Let Us Not Forget
JOIN THE FIGHT AGAINST PROSTATE CANCER BY HONORING THE 9TH ANNUAL PROSTATE CANCER AWARENESS OBSERVANCE DAY
How far would you go to protect yourself and your family? What if it was a matter of life and death? And what if the answer was a simple exam?
Like many, Kevin Byrd of Utica, NY would do just about anything for his family. When he learned that his grandfather was diagnosed with prostate cancer, he was devastated. But nothing prepared him for the death of his grandfather from the disease about 10 years ago. When my grandfather died from prostate cancer, my world was crushed, says Byrd. During Mr. Byrds time of bereavement, his colleague, Blossom Brown, shared that she had also experienced the loss of her grandfather to Prostate Cancer. I could not stand around to see another family suffer the loss of a loved one to prostate cancer, says Byrd. Kevin Byrd and Blossom Brown were motivated to keep their grandfathers legacy alive so they joined forces and established the Brown Byrd Foundation, a Christian organization and a registered 501 (c) (3) non-profit.
Prostate Cancer, also known as a Silent Killer, affects 1 in 7 men, making it the most common non-skin cancer in America and the second leading cause of cancer-related deaths in men in the United States. Every 2.9 minutes a man is diagnosed with prostate cancer. This means that a non-smoking man is more likely to develop prostate cancer than he is to develop colon, bladder, melanoma, lymphoma, and kidney cancers combined. In 2017 alone, it is estimated that more than 181,000 men will be diagnosed with prostate cancer, and more than 26,000 will die from the disease. Prostate Cancer is also the number one killing disease among the African-American male population. A man of African descent is 70% more likely to develop prostate cancer than a Caucasian man, and more than twice as likely to die from the disease.
The founders of the Brown Byrd Foundation have been longtime advocates and an active voice for the millions of men affected by prostate cancer. We created the Brown Byrd Foundation to give men and their families hope. Our foundation helps to fund some of the worlds most prominent research to improve prostate cancer prevention, early detection, increase awareness and treatment and ultimately cure it once and for all, Brown says.
The Brown Byrd Foundation has received many accolades for their fight against prostate cancer and has led to a featured segment on Fios1 Heroes on our Island and radio/ television interviews such as Keeping It Real with Shannon. In 2013, they received the Long Island, Health Care Heroes Award. In February 2012, their work was honored and entered into the Congressional Record Library of Congress by House of Representative Congresswoman Yvette D. Clarke. The foundation has also received numerous proclamations from world leaders, U.S. Presidents and the Common Council of Utica, NY recognized their commitment to prostate cancer by honoring the foundation with a street named Brown Byrd Lane. This year, Niagara Falls will be illuminating their falls in blue for the fourth consecutive year on February 2nd at 10 p.m. in honor of the Brown Byrd Foundation efforts to cure prostate cancer. (Learn more at
In 2008, the mayor of New York City was the first to honor the Brown Byrd Foundation by designated February 2nd as Prostate Cancer Awareness Observance Day. Since then, over 100 mayors have joined the efforts of the Brown Byrd Foundation by acknowledging this day in their city states. On February 2nd, citizens across the nation will wear a blue ribbon and light blue candles that symbolizes the thousands of men who lost the battle against prostate cancer. Citizens will also pray and have a 19 seconds moment of silence.
By the time you are done reading this article, a man would have died from prostate cancer. Eliminating prostate cancer in our lifetime is a possibility within reach, and the day when the disease becomes a manageable condition is closer than ever. It is very possible that a man diagnosed with prostate cancer today may live long enough to see a treatment developed that will save his life. We are getting closer to this reality every day. Please join the fight against prostate cancer today.
For more information about Prostate Cancer or to fund a growing number of promising prostate cancer research projects, contact the Brown Byrd Foundation at 30 Wall Street, 8th Floor, New York, NY 10005 or email . Contact Number: (212) 709-8335. Also, visit the Brown Byrd Foundation website at .
Gene May Help Guide Black Patients' Opioid Addiction Treatment
Researchers say they've found a genetic variant associated with opioid addiction, and it might lead to personalized treatment for the condition.
Specifically, the variant was found in black Americans affecting the gene OPRM1, which is responsible for the way opioids affect the brain. Researchers at Yale University said this may identify which blacks might require higher doses of methadone. Methadone is an effective treatment for people addicted to heroin.
