Afro-Netizen

Clinton Global Initiative 2008 Focuses on Global Health

By Mary Dillard

Guest Contributor

Today is the third day of the 2008 Clinton Global Initiative.  This year I decided to focus on listening to the global health panels, which have emphasized the goal of expanding the global health workforce. 

One statistic that was mentioned yesterday is that Africa has 11% of the world’s population, over 20% of the world’s disease burden, but only 3% of the world’s health workers.  This has not always been the case and there are a number of reasons the numbers of health care workers have diminished so precipitously over the past thirty years. These include the Structural Adjustment Programs imposed on a number of African countries during the 1980s and 90s that forced African governments to decrease the amount of money that went into public health.

A second factor was the so-called brain drain- a controversial term referring to the migration of skilled professionals from developing countries to fill human resource needs in wealthier countries.  This process began in the 1970s but accelerated due to the decline in working conditions for health workers in the 1980s and 90s.   

Over the past two days, several panel participants have called for private investors to pay more attention to partnering with the public sector, thus challenging the legacy of structural adjustment.  The clearest call for this came yesterday from Paul Farmer, co-founder of Partners in Health who reminded the audience that the CGI goals (Poverty Alleviation, Energy and Climate Change, Education and Global Health) are particularly relevant for impoverished countries in the global south. 

While Farmer was technically on the panel to speak about global health, he emphasized that the recent devastation that Haiti has faced is due to climate change.  Although this has been little reported in the U.S. corporate press, Haiti has been battered by four hurricanes in the past two months.  These storms have resulted in the deaths of over 1000 people and displacement of close to a million people. 

Farmer argued that with the splintering of NGO groups, it has been more difficult than ever to coordinate efforts or to share best practices of health care delivery but that it is crucial for people to pay attention to what is happening in Haiti in order to avoid an increasingly dire humanitarian crisis.   

Given the fact that there are many immediate healthcare crises occurring in the world, it may seem strange to focus the theme of the Global Health panels on recruiting healthcare workers.  However, this need was echoed by most panel participants over the past two days.  Yesterday, Dr. Nancy Aossey, President and Chief Executive Officer of the International Medical Corps (IMC) argued that this is a crucial priority for post-conflict and active conflict zones where IMC works including Chad, the Central African Republic, Liberia and the Democratic Republic of Congo.

Today was “policy-wonk day” on the health panels.  Most of the speakers on the smaller panels were very well versed in health policy and there was a clear emphasis on practical, replicable solutions to challenges facing health care workers around the world.  This morning’s global health panel featured Craig R. Barrett, Chairman of Intel Corporation,
Tedros Adhanom Ghebreyesus, Minister of Health, Federal Democratic Republic of Ethiopia, 
Aruna Uprety, Director, Rural Health and Education Service Trust of Nepal and Dr. Lola Dare, Executive Secretary of African Council for Sustainable Health Development (ACOSHED).

The Ethiopian Minister of Health reported on initiatives that his government is doing to expand the medical corps.  According to Minister Tedros, when the government set priorities,  “We decided to focus on trying to reach the Millennium Development Goals, particularly the goal of ending poverty by 2015.”  Ethiopia’s per capita health expenditure is only one dollar per person.  With such limited funds directed towards the healthcare, increasing the numbers of low and mid-level providers (traditional birth attendants, nurses, physicians assistants) became a priority and the Ministry decided to strategically allocate resources. 

The current national health plan focuses on what he calls  “Flooding and Retention”.  Flooding refers to exponentially increasing the number of trained doctors, while retention refers to efforts to keep trained healthcare professionals employed in that capacity.  In too many impoverished countries, salaries for health care providers are so low that people cannot afford to work in the sectors where they were trained.  This contributes to skilled workers either leaving the country or finding other employment.  The largest outlay of funds in the health budget will go towards “Flooding” with  the hopes that at least a fraction of the doctors trained will continue to live and work in Ethiopia. It’s a risky strategy but clearly one that the government believes it must take.

