Buffalo’s health disparities are focus of communitywide conference hosted by UB

Community activists, scholars, clergy and members of the public will gather April 28 at the Jacobs School of Medicine and Biomedical Sciences to discuss Buffalo's health disparities. (Photo by Douglas Levere, University at Buffalo)

Community activists, scholars, clergy and members of the public will gather April 28 at the Jacobs School of Medicine and Biomedical Sciences to discuss Buffalo’s health disparities. (Photo by Douglas Levere, University at Buffalo)

UB partnering with African American Health Disparities Task Force, other groups, on April 28 call-to-action

Submitted by the University at Buffalo

If you’re an African-American living in the 14204, 14206, 14211, 14212 or 14215 ZIP code, you are almost three times as likely to die prematurely as a white person living in a different ZIP code in Buffalo.

That fact is one of many reasons behind a conference being held later this month called “Igniting Hope: Building a Just Community with a Culture of Health and Equity.”

Free and open to the public, the conference will be held from 8 a.m. to 4:30 p.m. Saturday, April 28, at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, 955 Main St. More information is available HERE.

“To live up to our motto of a ‘City of Good Neighbors,’ we must all work together to create a community where race is no longer a defining factor in a person’s health and life expectancy,” said conference organizer, the Rev. George F. Nicholas, pastor of Lincoln Memorial United Methodist Church-Buffalo, and a member of the African American Health Disparities Task Force and the Greater Buffalo Racial Equity Roundtable.

“This conference is the first step of a call-to-action to eliminate health disparities,” he continued. “I am excited that UB is partnering with the community to take on this challenge.”

“UB is committed to working to address and ultimately reverse the consequences of the health disparities that Buffalo’s African-American community has lived with for too long,” said Michael Cain, M.D., vice president for health sciences and dean of the Jacobs School.

Consuelo Wilkins, M.D., executive director of the Meharry-Vanderbilt Alliance in Tennessee, and an expert in improving community health through community-engaged research, is the keynote speaker. Stephen Thomas, M.D., of the University of Maryland Center for Health Equity, and one of the nation’s leading scholars on eliminating racial and ethnic health disparities, will join the group by Skype.

Charles F. Zukoski, UB provost and executive vice president for academic affairs, will make opening remarks.

After discussion of the causes of disparities, breakout sessions will focus on actions to take in the areas of housing, health care, education, personal security and economic/employment.

The conference is the result of collaboration between UB, the African American Health Disparities Task Force, Millennium Collaborative Care, Erie County Medical Center, Population Health Collaborative and Greater Buffalo United Churches. It is designed to attract activists, scholars, students, clergy and members of the public to come together to figure out how to address – and ultimately reverse – these disparities.

Documenting Disparities

The event follows several years of intense research by the task force led by Willie Underwood III, M.D., associate professor at Roswell Park Comprehensive Cancer Institute; Nicholas; and others, al; aimed at quantifying the extent of health disparities in Buffalo’s African-American community.

In 2015, the task force issued a report revealing dramatic discrepancies between the outcomes of blacks and whites in Erie County. For example, infant mortality among blacks is almost three times the rate of whites; asthma hospitalizations for black children is more than four times the rate of whites; and the percent of premature deaths in people younger than 75 was nearly double for blacks than whites.

In addition, national data show black women are less likely to get breast cancer than white women, but are more likely to die from it.

“These unjust indications show you something is systemically wrong,” Nicholas said. “This is a crisis; this is not episodic. We are in a continued, ongoing health crisis.”

UB’s Role

“It’s significant that we are having the conference at UB,” Nicholas said. “It’s incumbent on the university to say we are providing leadership and resources. It makes it real. Without it, it just becomes a PR (public relations) exercise.”

And while faculty, administrators and students throughout the university have been involved in numerous efforts focused on some aspect of health disparities, efforts often aren’t well-coordinated.

Last spring, Alan Lesse, M.D., senior associate dean for curriculum at the Jacobs School, has been involved in educating students about health disparities and the social determinants of health. He convened a meeting at UB to bring faculty from all the disciplines together to discuss how to address disparities.

“It just blossomed from there,” he said. Now, the African American Health Disparities Task Force has representatives from throughout the university, including UB’s Jacobs School of Nursing, School of Management, Graduate School of Education, School of Law, School of Architecture and Planning, School of Public Health and Health Professions, School of Pharmacy and Pharmaceutical Sciences, and the Clinical Translational Science Institute.

Nicholas stressed the conference is designed as a call-to-action, to attract individuals who are working to reverse disparities or who would like to be involved.

And it isn’t just people involved with health professions who should attend.

“We are trying to change the conversation,” Nicholas said. “We are trying to develop a movement at this conference to change the narrative to present the data to a larger population.

“In our community, black folks are sicker and don’t live as long as whites. This is 100 percent preventable and fixable.”

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Many of these far-right media activists maintain what their own comrades call “plausible deniability” with regard to white supremacy. In this media landscape, the effect of having avowed white nationalists running for office is to push the limits of acceptable public racism even further. It not only provides cover for the “merely” anti-immigrant, anti-Muslim, and anti-Latino candidates and officials; it can also radically shift the Overton window, a term that describes the range of ideas that the mainstream media deem politically acceptable.

These new candidates are not limited by existing norms, “so they can imagine genocide, they can seriously play around with deporting millions of people,” said Spencer Sunshine, a longtime writer and researcher on the far right. As such notions enter the public discussion via the far-right media, racist violence becomes more likely. “White nationalists’ milieu is super-violent,” Sunshine said, “so any rise in their movement,” including mainstream publicity for their candidacies, will be “accompanied by violence.” With Trump’s election and the rise of alt-right media, we’re already seeing a spike in racist attacks. According to a study by the Anti-Defamation League’s Center on Extremism, white supremacists killed 18 people in 2017, around double the number from the previous year; meanwhile, hate crimes in major cities jumped 20 percent in the same year, according to the Center for the Study of Hate and Extremism at California State University, San Bernardino.