Proper methadone dosing is critical. Too high a dose can cause sedation and dangerous breathing difficulties, while too low of a dose can lead to relapse, the researchers said in background notes.
"Opioid addiction has become a national epidemic, and improving the effectiveness of medical therapies has to be a priority," study lead author Andrew Smith said in a university news release. Smith is a student in the M.D./Ph.D. program.
The researchers also said they've found that the same gene variant can predict the morphine dose required for effective pain control for black children undergoing surgery.
"We found specific gene effects in people with African ancestry, an understudied population," said study senior author Joel Gelernter, a professor of psychiatry, genetics and neuroscience at Yale.
The researchers didn't find these gene effects in people of European ancestry who had methadone treatment.
Smith and Gelernter said follow-up studies are needed to confirm the effects they saw in their study.
The findings were published Jan. 24 in the journal Molecular Psychiatry.
SOURCE: Yale University, news release, Jan. 24, 2017
U.S. Deaths From Cervical Cancer May Be Underestimated
Rates rose when latest study excluded women who'd already undergone hysterectomy
The number of women who die from cervical cancer in the United States may be higher than previously believed, and the risk is greatest among older and black women, a new study finds.
"This is a preventable disease and women should not be getting it, let alone dying from it," study leader Anne Rositch, an assistant professor of epidemiology at Johns Hopkins University in Baltimore, said in a Hopkins news release.
Due to big advances in early detection, such as the Pap test, it's long been thought that cervical cancer had made a big retreat in the United States.
But the researchers note that prior estimates of cervical cancer death had included women who'd already had a hysterectomy -- which can include removal of the uterus and cervix. One in five women in the United States has had a hysterectomy, according to the researchers.
Preventive screening such as the Pap test looks for signs of malignancy or pre-malignancy in the cervix, so it is only useful in reducing deaths from cervical cancer in women who have not undergone a hysterectomy, the researchers explained.
Their new calculation approach excludes women who'd had a hysterectomy.
When those women were factored out, Rositch's team found that U.S. cervical cancer deaths are 77 percent higher among black women and 47 percent higher among white women than previously thought.
The prior rate of cervical cancer death among black women older than 20 was 5.7 per 100,000 each year, while it was 3.2 per 100,000 each year among white women.
But when women who'd had a hysterectomy were excluded from the analysis, the rate in black women rose to more than 10 per 100,000 per year and to 4.7 per 100,000 per year in white women.
"These data tell us that as long as a woman retains her cervix, it is important that she continue to obtain recommended screening for cervical cancer since the risk of death from the disease remains significant well into older age," Rositch said.
The research also found that many women who die from cervical cancer are older than 65, the recommended cut-off age for regular cervical cancer screening.
Each year in the United States, there are 12,000 cases of cervical cancer and 4,000 deaths from the disease. But routine screening can prevent cervical cancer.
The study findings emphasize the need to learn more about the risks associated with cervical cancer in older and black women, and to determine the best screening and treatment options for these women, according to the researchers.
"Since the goal of a screening program is to ultimately reduce mortality from cervical cancer, then you must have accurate estimates within the population targeted by those programs -- adult women with a cervix," Rositch explained.
"These findings motivate us to better understand why, despite the wide availability of screening and treatment, older and black women are still dying from cervical cancer at such high rates in the United States," she added.
Two gynecologists who reviewed the findings agreed that better screening -- for all women -- is key to reducing the death toll from cervical cancer.
"The disparity in cervical cancer rates between whites and blacks illustrates the difference in medical care received by different populations in the United States," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City.
"This is an ongoing problem with many socioeconomic factors," she said. "Better community outreach for preventative care and also special attention for high risk populations may help to decrease rates of cervical cancer."
Dr. Mitchell Maiman is chair of obstetrics and gynecology at Staten Island University Hospital, also in New York City.
He said that "every effort must be made to insure that modern concepts in cervical cancer screening are executed. We must monitor our HPV vaccine programs with the goal of universal participation, and make sure that there are no racial disparities in its implementation."
The study appears in the Jan. 23 issue of the journal Cancer.
SOURCES: Jennifer Wu, obstetrician/gynecologist, Lenox Hill Hospital, New York City; Mitchell Maiman, M.D., chairman, department of obstetrics and gynecology, Staten Island University Hospital, New York City; Johns Hopkins University, news release, Jan. 23, 2017
THE TRUE MEANING OF "BRUH-THERLY" LOVE: ONE BLACK MAN'S STORY -- PART ONE
By George M. Hughes, Jr.
