

A teenager received a Covid-19 vaccine in Los Angeles over the summer. Its school district became the first in the state earlier this month to mandate students 12 and older get vaccinated. On Wednesday, the Oakland School District followed suit, making it one of the first in Northern California to do so

A teenager received a Covid-19 vaccine in Los Angeles over the summer. Its school district became the first in the state earlier this month to mandate students 12 and older get vaccinated. On Wednesday, the Oakland School District followed suit, making it one of the first in Northern California to do so

‘Why do you want to force the vaccine that is still undergoing vaccine trials,’ one speaker asked during the public comment section of the meeting, the East Bay Times reported. ‘Not you, the CDC or the FDA can make guarantees as to outcomes.’ 

‘I’m opposed to the vaccine mandate. Parents and students must have the choice whether or not to take a vaccine,’ said another, according to ABC7

Samantha Pal, the student director sitting on the Oakland board said that while many students supported the mandate, several, ‘expressed concern about alienating students and families with such a strict policy,’ the San Francisco Chronicle reported.  

Pal said a number of parents did not want their children getting shots out of fear, and that many suggested the district should, ‘provide more education on the vaccine to both parents and students, so as to help get families to a place where they feel comfortable getting the vaccine.’

There were 31 new coronavirus cases recorded in the Oakland School District over the past week, according to school figures

There were 31 new coronavirus cases recorded in the Oakland School District over the past week, according to school figures

There were 31 new coronavirus cases recorded in the Oakland School District over the past week, according to school figures

Currently, there are around 255 new cases per 100,000 kids aged 12 - 17, in the surrounding Alameda County

Currently, there are around 255 new cases per 100,000 kids aged 12 - 17, in the surrounding Alameda County

Currently, there are around 255 new cases per 100,000 kids aged 12 – 17, in the surrounding Alameda County

Board President Shanthi Gonzales – who abstained in the vote – said that, in particular, she was concerned it might alienate students of color, who have far lower vaccination rates than others. 

‘My concern is … sending those families a message that they’re not welcome and not allowed to come to school anymore,’ she said, according to the East Bay Times, adding that a number of students have limited health care access.

Mike Hutchinson, the only member of the board to oppose the resolution, voiced similar concerns, citing internal figures from the district superintendent that only 34 percent of African American and 55 percent of Latino students have been vaccinated.

‘I’m concerned about passing a mandate that (says) half of black and brown students can’t come to school,’ Hutchinson said, adding that the district’s remote option for students was already full.

Currently, around 80.8 percent of the students aged 12 to 15 in the surrounding Alameda County have received at least one vaccine dose

Currently, around 80.8 percent of the students aged 12 to 15 in the surrounding Alameda County have received at least one vaccine dose

Currently, around 80.8 percent of the students aged 12 to 15 in the surrounding Alameda County have received at least one vaccine dose

Children under 18 make up the age group with the second smallest number of confirmed infections next to the 71 -80, according to the county Health Department

Children under 18 make up the age group with the second smallest number of confirmed infections next to the 71 -80, according to the county Health Department

Children under 18 make up the age group with the second smallest number of confirmed infections next to the 71 -80, according to the county Health Department

Over the past week the Oakland School District recorded 31 new cases among its student body, and while there is no available data on the percentage of vaccinated students in the district, around 54 percent of 12- to 17-year-olds are fully vaccinated in the City of Oakland, according to public data.  

In Alameda County, where Oakland is located, more than 60,000 or 80.8 percent of the children 12 – 15 have received at least one dose.

Currently, there are around 255 new cases per 100,000 kids ages 12-17, and overall around 4,532 children per 100,000 under 18 have had confirmed cases throughout the pandemic. It is the age group with the second smallest number of confirmed infections next to the 71 -80 category, according to the county Health Department. 

Overall, children under 17 make up 14.5 percent of confirmed cases in California. 

Despite concerns, most of the Oakland school community supported the measure, the San Francisco Chronicle reported, and it also had the backing of the district teacher’s union, although with a push for expanded exemptions.

‘Vaccination is a must,’ said one teacher during an online rally in support of the vote Wednesday evening, ABC7 reported.   

In the overall state of California children under 17 make up around 14.5 percent of the total cases

In the overall state of California children under 17 make up around 14.5 percent of the total cases

In the overall state of California children under 17 make up around 14.5 percent of the total cases 

‘Please vaccinate and make it a mandate, it’s a simple mandate to preserve our community,’ another teacher said.     

Hutchinson, however, said it should be the responsibility of the state, not individual school districts, to impose vaccine mandates. 

‘The idea of local school boards across California deciding what’s required for vaccination to enter into school scares me,’ he said, according to the Chronicle. 

‘The failure of action is actually from the state representatives that sent this letter,” Hutchinson said. ‘It’s their failure of action why we’re in this situation. … Why haven’t they introduced legislation in Sacramento, which would provide the real solution to the problem we’re facing.’

While Gov. Gavin Newsom has held off on pushing any such mandate, California Health and Human Services Secretary Dr. Mark Ghaly said it is considering such a requirement for students older than 12 to attend school.  

‘That conversation is part of what we’re considering as a state, but no definitive action is being made at the moment,’ he told reporters Thursday, according to the Chronicle

Gun violence, gun suicides leading cause of NC child injury deaths in 2020

— The majority of child injury deaths in North Carolina last year were due to gunfire, officials said on Monday. Child deaths associated with firearms nearly doubled in 2020, officials said.