Dr. Lola Dare made one of the most compelling arguments to not only increase the number of health care providers but also to provide those workers with the necessary supplies. She reminded the audience, “I worked in pediatric health and I left because I had no supplies in order to do my job.”  Her comments highlight the fact that the best intentions mean nothing to workers on the ground unless they have the supplies necessary to provide the kind of care that they were trained to provide. 

Africa has the highest disease burden but also has the lowest number of health workers.  Clearly the Continent has faced tremendous challenges in providing adequate health care over the past thirty years.  Since CGI is about creating “political will” my hope is that one day we will see real progress, by convincing governments around the world to make their health budgets more important than their military budgets.

Mary Dillard is Associate Professor of African History at Sarah Lawrence College in Bronxville, New York.

A Black-White Diabetes Divide

By Laura  Blue

 Time Magazine

 

Black patients with diabetes do worse than white patients — even when they're getting treatment from the same doctor. That's the message of a new study published this week in the journal Archives of Internal Medicine. It's not the first paper to document health disparities between black and white diabetics, but it breaks new ground: By looking at the outcome discrepancy among a group of patients with access to the same health facilities — 90 Massachusetts physicians working in 14 health centers — the new study rules out the explanation that black patients, by virtue of being poorer, are excluded from seeing the better quality doctors to which their white counterparts are more likely to have access.

Even when they were being treated by the same pool of physicians, whites were more likely than blacks to meet the commonly accepted cut-off point for long-term control over blood pressure (30% v. 24%), over "bad" cholesterol (57% v. 45%), and over the blood-glucose measure, hemoglobin A1C (47% v. 39%). The researchers approached their data mindful of the need to ensure that any discrepancies were not simply the effects of what they term "socio-demographic factors": Comparing apples with apples — patients of the same gender, income-range and age — the white patients still fared far better.

The cause of the discrepancy, however, remains a mystery.

Although the researchers adjusted their data for factors such as obesity levels, these did not affect the racial disparity. Some might be tempted to see the data as reflecting racial discrimination among doctors, but that would probably result in a different pattern among different doctors. Instead, the discrepancy was common among all of the doctors, irrespective of how many black patients they saw or how good their overall performance rates were.

Furthermore, at least the initial patient-doctor interaction appeared to have been similar for all patients: rates of testing for blood-sugar control and for cholesterol, for example, were the same. "That suggests the physicians are implementing standard treatment plans," says Thomas Sequist, lead author of the study and an internist at Harvard Vanguard Medical Associates. It's only later, when it comes to treatment and, especially, outcomes, that a disparity is evident.

Sequist, for his part, has a hunch. He doesn't think most doctors discriminate at all. "I feel like the issue may more be that the doctors are treating all the patients the same — and if you treat all the patients the same you won't get the same outcomes because patients don't face the same challenges," he says. "We're not tailoring our counseling to the needs of our patients."

That's why Sequist did a follow-up study with the same group of physicians, asking whether they thought racial disparities were a problem in diabetes care. About 90% said there's a problem in the U.S. nationally, but less than half of that number believed the problem affects their own practices. Now, Sequist is giving those doctors reports on their treatment performance based on the race of the patient. He's also experimenting with what he calls "cultural competency training": lessons designed to help doctors recognize when patients may not share the same assumed health conditions, or when patients may face constraints that make the standard dietary and exercise guidance tougher to follow.

Sequist emphasizes that these lessons are not aiming to teach doctors "what a black patient thinks," but to get doctors to find out what their patients actually do think. Results of the trial won't be available until later this year. But, if it works, it could be a huge boon to treatment for all kinds of chronic conditions. "I think the issues are all the same," Sequist says. "They're around medication adherence and patient engagement."

The Global Clinton Summit in Review

By Mary Dillard
Guest Contributor

I once saw an interview with Bill Clinton where he was asked “What do you think of the American people?”  His response was, “Give them enough time and they always get it right.”  That struck me as wildly optimistic, but stayed in my mind because I felt that it gave real insight into the man.  Witnessing two days of the Clinton Global Initiative (CGI)  reminded me of that interview.  Former President Clinton seems determined to use his political capital in order to bring attention and resources to bear on some of the world’s most serious problems. And he’s as optimistic as ever. 