There’s nothing more private than discussing health issues related to your man- parts. But there’s also nothing more healing than connecting over a shared experience. I’ve learned through my experience that I am not alone, and that we owe it to our families and friends to be okay with discussing health issues with each other. When I was diagnosed with prostate cancer last year, I never thought I would be sharing my story with millions.
I’ve been made aware of and have registered with a site that helps the larger community of prostate cancer survivors share their experiences. The Clark Atlanta University Prostate Cancer Registry galvanizes prostate cancer survivors to share their stories in an effort to reduce health disparities and improve the treatment, care and long-term quality of life issues that affect African-American prostate cancer survivors most.
Read about my story and consider making a commitment with yourself to reach out, open up, share and boldly discuss health issues with your family, friends and even strangers. You never know who might be listening. You never know about the lives you could be saving by speaking up. This could be another one of your acts of true “bruh-therly” love.
Growing up in a household with my mother, father and older sister, I thought my father was superman. I viewed all of my uncles (all seven of them) at the same level. They rarely talked about health issues, but when they did, it always came across as secretive. As I became a teenager and then a young man, any issues or sicknesses that my father had were always conveyed to me with a sense that everything was fine and that I should never worry. If there was cause for concern about any health issue, my parents always told me after a long period of dealing with the issue themselves. One of those secretive health issues was prostate cancer and the removal of my father’s prostate years ago. I knew about it, but not in detail as it was described as simply having a procedure on his prostate. To this day, my father has not told his brothers or anyone outside of our direct family about his cancer diagnosis. Because like breast cancer, prostate cancer can run in the family, my father always encouraged me to get my PSA tests done yearly and to keep an eye on anything unusual.
So during the summer of 2015, I went in to see my regular doctor for a yearly physical. I had blood drawn for various tests. My doctor’s nurse called a week later and told me that my PSA level was a bit high and he wanted me to make an appointment to see a urologist. I made and kept this appointment with no worry in my head because I thought I was too young at 47. I was in decent health, and to me, I didn’t have any symptoms. To rule out cancer, I agreed to have a biopsy done on my prostate to prove that I was not sick. After my biopsy was done, it took the office 3 weeks to get back to me. Because it took so long, and there was no sense of urgency shown by the doctor’s office, we just assumed that everything was fine. NOT! When I was finally able to see him, I took my wife with me. To our shock, the doctor came in and told me that I was in early stage 1 of prostate cancer, the slow growing kind. The two things I thought about first were my daughter and wife. Our only child and daughter was 8 years-old at the time and it scared me to death that I might not be around to see her grow up. I was shocked and panicked
After the shock wore off, it was time for us to figure out what to do. That’s when I started asking questions. I asked friends, family and doctors for advice and understanding. By talking about my situation and being open with people, I learned a ton of information that helped me on my journey. I had a very close friend, who is like a brother, who had just been through the same thing I was going through a year earlier. He was a huge help with everything that I was going through and was there every step of the way. He’s very private, so this was a stretch for him to share. I also made a lifelong friend with Jeff, a husband of one of my wife’s work friends. He was up front and in my face with the realities of going through this process and I don’t think I would have made it without his support. During my open discussions with my family, I was also surprised to find out that several of my uncles and cousins have had prostate cancer and had their prostates removed. This was such a shock to me because it was never shared until I was impacted. Prevention is critical, so I make it my point to encourage the men I know to get their annual exams and especially the male members of my family like younger cousins.
So after evaluating all of my options and having some open dialog with my wife, father and select friends, I came to the decision to have my prostate taken out. Because I am so young (youngest in my family to get prostate cancer), the best decision for me was to have it removed. With other treatment options, I would be at risk of not being able to remove the prostate down the road if the cancer returned because of the scar tissue that develops from radiation. On December 4th, 2015, I had my radical prostatectomy. I was very open about my entire experience and shared it with many friends and family members in hopes of continuing to open the lines of communication about health-related issues in particular. I’ve paid it forward by being a direct and honest voice to others who are diagnosed in this shared and similar journey.
If you know someone on the journey or has been through the journey, encourage them to register anonymously at www.pcregistry.cau.edu or post this website address on their social media channels. You never know the lives you might save by sharing your story and experience. To share your story with George, contact him at George@blhconsulting.net.