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The growing profile of such candidates means they sometimes have a legitimate shot at winning office. When he was running for governor in Virginia last year, Corey Stewart, chairman of the Prince William Board of County Supervisors, made several appearances with Jason Kessler, the white nationalist who would soon organize the violent “Unite the Right” rally in Charlottesville. (Kessler has been charged in state and federal lawsuits with conspiring to incite violence at the neo-Nazi rally.) Stewart came within one percentage point of winning the Republican nomination by devoting virtually his entire campaign to defending Confederate monuments. That is to say, he won 43 percent of the GOP vote in a purple state clutching a huge Confederate flag and holding events attended by white nationalists. Stewart also palled up to Cernovich, sitting with him for an interview, and used the racist, sexist, white-nationalist terms “cuck” and “cuckservative,” applying them in a Reddit chat to his primary opponent, Ed Gillespie, and to then–Democratic Governor Terry McAuliffe. (The terms come from so-called cuckold porn, in which a white man—the “cuck”—watches, humiliated, as a black man has sex with the cuck’s white wife.)

This year, Stewart is running for Senate against Democrat Tim Kaine. He isn’t emphasizing the Confederacy this time, but he continues to speak in language designed to appeal to the alt-right. In January, he falsely claimed on Twitter that Michael Moore had “call[ed] for the ethnic cleansing of white people in America,” and later that McAuliffe had incited the violence in Charlottesville. Commenting on an article from an Orange County newspaper with the headline “Thousands of pounds of human waste,” Stewart tweeted, “California is full of crap. Stop sanctuary cities!”

So far, Stewart is leading in polls of Republican voters, though Kaine beats every Republican hopeful in a hypothetical matchup. As the Board of Supervisors chair in Prince William County, Stewart is best known for rounding up undocumented immigrants, getting county police to turn over 7,500 individuals to Immigration and Customs Enforcement, and calling for mass deportations. It’s hard to tell whether he’s a Trumpian opportunist flirting with white nationalism for political gain or a die-hard true believer, but in the end it might not matter. As Sunshine has noted, in far-right demonstrations throughout the country, Trumpists have been sharing bullhorns with virulent white supremacists, anti-Semites, and militia members.

And Stewart’s spokesman, Noel Fritsch, has even deeper connections to white nationalism. At one point, Fritsch was the main political consultant for Paul Nehlen, the white supremacist who challenged House Speaker Paul Ryan in the 2016 GOP primaries (and who will attempt to win the Republican nod for Ryan’s seat in the 2018 midterms). Fritsch worked for Nehlen during a period when he appeared on the racist podcast Fash the Nation, retweeted encomiums to the neo-Nazi march in Charlottesville as “an incredible moment for white people,” and told his African-American interlocutors on Twitter to “Run along, Tyrone.” Fritsch also served as a spokesman for former Alabama Senate candidate Roy Moore’s campaign, and is heavily involved in the far-right “news site” Big League Politics, which, according to a Daily Beast investigation, is owned and primarily operated by alt-right-friendly political consultants and publishes favorable articles about their clients, including Stewart, Nehlen, and Moore.

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Dwayne E. Dixon, a lecturer at the University of North Carolina, Chapel Hill, and an anti-Nazi protester at the Charlottesville rally, wrote on a faculty listserv that on February 7, Fritsch and another man (who turned out to be Patrick Howley, the founder of Big League Politics) accosted him with a video camera in the hallway to his office, physically tried to prevent him from leaving, and interrogated him with questions like “Are you responsible for the death of Heather Heyer?” (Heyer was the 32-year-old woman killed when James Fields, a self-proclaimed white supremacist, allegedly rammed his car deliberately into a crowd of counterprotesters in Charlottesville.) A source close to Dixon said that when he tried to get away from the two, “Fritsch bodychecked him so he couldn’t get past, trying to pin him so he’d have to fight them.” When Dixon slipped out and hid under a desk in a nearby office with a colleague and the colleague’s 12-year-old son, Fritsch and Howley “physically surrounded the desk so that none of them could get out.” The men finally left after Dixon called the police. (Fritsch and Stewart both declined to comment for this article.)

Yet Nehlen is even scarier, compiling lists of Jews in the media and reposting articles from The Daily Stormer, a neo-Nazi blog. With Ryan’s announcement that he will not seek reelection, Nehlen’s only opponent in the August 14 Republican primary is Nick Polce, who boasts a mere 609 “likes” on Facebook (as opposed to Nehlen’s 41,000-plus). A source familiar with Wisconsin politics told me it’s expected that “credible” Republicans will jump into the race before the June 1 filing date, but so far State Assembly speaker Robin Vos, ex-White House Chief of Staff Reince Priebus, and others have declined to run, leading to the frightening possibility that Nehlen could win the nomination.

Two men of color running for Congress in long-shot races are also making broad appeals to white nationalists. Shiva Ayyadurai, an Indian American running against Senator Elizabeth Warren in Massachusetts, has made a fast friend of Charlottesville tiki-torch-holder Matt Colligan, who has said repeatedly that “Hitler did nothing wrong.” (The candidate appeared on a live video broadcast with Colligan, calling the neo-Nazi “one of our great supporters.”) Ayyadurai has also issued campaign pins featuring Groyper, a cartoon toad that’s become a white-nationalist symbol. His candidacy occurs in an international context in which far-right, anti-Muslim politicos in India have aligned themselves with Nazism. Meanwhile, contemporary white identitarians, like Richard Spencer, have sometimes sought to include in their organizations fellow “Aryans” from India and Iran.

And Edwin Duterte, a Filipino American running against Democratic Representative Maxine Waters in California, has purchased a premium membership on Gab, a platform popular with white supremacists, where he’s referred to his opponent as “low-IQ Maxine,” echoing a racist comment made by Trump. Asked about it in a phone interview, Duterte just giggled and said, “It’s a good nickname.” He is also insisting that a debate with his Republican primary opponents include as moderators the neo-Nazi known as Baked Alaska (Tim Gionet) and a Twitter personality named folkloreAmericana, who recently retweeted a warning against “Juden Tricks” and who identifies his own video broadcast as “alt-media for all.” In our interview, Duterte bizarrely called for getting the Crips, the Bloods, and the alt-right together “in a room and see what they all agree on.”