The idea behind CGI is to get a range of people together discuss global issues, come up with action plans and steps towards action.  Each morning began with a plenary session followed by working group meetings in which CGI members and invited guests met to brainstorm action items, make suggestions and most importantly, make commitments.

While the press was not allowed in the working sessions, we were able to watch video feeds of the panel discussions. I chose to watch the feeds on education in order to see what would be discussed about Africa.  I knew that Bill Clinton has been extremely inspired by Kenya’s efforts at providing Universal Primary Education to all of its school age children. Kenya’s Education Minister George Saitoti reported on the popularity of the school program and what his country is doing to ensure its success.

Kenya is emphasizing teacher training, parental involvement in budget decisions and multi-age classrooms so that older students don’t feel segregated and stigmatized.  Since this initiative was first announced in 2003, enrollments have skyrocketed and Minister Saitoti mentioned that the countries oldest primary school enrollee is 75 years old! At a time when over 100 million school age children around the world are not in school, this is an ambitious undertaking and Kenya’s efforts are being watched closely to see whether its program can be replicated. 

On Friday’s panels, Andre Agassi touted the success of his charter school in Las Vegas which serves a 96% African American student population.  Dr. Fazle Hasan Abed, founder of Bangladesh Rural Advancement Committee (BRAC), spoke of BRAC’s expanded initiatives in Uganda, Tanzania and Southern Sudan and John Wood of Room to Read discussed his organization’s efforts to create 10,000 bilingual libraries around the world by 2010.  Author Toni Morrison attended the working sessions on education, while actor Jeffery Wright participated in the special sessions on poverty alleviation and highlighted his efforts to support the recent elections in Sierra Leone.

There seemed to be particular interest in supporting the rebuilding of the Lower Ninth Ward in New Orleans.  On Thursday, President Clinton personally pledged $500,000 as a matching grant to support housing construction for displaced residents.  By Friday, Brad Pitt’s “Make it Right” campaign increased the money directed towards New Orleans by an additional $5 million.  In making his announcement, President Clinton stated, “Anyone who wants to return home to New Orleans ought to be able to do so, and we want to do everything that we can to make that possible.”

It is difficult to describe the range of emotions that I felt at this event. The energy of the conference was electric.  It was exciting to hear world business, governmental and non-profit leaders talk enthusiastically about their commitments to create social change. I left Thursday’s sessions buoyed by a “Clintonesque optimism”.  Each day he announced more commitments from CGI partners and pledges to date total over $10 billion. At the same time, I couldn’t help wondering what happens next?  How does CGI insure that the commitments that are made reach the organizations that need them? How many times have global conferences inspired pledges only to find that the funds never materialized six months later?

At home, while I was turning these questions over in my head, I turned on the TV and there was Clinton again!  This time at the Apollo theater in Harlem, announcing the creation of CGI-U, an initiative directed towards college students.  I decided at that moment that I would suspend my academic cynicism and get my students on board.  I guess optimism is contagious. Plus, it will give me an opportunity to blog some more and see firsthand how these initiatives are working. 

Segregation Affects Blacks' Nursing Home Care

(September 11, 2007) -- ABC News reports on a study which indicates regional segregation affects the quality of care for African Americans in nursing homes. The study is published in the journal, Health Affairs.

Researchers from Temple University and Brown University found problems not in the South, but in the Midwest which was found to be the most segregated.

“The South was actually the least segregated, with nursing homes there more likely to have racially mixed resident populations.” The report continues:

“Study co-author Jacqueline Zinn, professor in the Fox School of Business at Temple University, notes that the differences in the care received by black nursing home residents and their white counterparts were not ‘within-home’ differences.

‘The care provided within the facility is consistent,’ she said. ‘It's just differences across [regions] with regard to the degree of segregation.’"