George M. Hughes, Jr. live lives Atlanta, Georgia.
UNIQUE LA COUNTY SICKLE CELL DISEASE CLINIC NOW OPEN AT MLK JR. OUTPATIENT CENTER
-- Majority of California Adults with Sickle Cell Disease Live in LA County --
The Sickle Cell Disease Foundation of California is proud to announce that LA County Department of Health Services is now offering clinical services specifically tailored to meet the needs of adults with SCD at the MLK Jr. Outpatient Center. The clinic began as a pilot in August 2016 and has since increased its number of patients.
A majority of California adults with SCD live in Los Angeles, which had no adult sickle cell disease hematologist or clinic until now. The clinic fills a major gap in expert health care services for over 1,000 Los Angelino adults with this devastating disorder who are not only African American, but also Hispanic, South Asian and of Middle Eastern descent.
SCD is a rare, complex, progressive, and debilitating disorder that results in excruciating, unpredictable bouts of pain, severe anemia, and early death without skilled treaters. Very few clinicians are able to manage the complications that affect adults with SCD, resulting in unnecessary treatment delays and pain, avoidable costs, and premature deaths. (The Washington Post recently ran a national story on this topic. See
Due to the loss of treatment centers and skilled healthcare providers, life expectancy is now under 40 years of age among Los Angeles adults with SCD (citation: Powars, Darleen R., et al. "Outcome of sickle cell anemia: a 4-decade observational study of 1056 patients." Medicine 84.6 (2005): 363-376). This is despite advances in care through new medications and gene therapy nationally.
We know that there is a large community of adults with SCD in the neighborhoods served by MLK Jr. Outpatient Center, said Ellen Rothman, the Chief Medical Officer at MLK Jr. Outpatient Center. We are planning an innovative and collaborative approach to provide not just specialty hematology, but also primary care, mental health services, comprehensive pain management including alternative therapies, and peer navigators. We are working with our campus partners, the Department of Mental Health and the MLK Community Hospital to provide the whole spectrum of services.
There has been no sickle cell clinic at MLK since former U.S. Surgeon General David Satcher’s SCD research center at the former King/Drew Medical Center closed decades ago. The development of multidisciplinary SCD services at MLK was initiated by the Pacific Regional Sickle Cell Collaborative, a new federal project that is introducing a regional approach to expand healthcare access for patients throughout eight Western United States.
Principal Investigator, Diane J. Nugent, MD, Founding President of the Center for Inherited Blood Disorders in Orange County, CA, states, The loss of care for patients with SCD over the past two decades is a healthcare tragedy and is a consequence of our system’s lack of recognition and support for the interdisciplinary teams needed to support families and patients with complex, chronic disease. The new MLK services are at one of many new sites needed throughout Southern California to improve outcomes and quality of life for all patients.
Adults with sickle cell disease deserve health care providers that understand the disease, its complications, and their pain. Knowing the MLK staff planning and providing the services gives me great confidence they will meet the community’s needs, states Mary Brown, President and CEO of the Sickle Cell Disease Foundation of California, the lead community-based organization in the Collaborative.
Massachusetts Health Connector Marks Record Enrollment and Strong Customer Service
The Baker-Polito Administration announced the results of the Massachusetts Health Connector’s recent Open Enrollment period that ended last week. The Connector successfully managed the highest enrollment totals of the Affordable Care Act (ACA) era, with significant applicant and member activity buttressed by strong customer service performance.
Enrollment for February 1st stands at over 246,000 people, the highest since the ACA was implemented and approaching the 252,000 in Health Connector coverage before 100,000 people became eligible for other coverage through Medicaid expansion in January 2014.
“Fixing the broken Health Connector and restoring a reliable customer service support system for the program were top priorities for our administration after taking office,” said Governor Charlie Baker. “Over the last two years, the Connector’s leadership and staff have worked tirelessly to transform the exchange into a functional and reliable service the people of Massachusetts deserve. While there is still work to do, I am proud of the work that has been accomplished to date and feel confident that the restored Health Connector can play a crucial role in the state’s health care structure.”;
“The Health Connector plays an important role in ensuring communities across the Commonwealth have access to affordable health care,” said Lieutenant Governor Karyn Polito. “We are pleased to see such significant and targeted progress toward enrolling new people and look forward to continued progress for years to come.”