Though segments of the Republican Party have condemned these candidates, other GOP institutions are treating white nationalists as normal or even desirable. A Republican women’s group from South Carolina hosted Nehlen as the guest speaker at its Presidents’ Day dinner, and militia groups with ties to white supremacists, such as the Oath Keepers and Three Percenters, have forged strong alliances with the GOP establishment in states like Oregon, Arizona, and Michigan, and have even been asked to provide security at party events.

Sitting politicians are also embracing white-nationalist supporters and groups. Two Republican congressmen up for reelection—Matt Gaetz of Florida and Dana Rohrabacher of California—have associated themselves with GotNews’s Chuck Johnson, whom Gaetz invited to Trump’s first State of the Union address and from whom Rohrabacher accepted a bitcoin donation worth $5,400. Along with GotNews, Johnson is best known for creating the white-nationalist fund-raising site WeSearchr, which has helped underwrite The Daily Stormer. Forbes has reported that Johnson worked with the Trump transition team—especially executive-committee member Peter Thiel—on hiring decisions. Among others, Johnson pushed for the hiring of Ajit Pai, who became head of the Federal Communications Commission.

Then there are Representative Steve King (R-IA) and former Maricopa County sheriff Joe Arpaio, now running for the Arizona Senate, who aren’t usually classified as white nationalists but deserve a place on this list because of their racism while in office. In December, King approvingly quoted the authoritarian prime minister of Hungary, Viktor Orbán, who had said, “Mixing cultures will not lead to a higher quality of life but a lower one.” Earlier, King suggested that only white people had contributed to civilization. Arpaio, of course, was found by the Justice Department to have initiated “a pervasive culture of discriminatory bias against Latinos” and to have violated their constitutional rights as sheriff. Arpaio is also connected to the Oath Keepers through the Constitutional Sheriffs and Peace Officers Association, an anti-federal-government organization that he helped found; as reported in Rolling Stone, the CSPOA shares leaders with the paramilitary group.

And on the local level, Michael Peroutka, a member until 2014 of the neo-Confederate hate group League of the South, is running for reelection after one term as County Council chair in Anne Arundel County, Maryland. He is also a Christian Reconstructionist, meaning that he wants to enact a theocratic government run by fundamentalist Christians.

This year’s conservative political action Conference was in many ways the political center of the Republican Party. There, Trump addressed white nationalists like Nick Fuentes, Peter Brimelow, and Marcus Epstein, as well as alt-lite figures now influential in the GOP, like Cernovich. Although CPAC has continued to ban Spencer, these other open racists were free to attend. As the line separating Trumpists from white nationalists grows finer, the president’s radical policies—such as ending the admission of most refugees, detaining pregnant women in ICE facilities, and seeking to curtail legal immigration—are increasingly being seen as reasonable political decisions. “White-nationalist candidates can make a very hard-right candidate look moderate,” warned the Western States Center’s Eric Ward.

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The public conversation around immigration in particular has shifted so far to the right that it’s almost unrecognizable from the mainstream discussions four years ago. Shockingly, a senior fellow at the prestigious Brookings Institution, William Galston, recently said on WNYC’s The Brian Lehrer Show that the United States’ five-decade-long policy of family reunification—what Trump calls “chain migration”—had been “a failure” and should be abolished. Trump, of course, recently ordered 4,000 National Guard troops to the Mexican border, despite the fact that arrests for undocumented border crossings have decreased by 1.4 million since the year 2000. Trump also issued a memo requiring that immigrants be detained until their court dates, even if those dates are several years away. Additionally, the director of Trump’s Office of Refugee Resettlement keeps a spreadsheet of detained undocumented teenagers who want abortions, so he can try to prevent them from obtaining the procedure.

Another danger of white-nationalist candidacies is that “we know electoral campaigns are one of the surest ways of increasing one’s base and raising dollars,” Ward noted. The more that racists run for office, the more they will develop a political infrastructure. “Campaigns create an influx of cash that can be used to run ads and pay salaries that allow white nationalists to organize.”

They also often force the left to spend time preventing catastrophically racist policies from being enacted instead of fighting for the things they want. “If the real issue is the lack of living-wage jobs in a community,” Ward told me, “a white-nationalist candidate can derail that by turning it into a discussion of immigration.” Ditto with issues like working conditions, addiction, gentrification, and lack of access to health care, where white-nationalist candidates can transform the discussion from community needs to the supposed oppressions visited on white people. In the end, one of the most meaningful ways to protect this country from the dangers posed by the white-supremacist movement is to strengthen a multiracial, multiregion movement for economic justice. If the left can’t do that, this year could be the start of a wave of white nationalists riding Trump’s coattails into office.

Faith can help cleanse societal waters of racism, says Cardinal Wuerl

Catholic News Service
WASHINGTON — With faith, people can confront and help overcome the evil of racism, Washington Cardinal Donald W. Wuerl said in an April 17 talk at The Catholic University of America.

“The elimination of racism may seem too great a task for any one of us or even for the whole church,” he said. “Yet we place our confidence in the Lord, because in Christ, we are brothers and sisters, one to the other. With Christ, we stand in the spirit of justice, peace and love.”

Cardinal Wuerl, who as the archbishop of Washington is Catholic University’s chancellor, was invited by its president, John Garvey, to speak on his recent pastoral letter, “The Challenge of Racism Today.”

Washington Cardinal Donald W. Wuerl. (CNS photo/Jaclyn Lippelmann, Catholic Standard)

Speaking at the university’s Pryzbyla Center to an audience consisting mostly of seminarians and other students, the cardinal compared racism to a residue that has contaminated streams that flow into the societal well from which people drink. He warned that the unhealthy contaminants causing racism in our culture can be subtle and ubiquitous.

“We have the possibility to be that fresh stream of water flowing into the societal well,” he said.

Noting that the U.S. bishops in their 1979 pastoral letter “Brothers and Sisters to Us,” identified racism as a sin, the cardinal said that evil has spanned continents and centuries and continues in today’s world.