Nearly 100 children lost their lives to guns, either by accidental gunfire or intentional suicides. Sixty-four child deaths were caused by someone else firing at the child and more than 30 deaths were self-inflicted, new state data shows. Most of the deaths were among teenage boys.

Firearms are used in half of all teenage suicides in North Carolina. The number of children who fell victim to suicide also increased by more than 50% in 2020.

Gun violence handgun bullet stock photo from Pexels

Activists say the way to prevent these deaths is to remove access to firearms from people who are depressed or in a suicidal crisis.

“Removing access to firearms and other lethal means allows time for both the moment of intense suicidal crisis to pass, and for someone to intervene with potentially lifesaving mental health support and resources,” the American Foundation for Suicide Prevention says.

The majority of children in North Carolina who died by suicide used a gun and were teenage boys. Suicides among white children in 2020 nearly double compared 2019, state data shows.

Handgun, firearm

Across the country, more children are being accidentally killed in shootings as gun ownership has soared. Experts say social isolation, economic struggles and school closures during the coronavirus pandemic has put many more teenagers at an increased risk of gun violence. Hundreds of children witnessed, suffered or died in shootings last year, according to the Gun Violence Archive.

Gun sales surged in America last year and the firearms industry says there was a 60% increase in gun sales from 2019 to 2020. Most of those sales in 2020 took place from March to May. In the first six months of 2021, gun sales increased by 15% from the year before that.

State officials are concerned that new gun owners are unclear on how to safety store their guns. The Child Fatality Task Force, a legislative study commission, is pushing lawmakers to pass a safe storage initiative to help educate gun owners. The North Carolina House of Representatives approved House Bill 42, the Firearm Safe Storage Awareness Initiative, but the Senate has yet to take it up.

Statewide there was a nearly 90% increase in children visiting emergency rooms with firearm injuries. The majority of those children were shot unintentionally, state data shows.

Gun battle outside convenience store among more than 560 shootings in Durham so far this year

Black Americans are nearly twice as likely to die from COVID-19 as white Americans, and are more than 10 times as likely as white people to die in a shooting. Black children made up the majority of North Carolina’s firearm deaths, despite making up around 20% of the child population.

“Generations of systemic racial discrimination and inequities in health care, housing, education, and other factors have exacerbated the risks of gun violence. These inequities have also made Black and Latino communities more vulnerable to the devastating effects of COVID-19,” according to a report from Everytown Research & Policy.

COVID increases racial wealth gap: Blacks own 22 cents for every dollar held by whites

COVID’s effects worsen America’s racial wealth gap: Blacks own 22 cents for every dollar held by whites
Closing gaps would create 1.7 million jobs, add $300-450 billion to the economy

By Charlene Crowell

As the global pandemic continues to take lives and infect multiple generations, virtually every dimension of life is challenged. And people with the fewest financial resources before COVID-19 are being challenged more than ever before.

It is both a challenge and an opportunity for leadership in the Biden Administration, Congress, the Federal Housing Finance Agency, the Department of Housing and Urban Development, along with the private sector address to effect policies and practices that reverse the nation’s still-growing racial wealth gap. Tried and true wealth-building tools like targeted homeownership and expanded small business investments together would bring sustainable and meaningful changes to those who historically have been financially marginalized.

In an effort to better understand and solve the dual sagas wrought from centuries of racial discrimination and COVID, major universities, government agencies, public policy institutes and corporations are releasing new research that analyzes the pandemic’s added challenges that exacerbate historical racial inequities.

For example, from January through March of this year, Blacks on average had 22 cents for every dollar of white family wealth, according to the St. Louis Federal Reserve’s Institute for Economic Equity These substantial gaps have remained largely unchanged since 1989 to the present, according to the Institute.

The gap’s disparities are also reflected in findings from research conducted by Harvard University. This esteemed Ivy League institution drew a key distinction between America’s income and wealth inequalities.

“Income is unequal, but wealth is even more unequal,” said Alexandra Killewald, professor of sociology at Harvard, who studies inequality in the contemporary U.S.
“You can think of income as water flowing into your bathtub, whereas wealth is like the water that’s sitting in the bathtub,” she said. “If you have wealth, it can protect you if you lose your job or your house. Wealth is distinctive because it can be used as a cushion, and it can be directly passed down across generations,” providing families more choices and greater opportunity in the present and the future… white Americans are benefiting from legacies of advantage…The typical white American family has roughly 10 times as much wealth as the typical African American family and the typical Latino family.”
While the issues raised by the Federal Reserve and Harvard may sound like variations on an old theme, a 150-year-old global financial firm, Goldman Sachs, urges targeted and sustained investment by both the public and private sectors to erase America’s racial wealth gap. While the report focuses on Black women, its projected outcomes would benefit Black men as well.
“If the improvements benefit Black women and men alike, we estimate larger increases in U.S. employment of 1.7 million jobs and in U.S. Gross Domestic Product (GDP) of 2.1%, which corresponds to $450 billion per year.”
Titled, Black Womenomics: Investing in the Underinvested, the March 2021 report calls for access to capital, education, equitable earnings, health care, and housing to lay the groundwork to reverse historical disadvantages, while creating financial independence and personal wealth.