“The Health Connector is vitally important to our state’s commitment to making health care accessible to everyone,” said Secretary Marylou Sudders, Secretary of Health and Human Services. “;Over the last two years, the Health Connector has gone from an agency hanging on to one that is home for thousands who need health insurance and a powerful advocate for universal coverage.”;
The Health Connector started Open Enrollment on November 1, 2016 with 233,000 members, and retained more than 85 percent of those members despite many facing significant premium increases due to rate changes by some carriers. The Health Connector implemented a large member communication plan during Open Enrollment encouraging shopping, and more than 65,000 members switched plans for 2017. The 28 percent switch rate was four times higher than the usual 3-7 percent switch rate during an Open Enrollment.
In addition, 53,000 people who did not have coverage through the Health Connector enrolled in a plan for 2017. That is an increase of nearly 50 percent from the 36,000 new members added during 2016 Open Enrollment. The Health Connector’s new member strategy was fueled by an outreach effort focused on communities with higher rates of uninsured residents and that have been typically slow to sign up for coverage. In those targeted communities, new enrollments were 52 percent higher than 2016, with communities like Mattapan (93 percent) Chelsea (81 percent), Brockton (85 percent) and Everett (77 percent) experiencing the biggest increases. The Health Connector contracted with 16 community organizations through its Navigator program to help educate consumers about options available to them, and help uninsured people complete an application and select a plan.
“A successful Open Enrollment is reliant on support from the entire Commonwealth, including Governor Baker and Secretary Sudders, on through to our hard-working staff, our Navigators and assisters, and our customer service team,” said Louis Gutierrez, the Executive Director of the Health Connector. “I am grateful that we were able to capably handle the significant member activity we saw, which also serves as a reminder that Massachusetts values access to affordable, health coverage, and will continue to do so in the future.”;
“After missing open enrollment last year and going without health insurance, I was always worried. I learned coverage was necessary after breaking my leg a few years ago while playing rugby. If I hadn't been covered, the expenses would've been astronomical, this taught me that in today's world, you have to be sure you're covered in case of an accident,” said Vincent Daley, a Cambridge resident who signed up for coverage through the Health Connector during Open Enrollment with the help of a Navigator. “The staff at the Cambridge Economic Opportunity Committee walked me through the process and showed what I needed to do. Applying for health insurance is not something you’re taught. But, after learning the process, I even helped a friend apply for coverage, too.”;
When Governor Baker took office in 2015, improving the Health Connector’s customer service was a top priority. Two years later, customer service outlets were able to successfully support a substantially high volume of calls and requests. Calls to the call center increased from 243,619 during 2016 Open Enrollment to 345,621 for 2017 Open Enrollment, an increase of over 40 percent. Visits to the Health Connector’s six walk-in centers increased from 14,710 for 2016 Open Enrollment to 17,711 for 2017 Open Enrollment, an increase of 20 percent. The customer service platforms were able to handle the additional traffic, particularly with the call center remaining within predetermined service levels for hold time and abandonment rates. Additionally, customer satisfaction scores remained near 80 percent satisfaction during this Open Enrollment.
BLACK AIDS INSTITUTE
The AIDS crisis is not over!
Despite improvements in HIV treatment, HIV/AIDS continues to disproportionately affect the Black community.
Did you know?
- It is estimated that there are between 800,000 and 900,000 people living with HIV in the U.S. One in four of those do not even know that they have HIV.
- A study of young MSM in six U.S. cities found that 91 percent of the HIV-positive African Americans in this study did not know their HIV status.
- HIV/AIDS was among the leading causes of death for Black men and women in the U.S.
- Blacks are 12 percent of the U.S. population, but represent over 50 percent of all new HIV infections.
- Nearly 185,000 Blacks have died of AIDS in the U.S.
- Black women represent 72 percent of new HIV infections among women in the U.S.
- Black youth ages 13-19 represent 65 percent of the reported AIDS cases among youth in 2002, even though they are only 15 percent of the U.S. population.
- Black Americans have the poorest AIDS survival rates of all racial and ethnic groups.
The truth about HIV/AIDS in the Black community
- No matter if you are Black, white, rich, poor, straight or gay, if you engage in certain behaviorsyou place yourself at risk for becoming HIV infected. Some behaviors that place you at risk are:
-Engaging in unprotected sexual activity, particularly if you have had multiple partners.
- Using unsterilized needles/syringes, particularly for injecting drugs.