“In societies around the world, the social construct of race has been used to classify ‘us’ and ‘them,’ separating those who are seen as ‘different’ — those who come from a different place or look differently or speak a different language,” Cardinal Wuerl said. “This construct has then led to the assertion of innate superiority of one group over the other. This has real destructive effects in society and in the lives of individuals and families.”

He said the concept of race is not a biological reality, but a social construct.

“Properly understood, there are not multiple races, but objectively there is only one race — the human race,” he explained. “We are all one species, one people, one human family, albeit manifested in diverse ethnic, cultural and societal ways.”

He added, “We are, all of us, brothers and sisters, children of the same God.”

Quoting from his pastoral letter on racism, Cardinal Wuerl said, “Today we need to acknowledge past sins of racism and, in a spirit of reconciliation, move toward a church and society where the wounds of racism are healed.”

Noting that African-Americans because of their skin color have borne “the social scars of denigration and a cultural classification rooted, fostered and experienced in slavery in this nation and the denial of their fundamental human dignity,” he said the societal impacts of racism endure today.

“The context in which our response to racism takes place,” the cardinal said, “must also include a recognition of the lingering effects of slavery and segregation and of the many social inequities that exist, including the disparate negative impact that certain policies have had, including the concentration of people by race in residential neighborhoods, de facto segregation in public schools, with many African-American children being consigned to poor quality schools, the inequities manifested in employment opportunities, health care and incarceration rates.”

In his pastoral letter, Cardinal Wuerl emphasized the importance of church efforts to foster social justice, opportunity and hope in facing those problems.

Speaking in the month that marked the 50th anniversary of the assassination of the Rev. Martin Luther King Jr., Cardinal Wuerl praised him as being first and foremost “a man of faith.”

“His Christian faith is what animated his life and kept him going day after day,” the cardinal said. “Always faithful to the Lord and his Gospel, he also insistently, forcefully, yet without violence, reminded this nation that we are all brothers and sisters, because we are all children of the same God.”

Cardinal Wuerl also praised Cardinal Patrick O’Boyle, the first resident archbishop of Washington in 1948. Immediately he began working to integrate the archdiocese’s schools, six years before the Supreme Court’s landmark Brown v. Board of Education decision that outlawed segregation in public schools. Then-Archbishop O’Boyle also gave the invocation at the beginning of the 1963 March on Washington, which featured Rev. King’s immortal “I Have a Dream” speech.

In February, Cardinal Wuerl blessed commemorative bronze plaques honoring unknown enslaved men, women and children buried throughout the Archdiocese of Washington. The plaques will be installed this spring in the archdiocese’s five cemeteries, to prayerfully remember those enslaved people buried in unmarked graves.

As he concluded his talk, the cardinal said, “My brothers and sisters, it is possible that we can build a new city, a new heaven and earth, a new community. … We’re capable of a much better world. Each one of us can renew the face of the earth.”

Afterward Julian Ehiem, a seminarian for Washington who is studying at Theological College, said the topic is very timely.

“We’re all one big family. From the theological point of view, we’re all God’s children, and that’s the first thing we should look at,” he told the Catholic Standard, Washington’s archdiocesan newspaper.

Ehiem, who was born and grew up in Nigeria before immigrating to the United States when he was in high school, said he appreciated how Cardinal Wuerl pointed out that Rev. King’s work for civil rights and racial justice was rooted in his Christian faith.

“He’s a very prophetic figure… (and) a great example of standing up for what you believe in,” the seminarian said, adding that Rev. King’s faith “was essential to who he was and his message.”

Confronting racism doesn’t require a “top-down” solution in the Catholic Church, said Joseph Basalla, a Catholic University junior and a history major from Cleveland.

“It’s an individual choice, for clergy and laypeople, to take a stand against what is morally and objectively wrong in our society,” he said. “By all of us consciously taking that stand, that’s how change occurs.”

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Atlanta struggles to meet MLK’s Legacy on health care

“I think we should be further along in Atlanta, but I think we should be further along in all cities in this country,” said Dr. David Satcher, a former U.S. surgeon general.

Atlanta struggles to meet MLK’s Legacy on health care

By Virginia Anderson

       ATLANTA — While public safety commissioner Bull Connor’s police dogs in 1963 attacked civil rights protesters in Birmingham, Ala., leaders in Martin Luther King Jr.’s hometown of Atlanta were burnishing its reputation as “the city too busy to hate.”

Yet 50 years after the civil rights leader was killed, some public health leaders here wonder whether the city is failing to live up to King’s call for justice in health care. They point to substantial disparities, particularly in preventive care.

“We have world-class health care facilities in Atlanta, but the challenge is that we’re still seeing worse outcomes” for African Americans, said Kathryn Lawler, executive director of the Atlanta Regional Collaborative for Health Improvement. That group includes representatives of more than 100 non-profit organizations, governments, hospital systems and other health care providers working to improve access and care for minority communities.

“We did certain things here, we went through the civil rights era, and we did things like desegregation, but we just over the years never kept the convert- Among the problems:

— Atlanta has the widest gap in breast cancer mortality rates between African American women and white women of any U.S. city, with 44 Black patients per 100,000 residents dying compared with 20 per 100,000 white women, according to a study in the journal Cancer Epidemiology in 2016.

* It is the city with the nation’s highest death rate for Black men with prostate cancer, with a rate of 49.7 deaths per 100,000 residents. The mortality rate for white men here is 19.3, the National Cancer Institute re-ports.

*  There’s a 12-year or greater difference in life spanmong neighborhoods in Fulton County, of which Atlanta is the county seat. Those living in the city’s Bankhead or Northwest neighborhoods, which are predominantly Black, fare worse when compared to those who live in affluent, mainly white Buckhead, researchers at Virginia Commonwealth University found.

* Large gaps in mortality exist between African Americans and whites in such diseases as HIV, stroke and diabetes, according to the Georgia Department of Public Health.

African Americans make up just over half of the city’s residents. But a recent study found that 80 percent of Black children here live in neighborhoods with high concentrations of poverty, which often have poor access to quality medical care, while 6 percent of white children do.

Several of the neighbor-hoods with predominately minority communities have poverty rates higher than 40 per-cent.