Most importantly, the report calls for the participation of Blacks – and especially Black women — to shape their own futures.

“[A]ny efforts to effectively address the issues can only be successful if Black women are actively engaged in formulating the strategies and framing the outcomes. Moreover, addressing discrimination and bias will be fundamental to real and sustainable progress…The large wealth gap faced by single Black women is particularly important because Black women are more and increasingly likely to be single and breadwinner mothers…Among Black mothers, more than 80% are breadwinners compared to 50% of white mothers,” states the report.
How existing financial disparities leave Black women more financially vulnerable is found in the report’s data points:
• Black women face a 90% wealth gap;
• The wage gap of Black women widens through their whole work-life, and especially rapidly between ages 20 and 35;
• Black women are five times more likely than white men to rely on expensive payday loans;
• Black women are nearly three times more likely to forego prescription medicine, and also much more likely than white men not to see a doctor because they cannot afford it; and
• The median single Black woman does not own a home, and single Black women are 24 times less likely than single white men to own a business.
Additionally, the nation’s shortage of affordable housing translates into 85% of Black women with families facing housing costs ranging from more than 30% to 50% of their incomes. Once the monthly rent is paid, these housing-burdened households have little left to cover utilities, food, childcare or other household needs.

Even Black families earning a median income will need 14 years just to save a 5% home down payment, according to a recent analysis by the Center for Responsible Lending (CRL).

A legacy of historically modest incomes and little inter-generational wealth available to be passed down by families leaves most Black Americans without the comparable financial advantages enjoyed by other races and ethnicities.

These and other circumstances lead many women – especially women of color — to turn to high-cost loans of only a few hundred dollars. Although the typical payday loan of $350 is marketed as a short-term fix to an unexpected expense, the reality for many with modest incomes is that the high-cost loan – which can come with interest as high as 400% — becomes yet another long-term financial burden that worsens financial strains with[every renewal.

“Predatory, high-interest lenders pull people down into financial quicksand, making them more likely to experience a range of harms, such as losing their bank account, defaulting on their bills, losing their car, and declaring bankruptcy. It is low-income consumers, and disproportionately communities of color – whom the lenders target – that are being harmed,” said Ashley Harrington, of CRL in testimony this summer before the U.S. Senate Banking Committee.

The harms of wealth inequality also extend to the broader U.S. economy, according to the Goldman Sachs report. In its view, expanding opportunities for Black women who are often on the bottom rung of the economic ladder can create a pathway to individual and national prosperity. “Overcoming these adverse economic trends would make for not only a fairer, but also a richer society. We estimate that confronting the earnings gap for Black women could create 1.2-1.7 million U.S. jobs and raise the level of annual U.S. gross domestic product (GDP) by 1.4-2.1% each year, or $300-450 billion in current dollars.”

The sum of these findings underscores the frustration felt by much of Black America. The Civil War ended slavery and promised the emancipated 40 acres and a mule. The civil rights laws of the 1960s promised to eliminate discrimination in voting, housing, and public accommodations. Next, the affirmative action programs of the 1970s promised equal opportunity employment in fields that had been previously barred to Blacks and other people of color.
It is time for this nation to make good on its age-old promises. Creating neighborhoods of opportunity from poverty pockets would strengthen cities and suburbs alike. If corporate leadership would join with the Administration and Congress to ensure that Black America and other people of color share in the nation’s prosperity, everyone would be better off.

No person and certainly no community will ever beg its way out of poverty. But down payment assistance for first generation, mortgage-ready homebuyers would build family wealth. Similarly, creating an equity investment fund targeted to struggling small Black businesses would preserve neighborhood opportunities, including more permanent jobs. .

In the timeless words of the late Dr. Martin Luther King, Jr., “All we say to America is, ‘Be true to what you said on paper.”

NIH-supported study suggests alternative to race-based kidney function calculations

News Release

Thursday, September 23, 2021

Alternate lab test shows comparable accuracy, non-biased results.

In a study supported by the National Institutes of Health, researchers propose changing a key measure in kidney disease diagnosis and treatment to eliminate the use of race as a variable, providing a non-biased kidney function test that does not compromise accuracy. The study suggests use of a blood lab test called cystatin C, which does not vary by a person’s race, to replace the current lab test called creatinine, which does. The findings come from a detailed analysis of data from the Chronic Renal Insufficiency Cohort (CRIC) Study, a nationwide longstanding study funded by NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The results are published in the New England Journal of Medicine.

Health care providers use estimated glomerular filtration rate, or eGFR, calculations as a primary diagnostic tool to learn how well a person’s kidneys function and to classify the severity of their disease, from mild loss of kidney function to end-stage kidney disease. The eGFR helps determine prognosis and treatment, such as when hemodialysis or a transplant may be needed.

Since 1999, race has been a variable used in estimating GFR. Current eGFR calculations also use a person’s age, sex, and serum creatinine levels. Serum creatinine, which the kidneys filter out, is a waste product from the normal metabolism of muscle cells in one’s body. Studies have shown that Black Americans, on average, can have higher levels of serum creatinine in their blood, independent of kidney function. To account for this difference, eGFR calculations include a person’s self-reported race to give more valid results.