 

African Americans are half of U.S. homicides in 2005

By David Whettstone
For The Afro-Netizen Newswire

Washington, DC (Aug. 9) - Troubling news came in a report Black Victims of Violent Crime from the Bureau of Justice Statistics (BJS), a division of the U.S. Department of Justice.  It states:

"Blacks were victims of an estimated 805,000 nonfatal violent crimes and about 8,000 homicides in 2005." 

This would amount to 49 percent of all U.S. murder victims during that year and 15 percent of all non-fatal violent crimes -- the latter category includes victims of rape, sexual assault, robbery, aggravated assault and simple assault.

According to the U.S. Census Bureau, African Americans numbered about 35 million -- just over 12 percent of the total population -- in 2005. Males made up 85 percent of all Black murder victims.  Another demographic indicated that more than half (51%) of Black homicide victims were between the ages of 17 and 29.

The report indicates that 93 percent of Black murder victims and 85 percent of White murder victims (in single victim/single offender matches) were slain by someone of their own race.

It states, “About four-fifths of Black victims of nonfatal violence perceived the offenders to be Black.  About 12 percent of Black victims perceived the offender to be White, while about eight percent thought the offender was neither Black nor White.”

Violence in America has the remarkable characteristic of being done by those who are close to us.  Prevailing perspectives are not always founded on solid perceptions. Crime for the most part is intra-racial (not inter-racial, as many fears and false reports present). The report indicated that Blacks (78%) were more likely to be victims of intraracial violence than Whites (70%).

It also stated:

“Black males were more likely to be violently victimized by strangers than Black females.  Black female victims of violent crime were more likely than Black male victims to be victimized by an intimate partner. Intimate partner violence accounted for 21 percent of violent victimizations against Black females, compared to about five percent of victimizations against Black males. The gender disparity for intimate partner violence among Blacks was similar to that for other victims [of other races].”

A conclusion from the BJS five-year study (2001-2005) of non-fatal violent crimes is: Black folk who were either younger, never married, low income earners, or urban residents were more subject to violent victimization than their counterparts who were either older, folks of other marital status, high income, or rural or suburban dwellers. In this period, about 55 percent of all violent crimes committed against Blacks were reported to police.

News of the BJS report will no doubt become the concern of many.  Within its 12 pages, the report is a “sea” of short comments with a lot of numbers.  The persistence of violence in African-American communities and perpetrated against individuals throughout the land is cause for further needful reflection, understanding, engagement, and action.

David M. Whettstone is a Washington, DC-based public policy advocate and writer, who works on national and local issues (including civil rights and criminal justice) and with religious and community-based organizations. 

 

Cracks in the System: Over 20 years of the Unjust Federal Crack Cocaine Law

By Jesselyn McCurdy
Guest Contributor
Afro-Netizen

In 2006, we “celebrated” the 20th anniversary of one of the most racially biased laws ever enacted by the U.S. Congress – the Anti-Drug Abuse Act of 1986, which established the federal 100-to-1 sentencing disparity between crack and powder cocaine.

Congress passed the Anti-Drug Abuse Act of 1986 in response to the death of Len Bias, an African American college basketball star who died of a drug overdose three days after being drafted to the Boston Celtics. At the time, Congress believed he died from a crack overdose, when it turned out that his death was caused by a combination of alcohol and powder cocaine. By the time this was discovered, the law was already passed.

Since the law’s passage in 1986, authorities have unfairly punished crack cocaine users more harshly than those who sell powder cocaine. Currently, if a person gets caught distributing 5 grams of crack cocaine, he or she is automatically subject to a 5-year mandatory minimum prison sentence; conversely, that same person can get a 5-year sentence by distributing 500 grams of powder cocaine. This law is unfair and must be changed.

The 100:1 disparity is wrongly based on enduring myths surrounding crack cocaine use – that it’s instantly addictive and makes people more violent than powder cocaine users. A 1996 study by the American Medical Association found that the physiological and psychoactive effects of cocaine are similar regardless of whether it is in the form of powder or crack.