“I think we should be further along in Atlanta, but I think we should be further along in all cities in this country,” said Dr. David Satcher, a former U.S. surgeon general and now senior adviser at the Satcher Health Leadership Institute at Morehouse School of Medicine here.

The health gaps between African Americans and whites in Atlanta or in any U.S. city are not due necessarily to short-comings in the health care system, according to people who have studied the issue. Rather, they are the result of decades of discrimination.

“It’s a constellation of things,” said Thomas LaVeist, chairman of the department of health policy and management at the George Washington University’s school of public health in Washington, D.C. “African Americans couldn’t own land, wealth couldn’t transfer from one generation to the next. Those were advantages [for whites] that were formed decades ago.”

“The disparities are really national problems,” he added, “and there really is not a city that’s spared.”

The result has been, the experts said, lower incomes, lower levels of education, higher stress, unsafe neighborhoods, lack of insurance and a host of other social factors that combine, over the years, to create differences in quality of health.

It starts with a lack of preventive care, said Dr. Otis Brawley, chief medical officer of the American Cancer Society and a longtime Atlanta resident. In addition to not having insurance or money for care, many African Americans lack trust in the health care system and see it as another part of American life that has let them down.

Ricardo Farmer, 57, has not been to a doctor for a checkup in almost 30 years, he said. He is uninsured, and his funds are limited. More than anything, however, Farmer said he does not trust the health care system.

“If I don’t have any symptoms, I feel like I don’t need to go,” said the tile craftsman.

Yet he has a back problem that causes him to miss work occasionally, and he has high blood pressure, which he self-treats by reducing his salt intake and giving up meat, and asthma, which sometimes forces him to the emergency room because he has trouble breathing.

An Abundance Of Health Care, For Some

Atlanta is a major health care hub, home to the federal Centers for Disease Control and Prevention, the American Cancer Society, the Arthritis Foundation, two schools of medicine and several universities that offer degrees in public health. And yet health care is still a scarce commodity in many poor neighborhoods.

“Atlanta spends $11 billion on health care in a given year, but much of that is misspent,” said Lawler. Too many patients end up in emergency rooms, for example, because they do not have a primary care doctor or seek treatment after their illnesses are much more advanced, she added.

In addition, after being diagnosed, getting treatment can be difficult for some, said Brawley. African American women are nearly four times more likely than whites to forgo treatment for breast cancer, which can include a combination of surgery, chemotherapy and radiation, he said.

Adherence to the radiation regimen is particularly challenging, he explained, because a woman typically has to go five days a week for six weeks. That presents problems for those who must rely on public transportation or work in low-wage jobs that don’t offer generous sick leave benefits.

“It takes them 2½ hours to get there every day, and [the treatment] takes 45 seconds,” Brawley said, when describing bus commutes for some residents. “So they figure it’s not worth it.”

Those involved in seeking better care for Atlanta’s poor say the lack of insurance coverage also plays a huge role in the problem. Yet, that, too, is tied to race, since twice as many African Americans than whites are uninsured in Georgia.

“One of the greatest barriers to care in all these states that didn’t expand Medicaid [under the Affordable Care Act] is lack of insurance,” said Brawley. “And it happened in all of the states of the ‘Old Confederacy.’ This is a huge racial insult.”

State Rep. Jason Spencer said Republicans’ opposition to Medicaid expansion “had nothing to do with race.” He said whites living in parts of northern Georgia also have higher mortality rates. “The common denominator is education and finances. The race card is a worn-out, tiresome excuse.”

‘I Didn’t Want To Think About Bad Things’

Austin Gilmore, 60, is emblematic of the patients who don’t have a regular physician and therefore ignore their health needs.

He had a roofing business and lived with his wife in a four-bedroom house with two bathrooms. But he lost his bearings when she died in 2011 from kidney disease. Without insurance and with few economic resources, he didn’t know where to turn for help.

“I didn’t even know I was depressed,” said Gilmore. He started drinking and eventually lost his house and his business.

“I had no livelihood, no job, no place to live. I didn’t want to think about bad things, so I drank,” Gilmore said. He knew he was harming his health.

In September 2016, Gilmore decided he could not ignore his health issues any longer. He went to an emergency room and after several days of treatment was referred to Mercy Care for longer-term care. He has been sober for 19 months.

“I thank God for Mercy Care,” Gilmore said. “I can’t think of where I’d be without them.”

Dr. Kathleen Toomey, district health director for the Fulton County Board of Health, said the county has initiatives to help narrow the gaps. But just as the disparities were not caused by the health care system alone, the problems will not be solved solely by the health care system.

“The ownership is not just on public health, but across all sectors of the community that address social, economic and environmental factors that influence health,” Toomey said.

By Virginia Anderson

This story also ran on NPR.

This article was reprinted from Kaiser Health News with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


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Students fundraise for Nigeria

Temple’s chapter of United Muslim Relief and the Organization of African Students auctioned student art in Mitten Hall on Sunday as part of an event about Nigerian maternal healthcare. | MATT ALTEA / THE TEMPLE NEWS

While helping Temple’s United Muslim Relief chapter plan this year’s fundraising event, Jide Soyinka, the Organization of African Students’ fundraising chair, brought up an idea that hits home for him.

“Multiple times my mom has told me that I almost died and she almost died while giving birth to me,” said Soyinka, a junior biology major who was born in Nigeria. “The health care, the supplies, the doctors, they aren’t as well-informed and the supplies aren’t the top-notch supplies you would get here in the U.S.”

Every year UMR collaborates with a different student organization to hold a fundraising event, highlighting a specific area in the world less fortunate than the United States. This year, they reached out to OAS to focus on Nigeria’s maternal health care crisis. The groups have been working on “Ekaabo: A Night in Nigeria” since the end of Fall 2017.

The organizations hosted “Ekaabo” in Mitten Hall on Sunday. The student groups aimed to raise awareness about Nigeria’s maternal health crisis with a black-tie event that included an authentic Nigerian dinner, an art auction and dance performances.

Georgia Owusu, the president of OAS, said she hopes the event gets people thinking about these issues and encourages action.