“Using race as a testing factor risks kidney disease misdiagnosis. There is great variance within the genetic ancestry of people who identify as ‘Black’ which means we cannot reliably view ‘Black’ people as being from a single ancestral group,” said Afshin Parsa, M.D., NIDDK program director for CRIC. “Misdiagnosis could lead to a person receiving incorrect drug dosing, or delays in receiving dialysis or a kidney transplant. Current eGFR calculations could be exacerbating racial inequities in a disease that disproportionately affects Black people, so this study set out to identify factors that wouldn’t rely on including a person’s race to calculate eGFR.”

CRIC researchers found that even when adjusting for a wide range of factors, using serum creatinine to calculate eGFR without using a race term can lead to systematic bias and race-related misclassification of kidney disease status in people tested.

Yet, unlike serum creatinine, most biomarkers – substances that can help identify disease or stages of a disorder – aren’t affected by race or ancestry. By analyzing data from CRIC participants, the researchers found that using cystatin C – which is not affected by race or ancestry – as a race-independent replacement biomarker for serum creatinine provided accurate and non-biased results.

“We hope this study’s results will build momentum toward widespread adoption of cystatin C for the purposes of estimating GFR. The alternative eGFR test requires no special equipment, can be standardized, and the more it’s adopted, the less it would cost,” said Chi-yuan Hsu, M.D., professor and chief of nephrology at University of California, San Francisco, and lead author of the study.

CRIC is one of the largest and longest-running studies looking at the causes, frequency, and consequences of chronic kidney disease, or CKD, in the United States. Nearly all CRIC’s participants are people with mild to severe loss of kidney function. Since Black people are at higher risk for CKD than other groups, approximately half of CRIC participants are Black. This analysis used more than 1,200 CRIC participants’ data, including measures of body mass and muscle mass, genetic ancestry data, and self-identified race.

“An accurate eGFR formula that does not rely on self-reported race is a huge leap forward for all people with, and at risk for, chronic kidney disease,” said NIDDK Director Griffin P. Rodgers, M.D. “NIDDK is committed to addressing health disparities, and we hope this study’s finding leads to positive changes in how CKD is identified and treated—helping address the risk of systemic bias and error in diagnosing and treating a disease that already disproportionately affects Black people.”

CRIC received funding through NIDDK grants DK060990, DK060984, DK061022, DK061021, DK061028, DK060980, DK060963, and DK060902.

About the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): The NIDDK, a component of the National Institutes of Health (NIH), conducts and supports research on 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 the NIDDK and its programs, see www.niddk.nih.gov.

About the National Institutes of Health (NIH):
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. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health®

###

How To Plan A Road Trip Scavenger Hunt

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Three local school districts mandate student vaccines. Others to follow?

School districts in Oakland, Hayward and Piedmont this week became the Bay Area’s first to require eligible students to get COVID-19 vaccines in the coming weeks, and others soon may follow after California’s top health official said Thursday he’s mulling whether to issue a statewide mandate.

California Health and Human Services Secretary Dr. Mark Ghaly said state officials have been closely monitoring what steps local school districts are taking to ward off the virus’ spread, which has been driven by the highly contagious delta variant since early summer.

“That conversation is happening — certainly as part of what we’re considering as a state — but no definitive action or decision is being made at the moment,” Ghaly said.

He acknowledged the COVID-19 vaccine has raised concerns even among some parents “who have their kids fully vaccinated against the number of other vaccine-preventable illnesses” but emphasized that student vaccine mandates are “not new considerations” in California or the U.S.

Schools nationwide have a decades-long tradition of ensuring that students are protected against communicable diseases. In California, students must be inoculated against polio, measles, chickenpox, tetanus and other illnesses.

“To date, protecting young kids from COVID has been led by getting the adults around these young Californians to be vaccinated,” Ghaly said. “Soon, we hope, I hope — as a father of three kids under the age of 12 and a pediatrician — that we can soon vaccinate many of our students and wrap a thicker blanket of protection around these school communities.”

Los Angeles Unified last month became the first and largest school district in California to declare that students age 12 and older must be fully vaccinated to attend classrooms.

The Oakland, Hayward and Piedmont school boards approved similar vaccine mandates Wednesday night. Meanwhile, a handful of other school districts are on the verge of being next.

Berkeley Unified’s school board discussed such a proposal Wednesday night but did not take a vote, and West Contra Costa Unified’s board had been scheduled to consider a vaccine mandate Tuesday until its meeting was cancelled so several logistical details could be resolved.

Two of the region’s biggest school districts — San Jose Unified and San Francisco Unified — have not introduced any vaccine mandates.

The hours-long discussion at Wednesday’s Oakland school board meeting mirrored the broader statewide debate over whether students should be forced to get COVID-19 shots or lose their spots inside classrooms.

In a 5-1-1 vote taken close to midnight, the Oakland school board decided that students 12 and older must be vaccinated “unless prohibited by law.” They’re currently eligible for the Pfizer vaccine, which received the FDA’s emergency approval for that age group.

Exceptions will be made for “personal belief exemptions” if students provide a note from a doctor confirming that information about COVID-19 vaccines was provided. It’s unclear what beliefs other than religious would qualify.

School board vice president Sam Davis, who called for the vaccine mandate, said he hopes it will persuade people hesitant about getting shots to talk to medical professionals about their concerns.

But school board member Mike Hutchinson said he worries about approving an order that — if enacted right away — would prevent many students from going to class.