- Racism, poverty and inadequate access to health care play an important role in increased HIV infections in Black communities.
- Poverty, drug use and homophobia are not unique to the Black community, but when combined with conspiracy fears, mistrust of government agencies and racism they become barriers to HIV prevention and treatment efforts.
- Many Black folks do not believe they are at risk, thinking, “HIV happens to other folks who are not at all like me.”
- Stigma in our community prevents us from talking openly about sex and sexuality.
- We have less access to treatment, less accurate health information and sometimes may involve ourselves in networks of people who infect one another and do not know it.
- Black men and women may not be aware of their partners’ HIV status or of the behaviors they engage in that place them at risk.
Now that you know, what can you do?
make sure you know the facts not just the myths about HIV/AIDS. Learn about HIV/AIDS and protect yourself and those you love through safer sex practices, clean needle use and prenatal care.
-Get tested: it may be hard, but you owe it to yourself to know. Go to your local health department, clinic or community-based organization and ask for a free HIV test.
-Get treated: If you are HIV positive, take an active role in maintaining your health. New treatments offer hope to people living with HIV. These drugs can slow down the reproduction and progression of HIV. When HIV cannot reproduce and progress, people live longer and stay healthier. The earlier you care for yourself the better health outcomes you will have.
- Get involved: Speak the truth about HIV/AIDS in the Black community; talk to family, friends, co-workers. Volunteer at a local community-based organization. Because if we want to end the HIV/AIDS epidemic in our communities, we have to take responsibility for altering its course.
There is currently NO cure for AIDS
There is currently NO vaccine that can prevent or treat HIV infection
Find out more
Visit www.BlackAIDS.org and find other fact sheets on HIV testing and HIV vaccines
Why 7 Deadly Diseases Strike Blacks Most
Health care disparities heighten disease differences between African-Americans and white Americans.
By Daniel J. DeNoon
From the WebMD Archives
Several deadly diseases strike black Americans harder and more often than they do white Americans.
Fighting back means genetic research. It means changing the system for testing new drugs. It means improving health education. It means overcoming disparities in health care. It means investments targeted to the health of black Americans. And the evidence so far indicates that these investments will pay health dividends not just for racial minorities, but for everyone.
Yet we're closer to the beginning of the fight than to the end. Some numbers:
- Diabetes is 60% more common in black Americans than in white Americans. Blacks are up to 2.5 times more likely to suffer a limb amputation and up to 5.6 times more likely to suffer kidney disease than other people with diabetes.
- African-Americans are three times more likely to die of asthma than white Americans.
- Deaths from lung scarring -- sarcoidosis -- are 16 times more common among blacks than among whites. The disease recently killed former NFL star Reggie White at age 43.
- Despite lower tobacco exposure, black men are 50% more likely than white men to get lung cancer.
- Strokes kill 4 times more 35- to 54-year-old black Americans than white Americans. Blacks have nearly twice the first-time stroke risk of whites.
- Blacks develop high blood pressure earlier in life -- and with much higher blood pressure levels -- than whites. Nearly 42% of black men and more than 45% of black women aged 20 and older have high blood pressure.
- Cancer treatment is equally successful for all races. Yet black men have a 40% higher cancer death rate than white men. African-American women have a 20% higher cancer death rate than white women.
Genes definitely play a role. So does the environment in which people live, socioeconomic status -- and, yes, racism, says Clyde W. Yancy, MD, associate dean of clinical affairs and medical director for heart failure/transplantation at the University of Texas Southwestern Medical Center.
Yancy says that all humans have the same physiology, are vulnerable to the same illnesses, and respond to the same medicines. Naturally, diseases and responses to treatment do vary from person to person. But, he says, there are unique issues that affect black Americans.
"We must recognize there are some arbitrary issues that are present in the way we practice medicine and dole out health care," Yancy tells WebMD. "It forces us to think very carefully about the very volatile issue of race and what race means. At the end of the day, all of us acknowledge that race is a very poor physiological construct. Race is a placeholder for something else. That something is less likely to be genetic. It is more likely to have to do with socioeconomics and political issues of bias as well as physiologic and genetic issues that go into that same bucket. Some racial differences are more nuances. But there are issues of disparity and there are issues relative to racism that operate in a very broad context."