The federal crack cocaine sentencing policy has devastated many African American families and communities, sending mothers and fathers away to prison to serve long sentences for minor drug crimes. This federal law breaks families apart and disfranchises those with felony convictions, prohibiting them from receiving welfare, food stamps, and public housing.

Although whites and Hispanics form the majority of crack users, over 80% of those convicted of federal crack offenses are black. This becomes even more offensive as blacks comprise only 15% of the country’s drug users, but make up 37% of those arrested for drug violations, 59% of those convicted, and 74% of those sentenced to prison for a drug offense.

Federal authorities have focused their law enforcement efforts on low-level users rather than high-level traffickers. A 2002 U.S. Sentencing Commission report showed that only 15% of cocaine traffickers are classified as high-level, while over 70% of crack defendants such as street dealers or lookouts have merely low-level involvement with drugs. These participants can get the same or harsher sentences as the major dealers of a drug organization.

This has led to some disturbing results:

•    African Americans serve almost as much time in prison for a non-violent drug offense   
     at 58.7 months, as whites do for a violent offense at 61.7 months.
•    Blacks serve substantially more time in prison for drug offenses than whites. In 2003, the
     average sentence for a crack offense is 123 months, 3.5 years longer than the average
     sentence of 81 months for a powder offense.
•    In 2000, approximately 791,600 African American men were in prisons and jails, versus
     603,032 African American men enrolled in higher education.
•    Black defendants more often receive mandatory sentences than white defendants.
•    One of every 14 African American children has an incarcerated parent, and they are 9
     times more likely to have an incarcerated parent than white children.

The law goes against Congress’ intent to punish “serious” or “major” drug traffickers. Congress needs to pass a new law that treats crack and powder cocaine equally under the law. Police and prosecutors must re-focus their attention on prosecuting high-level traffickers. The Sentencing Commission itself acknowledged that it needs change in their recent 2007 Report to Congress on Cocaine and Federal Sentencing Policy.

It is time to demand that Congress address this 20-year-old unjust law. If the tables were turn and whites were being treated unfairly under the law… I can’t help but think something would have been done about this a long time ago. Now it is time for the African American community to stand up and demand justice. 

Jesselyn McCurdy is the legislative counsel for the ACLU Washington legislative office.

Breast cancer deadlier for blacks

Why? Report blames racism, says mammograms, care may be inferior

By Jim Ritter
Health Reporter
Chicago Sun-Times

African-American women in Chicago are much more likely than white women to die of breast cancer, and the racial gap is widening, according to a new study that calls the disparity "morally wrong, medically unacceptable and reversible."

Just 10 years ago, black and white women in Chicago died at the same rate from breast cancer. But the most recent figures available, for 2003, show the mortality rate among black women was 73 percent higher, researchers at Mount Sinai Hospital's Urban Health Institute report in a study being released today. Nationwide, the gap was about half that -- 37 percent.

The disparity in death rates appears to be the result of racism, "and it appears to be institutionalized," said Alan Channing, chief executive of Sinai Health System.

In Chicago, white women are diagnosed with breast cancer at a rate 15 percent higher than the rate in black women.

So why are more blacks dying from the disease?

Read more

Confronting Gender After Katrina

An Interview with Shana Griffin
By Elena Everett

(From "One Year After Katrina" a 98 page report released yesterday by Gulf Coast Reconstruction Watch)

There have been a lot analyses about race and class post-Katrina, how does your organizing philosophy differ and work to address women’s issues?

I, and the women I work with try to organize from an intersectionality approach that includes an analysis of gender, race, class, citizenship status, sexuality, and a critique of privilege. We try to organize from an unfragmented approach, meaning we don’t expect people to walk through the door and drop 3/4ths of themselves and come in as a just woman or just a black person. We don’t exist as just women, we do have a race and we do have a class and ethnic background. It’s important to look at things from an intersectionality - in the Gulf Coast there are reasons why things are unfolding the way they’re unfolding.