“We would like to bring more awareness to the maternal care facilities and the lack thereof in parts of Nigeria,” Owusu said. “Infertility rates are really high in Nigeria and it’s all just because of a lack of resources and lack of infrastructure. So, the purpose of this event was to…bring more awareness, healthy babies into society, healthy motherhood, [and] healthy life into Nigeria.”

Temple’s chapter of United Muslim Relief and the Organization of African Students auctioned student art in Mitten Hall on Sunday as part of an event about Nigerian maternal health care. | MATT ALTEA / THE TEMPLE NEWS

Nigeria is the second-largest contributor to maternal mortality rates and child deaths taking place under 5 years old. Additionally, the majority of newborn deaths in Nigeria occur within the first week after a baby is born.

The money raised at the event will go first to UMR’s national headquarters and then be donated to the Wudil Zone, a local government area in Kano State in northern Nigeria. The proceeds will fund, equip and stock delivery rooms in multiple maternal health care facilities across the Wudil Zone.

“There’s a lot of strife in northern Nigeria and…that’s where the majority-Muslim population is,” Soyinka said. “We are collaborating with a Muslim organization, so we felt it was appropriate to be sending it to a majority Muslim population.”

Soyinka added that OAS chose to highlight the Nigerian maternal health care crisis because Philadelphia has a large Nigerian population.

“I’m sure a bunch of Nigerians here in Philly from there, whether they know it or not, were somehow affected, their parents were affected or people they know were affected by this,” Soyinka said.

“Ekaabo” featured performances by members of the Uzuri Dance Company, a student group that strives to empower women of color. The art sold in the auction was displayed throughout the evening and included sculpture, painting and photography pieces donated by Philadelphia artists.

Josh Lacerna, a junior finance major, also performed a duet with Aaron X. Smith, an Africology and African American studies professor, known for rapping during his classes. Lacerna and Smith’s performance was titled “Temple Love,” and Lacerna sang and played guitar while Smith rapped. In the lyrics, the two discussed the importance of uniting different cultures and religions at Temple.

“I’m hoping that they listen, whether Muslim or Christian,” Smith rapped. “This university is blessed just because of the diversity.”

The authentic Nigerian dinner consisted of jollof rice, a traditional West African stew, chili peppers and meat, fish or fried plantains.

Iman Soliman, the president of Temple’s chapter of United Muslim Relief, speaks at the club’s fundraising gala in Mitten Hall on Sunday night. | MATT ALTEA / THE TEMPLE NEWS

Molefi Asante, the Africology and African American Studies department chair, was the keynote speaker of the event. He focused on the historical background of Nigeria and future projections related to the country’s population growth in his speech.

Asante said the average age of the Nigerian population is about 19, while Europe’s is about 49. He added within 30 to 40 years, Nigeria will be one of the most populous nations in the world. The Nigerian city of Lagos alone is home to 21 million people, according to the Lagos State government.

“The challenges on the health care system are going to be enormous, and only with the diversification of the economy will Nigeria be able to support such a situation where they will have so many different people,” Asante told The Temple News.

Soyinka said he hopes the event taught people about Nigerian health care systems and connected native Nigerians with their home country.

“A lot of people coming into the banquet…won’t know what’s going on, because a lot of the stuff we’re talking about isn’t the type of stuff you’ll read in newspapers here in America or watch on TV,” he said. “We try to make sure people here on campus know about stuff that’s going on back at home and have an understanding of what’s happening back in Africa.”

“We take this as our chance to help support and uplift our homes and help the people at home suffering even from here,” Soyinka added. “At the end of the day, this is helping bring up children. Children are the future, so by us highlighting maternal health care, it’s highlighting the well-being of our future.”

Black smokers at higher risk for heart failure than whites, study says

MONDAY, April 16, 2018 — Smoking may significantly increase black Americans’ risk of heart failure, a new study warns.

The study included 4,129 black participants who were followed for a median of eight years. Half were followed for a shorter time, half for a longer period. Their average age: 54.

When the study began, none had heart failure or hardening of the arteries, which can lead to heart failure. During the study period, there were 147 hospitalizations for heart failure.

Compared to those who never smoked, smokers had triple the risk of hospitalization for heart failure. That risk was 3.5 times higher for those who currently smoked a pack or more a day. And it was twice as high among those with a history equivalent to smoking a pack a day for 15 years.

The researchers also found a link between current smoking and an enlarged left ventricle — a sign that the heart’s main pumping chamber is not working properly. Changes in its structure and function likely boost heart failure odds, according to study senior author Dr. Michael Hall. He is a cardiologist at the University of Mississippi Medical Center in Jackson.

The study was published recently 9 in the journal Circulation.

“Previous research has focused on smoking and atherosclerosis, or hardening of the arteries, but not enough attention has been given to the other bad effects of smoking on the heart,” Hall said in a journal news release.

“With increasing rates of heart failure, particularly among African-Americans, we wanted to look at the link between smoking and heart failure,” he added.

Because the study focused on three counties in the Jackson, Miss., area, the findings may not apply to black Americans who live elsewhere, according to Hall.

“Still, the study clearly underscores the harms of smoking and the benefits of quitting,” he said. “As health care professionals, we would recommend that all patients quit smoking anyway, but the message should be made even more forcefully to patients at higher risk of heart failure.”

About 20 percent of Americans over age 40 are expected to develop heart failure, according to the American Heart Association.

More information

The U.S. National Heart, Lung, and Blood Institute has more on heart failure.

Copyright © 2018 HealthDay. All rights reserved.

Smoking Puts Blacks at Higher Risk for Heart Failure

MONDAY, April 16, 2018 — Smoking may significantly increase black Americans’ risk of heart failure, a new study warns.

The study included 4,129 black participants who were followed for a median of eight years. Half were followed for a shorter time, half for a longer period. Their average age: 54.

When the study began, none had heart failure or hardening of the arteries, which can lead to heart failure. During the study period, there were 147 hospitalizations for heart failure.

Compared to those who never smoked, smokers had triple the risk of hospitalization for heart failure. That risk was 3.5 times higher for those who currently smoked a pack or more a day. And it was twice as high among those with a history equivalent to smoking a pack a day for 15 years.

