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Health Equity Matters Newsletter

Spring/Summer 2015 - Vol.4, #2

A quarterly e-newsletter in which the Centers for Disease Control and Prevention's (CDC) Office of Minority Health and Health Equity (OMHHE) shares news, perspectives and progress in the science and practice of health equity.

Leandris C. Liburd, PhD, MPH, MA

Leandris C. Liburd, PhD, MPH, MA Associate Director for Minority Health and Health Equity, CDC/ATSDR

Welcome to Health Equity Matters, an electronic newsletter intended to promote awareness of minority health and health equity work at CDC and in the broader public health community, support the achievement of our goal to eliminate health disparities, and foster ongoing communication and collaboration with our partners and the public.

It’s hard to believe we are more than halfway through 2015! I looked back over the last issue of Health Equity Matters, and we were anticipating several events and the release of new reports in the months ahead. I am pleased that we are able to share the outcomes of these events and reports in this issue. You will read about year 4 of the CDC Undergraduate Public Health Scholars Program (CUPS) and year 26 of the James A. Ferguson Graduate Fellowship. This year, over 3800 students applied to these programs, and just under 200 were accepted. In the last 4 years, over 12,000 students have applied to these programs, and just over 750 students have been selected! The CUPS students and Ferguson Fellows represent a diverse group of high achieving and passionate scholars interested in reducing health disparities through the science and practice of public health. Their community practicums, assignments in hospitals and departments of health, and analytic projects and laboratory research at CDC addressed important public health issues this summer, and advanced knowledge, policy, and practice. As always, we were energized and inspired by their contributions, and look forward to the day they join us in the pursuit of health equity.

We also experienced an historic health summit commemorating 100 years since the establishment of National Negro Health Week, which evolved to become National Minority Health Month. This historic summit brought together leading scholars in minority health and health disparities, federal officials, representatives of national organizations, community leaders, and students, to name a few. Visit our website for the line-up of speakers, presentations, and other supporting materials. A special issue of Tuskegee University’s journal – the Journal of Healthcare, Science and the Humanities - will capture the contents of the conference in scholarly, peer-reviewed articles scheduled to be released later this year.

One of my favorite writers is James Baldwin. He is one of the greatest thinkers and human rights activists of the 20th century. Mr. Baldwin said in his book, Nobody Knows My Name (1966), “The world is before you and you need not take it or leave it as it was when you came in.” Our Health Equity Champion, Dr. Shiriki Kumanyika, will not leave public health research or practice as it was when she first entered the field. Her leadership and influence in public health is not easily matched, and we salute her for carrying the banner of health equity in the academy, in federal health agencies, and as part of her national platform as President of the American Public Health Association.

This issue of Health Equity Matters is filled with important information about CDC minority health initiatives, including a new report on cancer disparities, and the development of a policy for the respectful treatment of American Indian/Alaska Native specimens. We also highlight the first Hispanic Health Vital Signs Report released in May, and we give a brief update on OMHHE’s involvement with the Ebola outbreak in West Africa. These stories and more fill this issue. We hope you enjoy it, and we welcome your comments. CDC's Office of Minority Health & Health Equity (OMHHE)
 

Leandris C. Liburd, PhD, MPH, MA
Associate Director for Minority Health and Health Equity, CDC/ATSDR
Office of Minority Health & Health Equity (OMHHE)

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News You Can Use!

News You Can Use!100 Years of Moving Public Health Forward

National Negro Health Week to National Minority Health Month The year 2015 is a significant milestone in minority health in that it marks 100 years since the establishment of National Negro Health Week created by Dr. Booker T. Washington, 30 years since the release of the landmark 1985 Secretary's Task Force Report on Black & Minority Health, and 5 years since the passage of the Patient Protection and Affordable Care Act. 2015 marks the 100th Anniversary of Dr. Booker T. Washington's inception of National Negro Health Week The Office of Minority Health and Health Equity and CDC's Division of Sexually Transmitted Diseases, NCHHSTP, were invited by Dr. Rueben Warren, Director of the National Center for Bioethics in Research and Health Care at Tuskegee University, to partner with them and Morehouse School of Medicine to host a public health forum commemorating the 100th anniversary of National Negro Health Week.

Why acknowledge National Negro Health Week in the 21st Century? National Negro Health Week laid the foundation for intentional dialogue and action to improve the health, longevity, and well-being of communities historically referred to as Colored and/or Negro, and other population groups experiencing health disparities that continue today as National Minority Health Month.

In addition, this commemorative health summit documents Tuskegee University's work in public health, which preceded the unethical U.S. Public Health Service Study of Untreated Syphilis in the Negro Males at Tuskegee, and reframes the negative image of Tuskegee University from that of the infamous unethical syphilis study to its current leadership role in promoting bioethics and strategies to improve population health.