“I’m concerned about passing a mandate that (says) half of Black and Brown students can’t come to school,” Hutchinson said. According to the district, roughly 34% of African-American students and 55% of Latino students have been vaccinated.

Board president Shanthi Gonzales, who abstained from voting, shared Hutchinson’s sentiment.

“My concern is sending those families a message that they’re not welcome and not allowed to come to school anymore,” Gonzales said, adding that even allowing for a personal belief exemption with a doctor’s note, there would still be barriers for students without regular access to a doctor or full health care.

Samantha Pal, a student member of the school board and a junior at Oakland High School, said the students she’s heard from prefer an approach that would educate families about the benefits of getting vaccinated instead of issuing an “alienating” mandate.

Some parents and other community members expressed anger at the prospect of a vaccine mandate.

“Why do you want to force the vaccine that is still undergoing vaccine trials?” one speaker asked. “Not you, the CDC or the FDA can make guarantees as to outcomes.”

Others thanked the board for taking steps to protect the health of students and teachers.

“We support adding the vaccine for COVID to the list of vaccines already required at schools,” said Dr. Lynne Rosen, a pediatrician who works for health clinic La Clinica. “It will help minimize disruptions for school instruction.”

The district still needs to determine when the mandate should take effect and how it’ll be enforced. Board members directed Superintendent Kyla Johnson-Trammell to return next month with recommendations.

In Piedmont, the school board decided all eligible students must receive both Pfizer doses by Nov. 17. Students younger than 12 must be fully dosed no later than eight weeks after they become eligible for shots.

Students who aren’t vaccinated would be referred to independent study and not allowed inside classrooms unless they’ve been excused from taking the vaccine by a licensed physician. Those students will be required to be tested for COVID-19 every week, however.

Hayward Unified trustees unanimously approved a policy similar to Piedmont’s, although students there won’t have to be fully vaccinated until Dec. 17.

“It’s a challenging choice,” Hayward school board member Gabriel Chaparro said about parents deciding whether their child should get vaccinated. “I know when someone tells me, ‘I will do this,’ I have a hard time holding my middle  finger down because no one is going to tell me what to do.”

The Centers for Disease Control and other prominent medical institutions have deemed the vaccines safe and effective in reducing the risk of dying or suffering severe respiratory and other health complications caused by COVID-19.

Staff writers Fiona Kelliher and Peter Hegarty contributed to this report.

National Kidney Foundation and the American Society of Nephrology Release New Way to Diagnose Kidney Diseases

Newswise — Sept. 23, 2021, New York, NY – Today, the National Kidney Foundation (NKF) and the American Society of Nephrology (ASN) Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases has released its final report, which outlines a new race-free approach to diagnose kidney disease. In the report, the NKF-ASN Task Force recommends the adoption of the new eGFR 2021 CKD EPI creatinine equation that estimates kidney function without a race variable. The task force also recommended increased use of cystatin C combined with serum (blood) creatinine, as a confirmatory assessment of GFR or kidney function. The final report, published today online in the American Journal of Kidney Diseases (AJKD) and the Journal of the American Society of Nephrology (JASN), was drafted with considerable input from hundreds of patients and family members, medical students and other trainees, clinicians, scientists, health professionals, and other stakeholders to achieve consensus for an unbiased and most reasonably accurate estimation of GFR so that laboratories, clinicians, patients and public health officials can make informed decisions to ensure equity and personalized care for patients with kidney diseases.

“This recommendation by the NKF-ASN Task Force is an important step forward in assuring health and healthcare equity. We commend the task force for the time, thought, thoroughness, and effort it took to explore this issue deeply and recommend the best path forward for us all,” said NKF President Paul M. Palevsky, MD, FASN, FNKF. “The NKF and ASN urge all laboratories and healthcare systems nationwide to adopt this new approach as rapidly as possible so that we can move towards a consistent method of diagnosing kidney diseases that is independent of race. While the work of the task force is an important initial path forward, both of our

organizations are committed to continuing to work to eliminate disparities in the diagnosis and treatment of kidney disease.”

“As the largest organizations representing kidney patients and health professionals, NKF and ASN are committed to eliminating health disparities that harm kidney patients and ensuring that racial bias does not affect the diagnosis and subsequent treatment of kidney diseases,” said ASN President Susan E. Quaggin, MD, FRCP(C), FASN. “By recommending the CKD-EPI creatinine equation refit without the race variable, the task force has taken action and demonstrated how nephrology continues to lead the way in promoting health care justice. It is time for other medical specialties to follow our lead, and NKF and ASN stand ready to help however we can.” More than 37 million adults in the United States have kidney diseases and 90% aren’t aware they have diminished kidney function. A disproportionate number of these people are Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, and Native Hawaiian or other Pacific Islander. These

Americans also face unacceptable health disparities and inequities in healthcare delivery.

The NKF-ASN Task Force organized its work, which took place over a period of 10 months, into three phases: 1) clarify the problem and evidence regarding eGFR equations in the United States.; 2) evaluate different approaches to address use of race in GFR estimation; and 3) provide recommendations. The group identified 26 approaches for the estimation of GFR and narrowed their focus by consensus to five such approaches.

“The holistic approach incorporated input from the medical community and patients to identify an approach that balanced social justice with scientific rigor,” said Cynthia Delgado MD, FASN, Associate Professor of Medicine, San Francisco Veterans Affairs Healthcare System (SFVAHS) and University of California, San Francisco and co-chair of the joint task NKF-ASN task force.