The researchers also found a link between current smoking and an enlarged left ventricle — a sign that the heart’s main pumping chamber is not working properly. Changes in its structure and function likely boost heart failure odds, according to study senior author Dr. Michael Hall. He is a cardiologist at the University of Mississippi Medical Center in Jackson.

The study was published recently 9 in the journal Circulation.

“Previous research has focused on smoking and atherosclerosis, or hardening of the arteries, but not enough attention has been given to the other bad effects of smoking on the heart,” Hall said in a journal news release.

“With increasing rates of heart failure, particularly among African-Americans, we wanted to look at the link between smoking and heart failure,” he added.

Because the study focused on three counties in the Jackson, Miss., area, the findings may not apply to black Americans who live elsewhere, according to Hall.

“Still, the study clearly underscores the harms of smoking and the benefits of quitting,” he said. “As health care professionals, we would recommend that all patients quit smoking anyway, but the message should be made even more forcefully to patients at higher risk of heart failure.”

About 20 percent of Americans over age 40 are expected to develop heart failure, according to the American Heart Association.

More information

The U.S. National Heart, Lung, and Blood Institute has more on heart failure.

© 2018 HealthDay. All rights reserved.

Posted: April 2018

Study Examines Maternal Metabolic Factors and Early-Onset Puberty

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SOURCE Kaiser Permanente

Kaiser Permanente study the largest population-based research on topic

OAKLAND, Calif., April 16, 2018 /PRNewswire/ — In a study of more than 15,000 girls and their mothers – all Kaiser Permanente members in Northern California – maternal overweight and hyperglycemia were linked to the earlier onset of puberty in girls 6 to 11 years old. Early puberty has been linked to multiple adverse health developments as girls grow up.

Kaiser Permanente Logo. (PRNewsFoto/Kaiser Permanente)

The study, “Associations between maternal obesity and pregnancy hyperglycemia and timing of pubertal onset in adolescent girls: A population-based study,” was published today in American Journal of Epidemiology. The girls in the study were from diverse cultures and ethnicities.   

“We know that maternal weight can influence childhood weight. What we are learning is that the in utero environment may also affect the timing of future pubertal development in offspring, which makes sense since human brains are developed in utero and the brain releases hormones affecting puberty,” said lead author Ai Kubo, MPH, PhD, research scientist with the Kaiser Permanente Northern California Division of Research.

This research builds on previous Kaiser Permanente research that demonstrated earlier onset of puberty in American girls, as well as the possible role of environmental, perinatal and other risk factors. Early puberty, including the early onset of breast development or menarche (initiation of menstruation), increases the risk of adverse health outcomes including obesity, type 2 diabetes, polycystic ovarian syndrome, and cancer in adolescence and adulthood. For girls, it has been linked to a higher risk of adverse emotional and behavioral outcomes including depression, anxiety, earlier sexual initiation and pregnancy.

In 2010, Kaiser Permanente pediatricians in Northern California began routinely documenting Tanner stages, a standardized measure of pubertal development, in electronic health records during routine pediatric exams. This study is the largest to link the Tanner-stage measurements of girls with the medical records of their mothers in order to assess the role of pregnancy-related factors on pubertal timing.

Researchers found that maternal obesity (body mass index of 30 or more) and overweight (body mass index between 25 and 30) in mothers was associated with 40 percent and 20 percent greater chance of earlier breast development in girls, respectively. The study also found a 7-month difference in onset of breast development in daughters of obese versus underweight mothers.

For pubic hair development, similar associations between maternal obesity and earlier onset were found. However, the data suggest that the associations may differ by race and ethnicity. For instance, Asian girls with obese mothers were 50 percent more likely to experience earlier onset of pubic hair than Asian girls with normal-weight mothers, while there were no associations among African-American girls.

The study also found a significant relationship between hyperglycemia (elevated blood sugar during pregnancy) in mothers and the earlier onset of breast development, but not in mothers with gestational diabetes.

“It’s possible that women with the diagnosis of gestational diabetes were more careful about weight and diet, which might have changed the amount of weight gain and offspring development patterns, but other studies need to replicate the finding to be able to conclude that there is an association,” Kubo noted.

Senior author Lawrence H. Kushi, ScD, research scientist with the Division of Research, said the study provides new avenues for slowing the trend toward earlier sexual maturation in girls. “Understanding the intergenerational effects of in utero exposures is helping health care systems such as Kaiser Permanente to develop new strategies for assisting women to manage weight and hyperglycemia before and during pregnancy, not only for their own health, but also for that of their children.”

Kaiser Permanente, the nation’s largest integrated health system, is uniquely positioned to conduct research over the life course because its members stay with the health system for many years. This stable membership – in conjunction with comprehensive electronic medical records – enables studies such as this one, in which the long-term effects of exposures during pregnancy can be examined. For example, previous studies have examined the relationships between breastfeeding and the risk of breast cancer recurrence; maternal obesity, gestational diabetes and the early onset of puberty; and the early onset of puberty and obesity in girls.

This study was funded by the National Institutes of Health.

In addition to Kubo and Kushi, co-authors were Cecile A. Laurent, MS, Assiamira Ferrara, MD, PhD, and Charles P. Quesenberry, PhD, Kaiser Permanente Northern California Division of Research; Juliana Deardorff, PhD, University of California,  Berkeley School of Public Health; and Louise C. Greenspan, MD, Kaiser Permanente San Francisco Medical Center.

About the Kaiser Permanente Division of Research
The Kaiser Permanente Northern California Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 350 epidemiological and health services research projects. For more information, visit divisionofresearch.kaiserpermanente.org or follow us @KPDOR.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than more than 12 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

For more information, contact:
Janet Byron, janet.l.byron@kp.org, 510-891-3115
Heather Platisha, Heather.Platisha@creation.io, 415-262-5992

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Texas isn’t the ‘worst,’ but moms are still dying

It’s good news that Texas’ maternal mortality rate is much lower than previously believed, allowing the Lone Star State to shed the shameful, and apparently erroneously bestowed, distinction of having one of the highest rates in the world.

The bad news is that women are still dying.