Like Yancy, LeRoy M. Graham Jr., MD, says the time is ripe for Americans to come to grips with these issues. Graham, a pediatric lung expert, serves on the American Lung Association's board of directors, is associate clinical professor of pediatrics at Morehouse School of Medicine in Atlanta, and serves as staff physician for Children's Healthcare of Atlanta.
"I just think we as physicians need to get more impassioned," Graham tells WebMD. "There are health disparities. There are things that may have more sinister origins in institutionalized racism. But we as doctors need to spend more time recognizing these disparities and addressing them -- together with our patients -- on a very individual level."
Black Americans and Lung Disease
A 2005 report from the American Lung Association shows that black Americans suffer far more lung disease than white Americans do.
- Black Americans have more asthma than any racial or ethnic group in America. And blacks are 3 times more likely to die of asthma than whites.
- Black Americans are 3 times more likely to suffer sarcoidosis than white Americans. The lung-scarring disease is 16 times more deadly for blacks than for whites.
- Black American children are 3 times as likely as white American children to have sleep apnea.
- Black American babies die of sudden infant death syndrome (SIDS) 2.5 times as often as white American babies.
- Black American men are 50% more likely to get lung cancer than white American men.
- Black Americans are half as likely to get flu and pneumonia vaccinations as white Americans.
"There are a couple of reasons," Graham says. "One is that 71% of African-Americans versus 58% of white Americans live in communities that violate federal air pollution standards. When we look at African-Americans in terms of demographic distribution, they are more likely to be located near, if not next to, transportation corridors, and to places where the air is drawn."
Another reason is that a higher percentage of black Americans than white Americans live close to toxic waste dumps -- and to the factories that produce this waste.
Genetic differences may also play a role. For example, it is clear that cigarette smoking causes lung disease. Cigarette smoking is declining faster among blacks than among whites -- but blacks still die of lung diseases more frequently than white Americans. This could be due to health care disparities -- blacks may get diagnosed later, when diseases are harder to treat -- but it could also be due to genetic susceptibility.
"The environment is involved, and there is potential genetic susceptibility -- but we also have to talk about the fact that African-Americans' social and economic status lags behind that of Caucasians," Graham says. "And low socioeconomic status is linked to more disease."
It's not a simple question of access to health care itself, but access to specialists. Even within HMOs, Graham says, blacks get specialist referrals less often than whites.
"I wonder if minority populations put as much pressure on their doctors to get specialty referrals," says Graham, who works to empower black community groups to know what they should expect from their health care. "And there may be more insidious, darker reasons why doctors are less likely to refer African-American patients. But as a specialist myself, I know that patients who get to see me have gone to their doctors and said, 'This isn't working.'"
African-Americans and Heart Disease, Stroke
"What sets the stage for the more aggressive and higher incidence of heart disease in African-Americans is a very high incidence of high blood pressure," Yancy says. "This predisposes African-Americans to more heart disease, kidney disease, and stroke. And heart failure -- an African-American is much more likely to get there with an absence of previous heart disease. That is most important. This makes us focus on high blood pressure as it forces heart failure."
Clinical trials show blacks and whites respond differently to treatments for high blood pressure. Indeed, treatment guidelines suggest that doctors should consider different drugs based on a patient's race.
"Data suggests that all therapies do equally well -- but patients at higher risk need more intensive therapy," he says.
A similar situation exists for heart failure. A promising treatment for heart failure didn't seem to be working -- until researchers noticed that it worked much better for black patients than for white patients. A study of black patients confirmed this finding -- and provided tantalizing evidence that the drug will help patients of all races with certain disease characteristics.
"The way this discussion of race differences has been helpful for the whole field of cardiology, is it is exposing new treatment options for all people with heart failure, African-American and Caucasian," Yancy says.
Black Americans and Diabetes
Black Americans -- and Mexican-Americans -- have twice the risk of diabetes as white Americans. In addition, blacks with diabetes have more serious complications -- such as loss of vision, loss of limbs, and kidney failure -- than whites, notes Maudene Nelson, RD, certified diabetes educator at Naomi Barry Diabetes Center at Columbia University.
"The theory is that maybe it is access to health care, or maybe a cultural fatalism -- thinking, 'It is God's will,' or, 'My family had it so I have it' -- not a sense of something I can have an impact on so it won't hurt me," Nelson tells WebMD. "But more and more there is thinking it is something that makes blacks genetically more susceptible. It is hard to tell how much of it is what."