On TV, immediately after Katrina and as things began to unfold in the city with the flood waters, most of the faces we saw were women, poor black women and their children and their families. If you took any urban area and gave it 24 hour notice to evacuate, it would be the same population, the same poor black women in the most vulnerable situations.

What do you see as unique challenges and issues women have been facing in the Gulf post-Katrina?

One of the biggest post-Katrina challenges is the complete absence of consideration or special provisions to meet the needs of women. So many studies related to disaster or times of war and conflict show that women are one of the most vulnerable populations. Violence against women increases as well as their responsibilities since they are generally the primary caregivers for the elderly and children. There’s been an invisibility toward the needs of women of color in the Gulf Coast region.

To me, it’s not enough to have a solid race and class analysis, because beyond those two, you also need a gender analysis. Because of the absence of the gender analysis of many agencies, organizations who identify as women of color organizations have to constantly fight to render ourselves visible and at the same time, we have to justify our existence in the work that we’re trying to do.

New Orleans pre-Katrina population was more than half women and today when you look at the statistics around housing, healthcare, even incarceration  women and especially black women are much more vulnerable. In 2003 in Louisiana 80% of new HIV cases were black women - in public housing, the vast majority of tenants were women…I can go on and on  those who are most directly impacted are women when it comes to the aftermath of natural and man-made disasters.

How do you feel the initiative and clinic will work to address some of those issues?

The purpose of the clinic is to improve low-income and uninsured women of color’s healthcare access and to promote an holistic and community-centered approach to primary to healthcare. At the same time we look at the oppression and violence that have impact on the health status of women and to improve those situations. It’s more than providing healthcare services it’s also about challenging the conditions that limit our access and our opportunities, such as poverty, racism, gender-based violence, imperialism, and war. We see it as more than just a clinic  we want it to also be an organizing center that can meet immediate needs while also working for racial, gender, economic, and environmental justice.

We see our clinic as a great opportunity to talk to people and discuss why these services and this approach is needed. We have the power to reinvent ourselves and create institutions that are equitable.

Shana Griffin is resident of New Orleans and organizer with INCITE: Women of Color Against Violence and Critical Resistance New Orleans. Shana grew up in the Iberville Housing Development and is completing a Masters Degree in Sociology at the University of New Orleans. She is currently working on the Women’s Health and Justice Initiative, which is a coordinating with several organizations to open a Women’s Health Clinic this September in the historic Treme district of New Orleans. For more information, email whji_info at yahoo dot com.

Elena Everett is Program Associate, Institute for Southern Studies and Gulf Coast Reconstruction Watch. She can be reached at elena at southernstudies dot org.

Poor areas face hurdles to fitness

Unsafe streets, unhealthful food make it tough for some Chicagoans to get in shape

By John Keilman
Tribune staff reporter

For Bridget Smith, getting fit means cutting calories, burning fat and avoiding wild dogs.

The 52-year-old Chatham bookseller is trying to lose 20 pounds to keep her diabetes in check, but like many who live in poor or minority Chicago neighborhoods, she faces a host of unique challenges.

The fruits and vegetables sold in her local market are so unappealing that she drives to Hyde Park to shop. Going for a bike ride means attaching the wheels kept in her third-floor apartment to the frame stashed downstairs, a precaution she took after thieves snatched her last bicycle.

And she tries to round up a group when she goes for a walk, thinking the vicious dogs that sometimes plague the South Side might be more likely to attack a lone pedestrian. It all adds to the difficulty of losing weight, Smith said.

"There are less options here," she said. "And less of a support system."

Dropping pounds is a daunting task for anybody, but it can be especially tough in urban neighborhoods. Experts say the areas often offer copious fast food, little healthy produce, meager or substandard recreational facilities and streets that feel too dangerous to walk or bike--hardly a recipe for weight-loss success.

"This isn't just a matter of individual will power. There are a lot of other influences out there," said Dr. Deborah Burnet, a University of Chicago medical professor who has investigated obesity on the South Side.