That fact is not changed by a study this week blaming much of the alarming spike in pregnancy-related deaths in the pivotal year of 2012 on data errors.

Several of the state’s top health experts concluded in the report, published in the journal Obstetrics & Gynecology, that an enhanced way of counting the deaths using multiple sources shows the number of women who died in 2012 was actually 56, not 147.

Experts had been concerned about bad data for a while, so it’s good that we have some more reliable numbers and accurate picture of the problem.


To read this article in one of Houston’s most-spoken languages, click on the button below.

Lisa Falkenberg

Still, the picture is from 2012. There are still many questions and the need to assess data from more recent years to determine the situation today.

Read more: Texas pregnancy-related deaths inflated, new study finds

But we can’t let a bit of good news kill the motivation that has been building to address a problem that can still be described as bad for the state of Texas.

“I would hate to see us lose the momentum that we’ve gained,” said Dr. Lisa Hollier, an obstetrician and gynecologist at Texas Children’s Hospital.

“We still have women dying of preventable causes,” she said. “We still have a two-fold, a doubling, in the risk of death for African-American women. Those things need to change. I don’t think we should accept where we are.”

Hollier, who co-authored this week’s report and also chairs the Texas Maternal Mortality and Morbidity Task Force, points out that deaths aren’t the only measure of the problem. For every maternal death, Hollier says there are 50 women who experience severe complications that can lead to hysterectomies, breathing problems requiring ventilator support and kidney failure, to name a few.

“If there are 50 women who die in a particular year, there are 2,500 women who had severe complications,” Hollier said. “There are so many more women who are affected than just that tiny tip of the iceberg which is mortality.”

Hollier seemed confident that the lawmakers, physicians and representatives from medical societies she had spoken with since the report came out remain supportive of improving health access and outcomes for women.

“Everyone is still behind the movement to make motherhood safer,” she said.

Read more: Dying mothers should shock Texas into action

Forgive me if I’m not so sure. In Texas, a state whose only motivation to reform bad policy seems to be high-profile crises drawing national media coverage and scathing federal court rulings, I’m worried that when the glare of the national spotlight fades, so will the attention on women’s health and maternal deaths.

“I have grave concerns,” agreed state Rep. Armando Walle, D-Houston, who has spearheaded efforts to address the issue. “I don’t want this report to be used as a distraction not to fund the necessary programs that allow women access to providers and to deal with postpartum depression.”

Walle said he is encouraged by local efforts involving Houston Endowment Inc., nonprofits and elected officials to remain focused on the issue.

“Every medical professional I’ve spoken to acknowledges that there’s a problem,” he said. “There’s bipartisan consensus to do something in the next couple of sessions. Regardless of what this report says … I’m going to move forward with legislation that we’re going to carry next session.”

Editorial: Help moms with maternal health

Several of his priorities are common-sense policies that Hollier supports as well.

One, of course, is the perennial issue of increasing women’s access to primary and preventative care in a state that refused to expand Medicaid under Obamacare, and where women’s health programs have been decimated by deep funding cuts and the politically motivated extraction of what had been the state’s largest and most experienced provider, Planned Parenthood.

The state sacrificed millions of federal matching dollars to kick out Planned Parenthood because some of its clinics provide abortions. And studies have shown women have paid the price with loss of access to quality care and family planning services.

Hollier supports extending Texas women’s Medicaid eligibility for a year postpartum. As it is now, many women lose Medicaid coverage 60 days after giving birth. The state health agency says it has begun allowing women to enroll in the state program, but Hollier worries about paperwork and bureaucratic hurdles that disrupt continuity in a new mother’s care.

Another priority for Hollier is creating a culture of safety in hospitals. That involves, in part, promoting a set of evidence-based practices that can help hospitals more successfully deal with problems that can arise for pregnant women, such as hemorrhage. Hospitals that embrace protocols known as “patient safety bundles” learn the best way to teach staff to look for warning signs of a problem, respond to it and report outcomes to measure their progress.

The Texas Department of State Health Services has joined an alliance of health organizations promoting this approach and is encouraging hospitals around the state to participate, Hollier said.

It’s encouraging, but as regulation goes in Texas, it’s voluntary. Hospitals, if they wish, are free to stick to outdated practices that do nothing to reduce risk of maternal deaths.

The last, and perhaps most important, priority Hollier mentioned is for women to become their own advocates, to ask questions of nurses and doctors about their care, and if the situation arises, to assert themselves the way tennis star Serena Williams says she did during the birth of her daughter.

The state has a stake in saving women’s lives that goes far beyond saving the state’s reputation. The problem of Texas women dying before, during and after childbirth may not, in fact, be as bad as we thought.

But here’s another fact Texans should keep in mind as we demand better, safer, more accessible care for women: even one preventable death of a Texas mother is too many.



Ascension contributing to health care disparity gulf in Milwaukee

Statement of Alderman Tony Zielinski

April 13, 2018


The recent news of hospital downsizing and service cuts by Ascension Wisconsin in Milwaukee is extremely troubling to me. By making these choices Ascension is exacerbating the health care disparity problem in Milwaukee, where there is already insufficient delivery of health care services in neighborhoods where people of color reside.


Vernellia R. Randall is a professor at the School of Law at the University of Dayton. Professor Randall writes extensively on and speaks internationally about race, women, and health care. In her published article Inequality in Health Care Is Killing African Americans (Vol. 36 No. 4), she points to racial discrimination in the U.S. and its lasting and harmful impact on African Americans.

“Compounding the racial discrimination experienced generally is the institutional discrimination in health care affecting access to health care and the quality of health care received. Racial discrimination in health care delivery, financing, and research continues to exist. Racial barriers to quality health care manifest themselves in many ways, including (1) economic discrimination, which rations health care on ability to pay; (2) insufficient hospitals and health care institutions and clinics; (3)insufficient physicians and other providers; (4) racial discrimination in treatment and services; and (5) culturally incompetent care.”

Sadly this is what we are seeing now as Ascension downsizes its services at St. Joseph Hospital. The safety net is essentially being yanked out from under the mostly African American patient base at St. Joseph, leaving already underserved individuals to figure out what their next best options are.