NKF and ASN are pleased to share the new equation recommendation with the kidney community – as well as other stakeholders, particularly the medical students, residents, fellows, and other trainees who spearheaded the call to action on this important issue. NKF and ASN encourage the Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) to develop updated guidelines that ensure a uniform approach consistent with the task force’s recommendations. Such clinical practice guidelines will help ensure institutions and the laboratory community rapidly adopt the new equation to estimate kidney function. This new approach will replace the existing equations for estimating kidney function and well as assure confirmatory testing is done when there are important clinical decisions. Both the interim and final report will inform the medical community for clinical practice.

“We appreciate the patience of the community as the Task Force developed a sound strategy to not disproportionately disadvantage patients from any particular racial or ethnic group. Our approach was guided by health equity, patient centeredness and patient safety, and was informed by evidence,” said Neil Powe, MD, MPH, MBA, FASN Chief of Medicine at the Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and the Constance B. Wofsy Distinguished Professor, Vice-Chair of Medicine at the University of California San Francisco and co-chair of the joint NKF-ASN task force. “We hope strong efforts will develop new, more informative, GFR markers and unite all of us in a focus on interventions to eliminate health disparities, thereby improving the quality of care for everyone in the United States.”

It’s a common practice in the medical field to use calculations to make accurate estimations that are reliable, non-invasive and identify certain illnesses and their potential risks. Those estimations are often confirmed with additional testing that is more invasive or more expensive. It will take laboratories, hospital systems, physician practices, and academic institutions time to incorporate the new approach into their results for doctors and patients.

NKF and ASN recommend diagnosing kidney disease using a blood test for creatinine to estimate GFR and a urine test for albumin to calculate urine to creatinine ratio (uACR). The new approach may report a different eGFR and could alter the stage of kidney diseases in some people. Patients should learn their latest eGFR and uACR to assess if the new eGFR calculations change their kidney disease status or stage. Patients and healthcare professionals can use an updated eGFR calculator that uses the new equation to determine a non-race-based calculation to assess their kidney function. It’s important for patients to speak with their doctors to determine if this may affect their treatment and care going forward.

We invite public comment to the final report. To learn more about NKF and ASN, visit www.kidney.org and www.asn-online.org.

Editor’s Note: See additional quotes from task force members.

Kidney Disease Facts

In the United States, 37 million adults are estimated to have chronic kidney diseases—and approximately 90 percent don’t know they have diminished kidney function. One in three adults in the United States are at risk for chronic kidney disease. Risk factors for kidney disease include: diabetes, high blood pressure, heart disease, obesity, and family history. People of Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, or Native Hawaiian or Other Pacific Islander descent are at increased risk for developing the disease. Blacks or African Americans are almost 4 times more likely than White Americans to have kidney failure. Hispanics are 1.3 times more likely than non-Hispanics to have kidney failure.

Approximately 785,000 Americans have irreversible kidney failure and need dialysis or a kidney transplant to survive. More than 555,000 of these patients receive dialysis to replace kidney function and 230,000 live with a

transplant. Nearly 100,000 Americans are on the waitlist for a kidney transplant right now. Depending on where a patient lives, the average wait time for a kidney transplant can be upwards of three to seven years.

About the American Society of Nephrology

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 21,000 members representing 131 countries. For more information, please visit www.asn-online.org or contact the society at 202-640-4660.

 

About the National Kidney Foundation

The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.kidney.org.

Professors share Latinx stories

Photo of a MacBook Pro showing four Zoom screens that each include a person with separate backgrounds. The background of the laptop is blurred.
Juan de Lara (top right) moderated the Facebook Live event with panelists Pierrette Hondagneu-Sotelo (top left), George J. Sanchez (bottom left) and Natalia Molina (bottom right), who are all professors at USC. (Claire Chen | Daily Trojan)

In honor of Latinx Heritage Month, the USC Dornsife College of Letters, Arts and Sciences and Center for Latin American and Latinx Studies hosted Latinx Stories of Los Angeles Wednesday. In the Facebook Live event, three speakers — distinguished professor of American Studies & Ethnicity Natalia Molina, professor of Sociology Pierrette Hondagneu-Sotelo and professor of American Studies & Ethnicity and History George J. Sánchez — gathered for a discussion moderated by Associate Professor of American Studies and Ethnicity Juan de Lara on their respective books chronicling the histories of different Latinx communities in Los Angeles, from Echo Park in Central L.A. to Watts in South Central. 

Molina’s “Place-making at the Nayarit: How a Mexican Restaurant in Los Angeles Nourished its Community” centers on the role of one Mexican restaurant in supporting the local community in Echo Park and providing a space for Mexican immigrants — who were usually seen as “invisible” laborers in the city — to reclaim their voices and find belonging. Sánchez’s “Boyle Heights: How a Los Angeles Neighborhood Became the Future of American Democracy” traces the neighborhood’s history, starting from the early 20th century, and spanning decades in Boyle Heights’s journey from a multi-racial and ethnic area populated by Japanese, Jewish, African Americans and other groups to a community reconfigured by an influx of undocumented immigrants and the departure of other groups. 