Research has long demonstrated a link between poverty and weight. Data from the Centers for Disease Control and Prevention show that poor women are twice as likely to be overweight as their affluent counterparts.

The disparities go down to the neighborhood level. A survey released last year by Sinai Health System found that Chicago's Norwood Park, a predominantly middle-class area, had a lower percentage of obese adults than poorer neighborhoods such as Humboldt Park and North Lawndale.

"I don't know if there's ever been a study that hasn't found that poor people and people of color always have much higher obesity rates than white people and better-off people," said Steve Whitman, director of the Sinai Urban Health Institute.

Cultural differences probably account for some of that; Whitman noted that overweight residents of black and Hispanic neighborhoods were more apt to view themselves as being at the correct weight or too skinny. Some experts cite a lack of awareness about how to eat healthfully or get sufficient exercise.

But experts also say other forces are at work, starting with the opportunities for exercise in struggling neighborhoods. Few have private health clubs, and fitness centers run by the YMCA and the Chicago Park District usually charge for entry.

The costs can be relatively low. The price at the Ogden Park fitness center in Englewood, for instance, is $20 for 10 weeks of access. But even that can be too much for the poor, said Angela Odoms-Young, a Northern Illinois University researcher who has studied the neighborhood's obesity risk factors.

Those who prefer jogging or biking face their own difficulties. Health surveys in Englewood and North and South Lawndale concluded that residents might not want to exercise outside because they perceived their neighborhoods as too dangerous.

Matilda Baker, 44, an accountant who lives in South Shore, knows that feeling. She used to work out at the local YMCA but dropped the family membership to save money when her daughter, a competitive swimmer, began practicing with a suburban club.

She and her husband now walk on the nearby lakefront path and are thinking about buying bicycles. But in her neighborhood, which has an above-average rate of violent crime, safety is always a concern.

"You never know if you take your bikes out if you'll come back," she said.

Finding a safe place to exercise isn't the only obstacle. Getting proper nutrition also can be a trial in many areas.

Walking through food stores in Englewood on a recent afternoon, Odoms-Young found few wholesome products. The area's lone major grocer, an Aldi on 63rd Street, had a decent selection of fresh fruits and vegetables, though the floor space reserved for its pallets of apples, corn, bananas and tomatoes was a fraction of what you'd find in a suburban supermarket.

Far more numerous were small convenience stores that carried little nutritious food aside from some frozen okra, shriveled potatoes or, in one case, a solitary head of lettuce that shared a dark refrigerator case with packages of hot dogs.

Read more

Bone Health: Do Vitamin D Pills Help Blacks?

No Benefits Seen in Study of Postmenopausal Black Women

By Miranda Hitti
WebMD Medical News   

July 25, 2005 -- New research shows no bone benefits for healthy postmenopausal black women who took vitamin D supplements for three years.

The researchers don't dismiss the vitamin pills. They don't know if the results would be similar for women of other ethnic groups, elderly women, or those more severely lacking vitamin D.

The researchers included John Aloia, MD, of the Bone Mineral Research Center at Winthrop University Hospital in Mineola, N.Y. The study appears in the Archives of Internal Medicine.

Bone Background

Strong bones are important throughout life. Bone density peaks at about age 30. According to the National Osteoporosis Foundation, the critical years for building bone mass are from prior to adolescence to about age 30.

Bones naturally thin as we age. The worst cases result in osteoporosis -- thin, brittle bones that are more likely to break. Both men and women can develop osteoporosis or osteopenia, a milder condition that can lead to osteoporosis. Certain people are more likely to develop osteoporosis, and vitamin D deficiency makes it more likely.

Getting Vitamin D

Vitamin D is involved in bone health, along with calcium and other minerals. The body can make vitamin D when exposed to sunshine. It can also get vitamin D from supplements or certain foods, such as low-fat dairy products.

In old age, black women tend to get fewer bone fractures than whites.

It's harder for blacks to make vitamin D. Their skin color provides some natural sun protection, filtering out some sunshine needed to produce vitamin D.

Read more