There is, indeed, evidence that African-Americans may have a genetic susceptibility to diabetes. Even so, Nelson says, the real problem is empowering patients to keep their diabetes under control.
"Patients often have the sense that they are not as much in charge of managing their diabetes as their doctor," Nelson says. "Where I work, in various settings, there is an emphasis on patients. We say this is what your blood sugar is; this is what influences your blood sugar; you have to remember to take your meds. So as a diabetes educator I know there has to be an emphasis on patients putting out more effort to manage their own health."
It's easy to say people with diabetes should learn how to control their disease. But the tools for this kind of self-empowerment often aren't available in black neighborhoods, says Elizabeth D. Carlson, DSN, RN, MPH. Carlson, a postdoctoral fellow in the division of cancer prevention and education at the University of Texas M. D. Anderson Cancer Center in Houston, studies the social determinants of health.
"I go to this black neighborhood 20 minutes from my house in a white neighborhood, and the health education they get in school is much worse than the health education my kids get," Carlson tells WebMD. "It is not just formal education, but everyday things. It's being afraid to go out and exercise because you live in a high-crime neighborhood. It's not having transportation to your health care provider. It's not having decent fresh fruits and vegetables in the local grocery."
Black Americans and Sickle Cell Anemia
It's no surprise that sickle cell anemia affects African-Americans far more than it does white Americans.
This, clearly, is a genetic disease that has little to do with the environment. Yet even here -- with a killer disease -- social and political issues come into play.
Graham notes that the cause of sickle cell anemia has been known since the 1950s. But for many generations, he says, sickle cell anemia has not had the funding and research attention it deserves.
"If you look at the time and attention devoted to sickle cell anemia, it pales when compared to cystic fibrosis and other genetic diseases," Graham says. "There are actually more Americans with sickle cell disease than with cystic fibrosis -- 65,000 to 80,000 versus 35,000 to 40,000 -- but the amount of money spent on cystic fibrosis research outstrips sickle cell anemia by many fold. This is a shame on the medical research arm of our nation."
To its credit, Graham says, the National Institutes of Health is changing this situation. One reason for this change -- as research into lung disease, heart disease, and diabetes shows -- is the growing realization that the health of black Americans isn't a racial issue but a human issue.
Tips For Avoiding The Onset Of Seasonal Affective Disorder (SAD)
By Karl P Borrows
Most of the time, you simply can't escape the winter blues. This is particularly true if going to a sunny, warm place is impossible for you. In such instances, you will have no choice but to stay and find ways to deal with the current cold, gloomy weather conditions.
In case the effects of the gloomy weather are still getting to you and your depression is getting worse, it may be time for you to see a therapist and find out if you are suffering from Seasonal Affective Disorder or SAD. This is a form of downheartedness that occurs when you develop symptoms of depression during the darker and cold winter months each year. Because this is prevalent during winter, it is also known as the winter blues and winter depression.
The good news is that this is a condition that can easily beat by following certain tips and strategies. These include the following:
Change your diet for this season. The food you eat and don't eat can play an important role in uplifting your mood during the cold season. As much as possible, drink lukewarm water and reduce or avoid drinking cold water with ice. Also, add warm spices such as cayenne, black pepper, garlic, ginger, and horseradish to the dishes you cook. You can also increase vegetable temperatures by stir frying them in a wok or by lightly steaming them.
Paint your walls with a brighter color. The color of your home can help greatly in alleviating your mood. According to experts, the best options to go for include yellow, orange, red, and copper tones. These colors can cheer up the dimmest of moods and bring warmth into your life even when the sky is grey and the dim earth tones are all around.
Invest in some new light bulbs. The brighter your home and rooms are, the better your mood will be during winter. You can get full spectrum bulbs and use them during the season. You can also consider getting a SAD light or light therapy lamp since they are designed to provide feelings of calmness and peace.
Enjoy aromatherapy. Essential oils and aromatherapies can help with SAD since they target the part of the brain that is responsible for mood control, sleep, and hunger. Light scented candles or use the right device and oils that soothe you for this.
Take warm baths frequently. Lastly, if you have or want to take a bath, do so in a bathtub. Wrap yourself in a warm cotton or wool when you get out of the tub. Also, wrap your wet hair up tight and blow it dry immediately. This is because the head is where you lose a high percentage of heat and compounding this with evaporation from wet hair will eventually leave you with a cold head.
Read more about SAD and SAD light therapy here.