An L.A. neighborhood undergoing dramatic change was also the focus of Hondagneu-Sotelo’s book “South Central Dreams,” co-authored with distinguished professor of Sociology and American Studies & Ethnicity Manuel Pastor. “South Central Dreams” explores how a historically important African American neighborhood transformed into a predominantly Latinx community over the past 40 or 50 years and the implications of such a transformation on the day-to-day lives of residents.

Following introductions, the speakers jumped into a conversation about the changing nature of “Latinidad,” or what it means to be Latinx, fueled by the interactions and connections between Latinx and other racial groups in communities. 

Hondagneu-Sotelo shared a snippet South Central’s history. During the 80s’ and 90s’, residents in neighborhoods such as Watts faced job loss, deindustrialization and street violence and Black families, specifically those with the means to, moved to the suburbs. Meanwhile, first-generation Mexican and Central Americans settled in the area for its affordable housing and job proximity. In the same vein, Sánchez reflected on the parallels between Boyle Heights and South Central in the gradual process of integration between Latinx and other ethnic and racial groups and how it shaped the Latinx experience and identity in Boyle Heights. First-generation immigrants in Boyle Heights in the early 1900s also often stayed apart from other racial groups, Sánchez said. The labor unions and schooling system became key in bringing together and creating connections between people of different races.

“​​That didn’t mean that Boyle Heights didn’t go through very difficult periods,” Sánchez said. “The periods that I talked about [were] Mexican repatriation followed by Japanese American internment during World War II. People are watching this happen to their neighbors [and] to their classmates, and they end up with a civil rights tradition that emerges in Boyle Heights.”

The speakers also shared their thoughts about their works’ place in Latinx history and scholarship, and their impacts on understanding L.A.’s complex landscape. Sánchez said their books all portrayed L.A. as a Latinx city and explored Latinx experiences where changing communities welcomed new residents to their neighborhoods, a perspective that differs from those of the past.

Molina added that their books also explored L.A. as a racialized city. Looking at the similarities the Latinx experience has with other racial and ethnic groups’ experiences in L.A. is a way to bring the different groups together on common causes.

“To me, the message of these three books is a message of hope,” Molina said. “We may have different racial and ethnic experiences, but we do understand there are commonalities in terms of access to health care, access to education, how we experience the pandemic. This is a very important moment to have this message of hope and common cause, as we see the inequalities that the pandemic has completely brought to the forefront, as we go to elect a new mayor, as we just went for a recall.”

Given that Latinx communities hold a strong position population-wise in L.A. and, thus great political power as well, Pastor — who jumped in for Hondagneu-Sotelo in the middle of the event — emphasized the importance of multiracial organizing and citywide coalitions going forward. Pastor said Black and brown organizing seeks to find common ground on shared issues and to link to greater progressive movements. Black organizers and community members in South Central rely not only Black votes but also on labor and Latinx votes. Similarly, Latinx political figures carefully consider their relationship to the Black political establishment and organizing efforts. 

“Latinos in South L.A. have developed the skill in building coalitions on a face to face, neighbor to neighbor basis as have Black people in South L.A.,” said Pastor. “That is an important skill we need citywide.”

The event concluded with De Lara expressing his gratitude for the accomplished Latinx scholars at USC working on issues that transcend disciplines. De Lara also encouraged the audience to read the books featured from the afternoon.

In a separate interview, Molina spoke on what she hopes the participants of the event take away from the conversation.

“I hope that people have a more informed and diverse sense of what it means to be Latino,” Molina said. “In dominant media, we think about Latinos as workers, maybe just immigrants, and don’t really see their lives. I think these books give you a rich history of how Latinos have been integral in terms of what it means to be a good neighbor, what it means to protest, what it means to shape democracy, what it means to participate in politics.”

How either party can win the loyalty of Black voters moving forward

The recent Census Bureau report showing the white population declining for the first time in history rang alarm bells for some Republicans and caused cheers of excitement among some Democrats. The Republican rush this year to pass restrictive new voting laws indicates that the GOP fears the nation’s increasing diversity will benefit its opponents in the near future. For the Democrats, demographic trends look promising. As the white share of the electorate has declined in recent decades, the party has won the popular vote in seven of the past eight presidential elections. And President Joe Biden won nearly 9 out of 10 Black votes in the November 2020 election.

But Democrats would be wrong to assume that they can simply run out the demographic clock, and Republicans would be foolish to ignore their own opportunity to change the game.

In fact, history teaches us that all of this could still change, and demographics aren’t destiny.

Almost 100 years ago, in 1929, the GOP had won the presidency in seven of the previous nine elections, and Black voters overwhelmingly identified with the Republican Party. Most Americans probably didn’t anticipate the dramatic political realignment about to take place.

By the end of the decade, the federal government, under the leadership of 10 different Republican presidents from 1877 to 1929, had failed to enact any new major civil rights laws to protect Black citizens from lynching or discrimination.

A series of high-profile race massacres — East St. Louis in 1917, the Red Summer of 1919, the Tulsa massacre in 1921 and Rosewood in 1923 — made clear the violent ramifications of such failures, leaving many Black voters feeling increasingly unprotected by the Party of Lincoln.

The Chicago Defender, one of the most influential Black newspapers in the country, had enough with Republicans. A few weeks before the 1928 election, the newspaper took the unusual step of endorsing Democratic presidential nominee Al Smith over Republican nominee Herbert Hoover. “If 50 years of support to the Republican Party doesn’t get us justice, then we must of necessity shift our allegiance to new quarters,” the Defender argued. The newspaper was also concerned about Hoover’s support for the “lily white” movement in the GOP and the party’s growing affiliation with the Ku Klux Klan.