The summit featured luminaries in the field of public health who examined trends in African-American and minority health, and highlighted innovative ways to advance science, policy, and programs that reduce health disparities and advance health equity. Dr. Yvonne Maddox, Acting Director of the National Institute on Minority Health and Health Disparities at the National Institutes of Health who discussed national initiatives to reduce health disparities, and minority health and health disparities research Among the keynote presenters are Dr. Sherman James, internationally recognized epidemiologist and scholar who is well known for his theory of John Henryism as one explanatory model for the high prevalence of hypertension among Black men – particularly black men living in the southern region of the United States. We were also joined by Dr. David Satcher, former CDC director and U.S. Surgeon General, and Dr. Yvonne Maddox, pictured to the right, Acting Director of the National Institute on Minority Health and Health Disparities at the National Institutes of Health, who discussed national initiatives to reduce health disparities, Angela Glover Blackwell, founder and president of PolicyLink and minority health and health disparities research.

There were plenary panels and concurrent sessions including sessions on programs to increase the diversity in the public heath workforce, and understanding the importance and impact of data. There was also a poster sessions where MPH and bioethics honors students presented their research and policy work. The closing speaker for the summit was Angela Glover Blackwell, pictured to the left, founder and president of PolicyLink, who challenged and inspired us to build upon the many lessons learned over the decades and pursue health equity as the only way forward in the 21st century.

OMH Directors Meeting in Atlanta

Directors of 5 federal Offices of Minority Health joined OMHHE for the 2015 National Minority Health Month program, "National Negro Health Week to National Minority Health Month: 100 years of moving Public Health Forward, held on the CDC campus April 17th in Atlanta.

The focus of their plenary panel was a discussion of the work of federal offices of minority health to reduce health disparities through policy, research, improved access to high quality health care, and public health practice. Building upon the 30 year legacy of the Heckler Report, these offices, along with the Offices of Minority Health at the Health Resources and Services Administration (HRSA), HHS Agency OMH Directors Panelthe Agency for Healthcare Research and Quality (AHRQ), and the National Institute on Minority Health and Health Disparities (NIMHD), are implementing national initiatives that move the work of improving minority health toward achieving health equity.

Seated from left to right are: Leandris Liburd, PhD, MPH, Office of Minority Health and Health Equity, Centers for Disease Control and Prevention; J. Nadine Gracia, MD, MSCE, Deputy Assistant Secretary for Minority Health and Director of the Office of Minority Health at the U.S. Department of Health and Human Services; Cara James, PhD, Director, Office of Minority Health at the Centers for Medicare & Medicaid Services; Jonca Bull, MD, Director, Office of Minority Health, Food and Drug Administration; and Roslyn Holliday Moore, MS, Senior Policy Analyst, Office of Behavioral Health Equity, Substance Abuse and Mental Health Services Administration.

Listening to Communities: Developing a Policy for CDC's AI/AN Specimens

CDC is developing a comprehensive policy for respectful treatment of American Indian/Alaska Native (AI/AN) specimens. The agency has in place a specimen management policy but the existing policy does not provide guidance that accounts for the specific ethical, social, cultural and spiritual values of AI/AN communities. OSTLTS AAIP Denver MeetingThe policy development effort was prompted by a request from the CDC Tribal Advisory Committee (TAC), a body of elected tribal leaders that advises the agency on the public health priorities and concerns of AI/AN populations. The TAC's request was informed by concerns highlighted in a 2010 legal settlement between the Havasupai tribe and Arizona State University.

Researchers from the university had collected blood from the Havasupai to study diabetes and then used the samples for research that the tribe had not agreed to. For more information see: National Congress of American Indians (NCAI), American Indian & Alaska Native Genetics Resource Center, Havasupai Tribe and the lawsuit settlement aftermath.

Although CDC uses specimens for public health activities beyond research (e.g. investigating disease outbreaks, developing vaccines, assessing exposure to toxins in the environment), the Havasupai case underscores the importance of handling AI/AN specimens appropriately, from collection and storage to use and disposition (or return).

The policy is being developed according to CDC's 5-part framework: problem identification; analysis; strategy and policy development; enactment; and implementation. Stakeholder engagement and education are crosscutting elements. A unique feature of the AI/AN specimen policy process is the inclusion of AI/AN perspectives through several elements of a cooperative agreement with the Association of American Indian Physicians (AAIP), one of CDC OSTLTS's National Partners. These elements include listening sessions (organized at academic conferences, urban community centers and in Indian country; background papers (expert-authored articles on national and international specimen policy); and Independent External Experts (a diverse group of academics, health professionals, and community members who will lend their individual expertise). A policy that incorporates the perspectives of AI/AN communities not only fosters a stable environment for ongoing CDC work involving their specimens and encourages broader AI/AN participation in public health, a vital factor in advancing health equity in their communities.