But by 1932, it was Hoover’s response to the Great Depression that caused him to lose reelection to Democrat Franklin D. Roosevelt. The new president made good on a promise to implement a “New Deal,” and it paid electoral dividends. A few years later, Oscar De Priest, a Black Republican who opposed New Deal programs and represented Chicago as the only African American in Congress, lost his seat to Black Democrat Arthur Mitchell, who supported Roosevelt’s aggressive federal intervention and rode a Democratic midterm election wave (rare for the party in control of the White House) to power. Finally, in 1935, after decades of Republican domination, Mitchell became the first African American to serve in Congress as a Democrat.

The floodgates began opening, and African Americans started leaving the Republican Party in droves. In the 1936 election, Roosevelt became the first Democratic presidential candidate to win the Black vote and received 71% of African American votes. But Roosevelt’s record was mixed, at best, as he tried to keep the party’s Southern whites within his New Deal coalition. As a result, key programs like Social Security and the National Labor Relations Act excluded agricultural and domestic workers, who were disproportionately Black. While Roosevelt was lauded for seeking the counsel of advisers known as his “Black Cabinet,” he resisted calls to appoint an African American to serve in his actual Cabinet. And when Jesse Owens won four gold medals at the 1936 Olympics in Hitler’s Berlin, Roosevelt refused to invite him and other Black Olympians to the white House.

As the Democratic Party’s Southern-based lawmakers continued to obstruct civil rights progress, the Black vote remained competitive for the next three decades. Republican President Dwight D. Eisenhower won nearly 40% of African American votes in 1956, but Eisenhower’s success may have been more attributable to his opponent’s weaknesses than his own accomplishments. As the two parties courted white Southerners in the wake of the landmark 1954 Brown v. Board of Education Supreme Court decision, both Eisenhower and Democratic nominee Adlai Stevenson urged the nation to proceed cautiously on racial integration.

By 1960, the two parties had tiptoed tenuously on the emerging civil rights issues of the day. “I must make it palpably clear that the dearth of positive leadership from Washington is not confined to one political party,” the Rev. Martin Luther King Jr. announced in a September 1960 speech to the National Urban League. “The fact is that both major parties have been hypocritical on the question of civil rights. Each of them has been willing to follow the long pattern of using the Negro as a political football.”

Just a month later, while King sat in a Georgia jail cell, Democratic nominee John F. Kennedy placed a quick private phone call to King’s wife, Coretta, to convey his concern, and that call persuaded King’s influential preacher father, Martin Luther King Sr., to support the Democratic candidate over Republican Richard M. Nixon.

The racial realignment was finally completed when Democratic President Lyndon B. Johnson signed the Civil Rights Act of 1964, and the GOP responded by nominating Barry Goldwater for president, just a few weeks after he had broken with most of his Republican colleagues to vote against the bill. For the first time since Reconstruction, one political party delivered major concrete legislation to help Black people. African Americans took note, and many remained pleasantly surprised as Johnson went on to sign the Voting Rights Act of 1965 and the Fair Housing Act of 1968.

Today, the roles have been reversed from the 1920s, but Black voters find themselves once again reevaluating their political alliances after giving their votes almost exclusively to the Democratic Party for six decades.

Like their ancestors from a century before, Black Americans feel increasingly unprotected in 2021 by a government that has already failed Tamir Rice, Trayvon Martin, Elijah McClain, Breonna Taylor, Sandra Bland, George Floyd and countless others. They’ve watched their voting rights be chipped away since the Shelby County v. Holder decision gutted the Voting Rights Act, and they’ve watched a mob of angry white insurrectionists try to overthrow the U.S. government.

Black voters have been the most loyal constituency in the Democratic Party, but Democrats now control the White House and both houses of Congress and yet they have failed to pass the George Floyd Justice in Policing Act, the John Lewis Voting Rights Act or the Emmett Till Antilynching Act. Instead, party leaders have prioritized universal issues like infrastructure over controversial race-specific proposals like reparations. Yes, bread-and-butter issues such as health care and wages help Black people too, but universal policies don’t eliminate centuries-old racial disparities that account for structural inequality in employment, housing, education and the criminal justice system.

And yet Republicans haven’t offered a solution either. Instead they have manufactured controversies about critical race theory, “cancel culture” and Confederate statues as they manipulate the system — the Electoral College, congressional gerrymandering, lifetime judicial appointments and an unrepresentative U.S. Senate — to grasp power as a minority party.

But here’s the thing. In the last election, Joe Biden won 92% of Black voters over 60 years old but only 78% of Black voters ages 30 to 44. Although the youngest group of Black voters, 18-29, were slightly more supportive, some young Black voters have rejected their parents’ and grandparents’ unflinching allegiance to a particular political party.

If any political party wants to win Black voters in the future, it could start by redirecting government resources to underserved Black communities and enacting legislation to eliminate racially discriminatory law enforcement practices. If Republicans want to gain our votes or Democrats want to keep them, they’ll need to introduce and implement their plans to reach true racial equality.

Keith Boykin is the author of the new book, “Race Against Time: The Politics of a Darkening America.”

Attorney General James Takes Action to Protect Children and Families from Lead Poisoning in NYC

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