Hispanic Health Vital Signs

CDC Vital Signs: Hispanic Health

CDC published its first national study of leading causes of death, disease prevalence, risk factors, and access to health services among Hispanics or Latinos living in the U.S. on May 5, 2015. The CDC report, Vital Signs: Leading Causes of Death, Prevalence of Diseases and Risk Factors, and Use of Health Services Among Hispanics in the United States - 2009-2013, showed that similar in non-Hispanic whites, the two leading causes of death in Hispanics are heart disease and cancer. Even though Hispanics die at lower rates than whites from the 10 leading causes of death combined, Hispanics have higher death rates than whites for diabetes and chronic liver disease and cirrhosis.

"Four out of 10 Hispanics die of heart disease or cancer. By not smoking and staying physically active, such as walking briskly for 30 minutes a day, Hispanics can reduce their risk for these chronic diseases and others such as diabetes," said CDC Director Tom Frieden, M.D., M.P.H. "Health professionals can help Hispanics protect their health by learning about their specific risk factors and addressing barriers to care."

The study, conducted by CDC's Office of Minority Health and Health Equity (OMHHE), used recent national census and health surveillance data to assess differences among non-Hispanic whites, Hispanic/Latinos, and Hispanic/Latino origin subgroups overall and by sex and nativity, and to identify subpopulations of Hispanic/Latinos at greatest risk for leading causes of death and disease. 1 in 6

Currently, almost 1 out of 6 people living in the U.S. are Hispanic (almost 57 million) and the rate is projected to increase to nearly 1 in 4 (more than 85 million) by 2035.

The CDC Vital Signs Report has been featured in over 890 news and print features (including CNN, BBC, Univision, Telemundo, among others) in addition to websites and social media outlets. CDC Vital Signs also links to the National Library of Medicine's MedlinePlus English and Spanish sites. We expect the discussion about Hispanic health to be ongoing.

Following the release of the Vital Signs report, CDC hosted a Vital Signs Town Hall Teleconference to discuss public health initiatives that have been used to address Hispanic health. To listen to this or other teleconferences, visit Archives by Date or Archives by Topic. Visit the Web Page Vital Signs, Hispanic Health. Read the Full Report: MMWR Weekly, May 8, 2015 / 64(17); 469-478. For more information on the Hispanic/Latino Population, visit CDC's OMHHE, Hispanic/Latino Populations page.

Summer Interns Learned and Shared Experiences in Public Health

The Centers for Disease Control and Prevention (CDC), Office of Minority Health and Health Equity (OMHHE) welcomed 171 undergraduate students and 10 graduate students for the 2015 CDC Undergraduate Public Health Scholars Program (CUPS) CDC Staff presenting to CUPS Students at 2015 Orientation Week held at CDC's Roybal Campus in Atlanta, Georgia and Dr. James A. Ferguson Emerging Infectious Diseases Fellowship Orientation Week held in Atlanta, May 27–29, 2015. The event marked the official launch of the eight to ten-week summer public health program that included a series of group discussions, information exchanges, and innovative learning opportunities that introduced students to CDC's priorities, current public health initiatives, health disparities, and emerging public health issues at the federal level.

The participating students were selected from over 3,800 applicants to spend the summer working at CDC, state and local health departments, community-based organizations, and academic institutions. Carmen Villar, MSW, CDC Chief of Staff, was a keynote speaker at the opening session. "Whatever level of public health you are in, you can affect change," said Villar as she recounted her first days at CDC as a Presidential Management Fellow. CUPS Students at 2015 Orientation Week held at CDC's Roybal Campus in Atlanta, Georgia "When you're thinking about your next steps, whether you work at the local, state or federal level, or you move to the 'Hill' and you decide to make policy, you can affect change in every step of the way."

The CUPS program is intended to expose students interested in minority health to the field of public health research and practice. Ultimately, these students will join the public health workforce and contribute to high quality public health services and research. This hands-on experience will increase the interns' awareness of the broad scope of public health careers. The five programs are administered by four institutions working in collaboration with the OMHHE – Columbia University, Kennedy Krieger Institute, Morehouse College, and the University of Michigan.

CUPS is aligned with the Dr. James A. Ferguson Emerging Infectious Diseases Fellowship, funded by the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), and administered by OMHHE. The nine-week Ferguson program provides full-time medical, dental, pharmacy, veterinary or public health graduate students with a comprehensive public health research experience in the field of infectious diseases, complemented by clinical and public health leadership opportunities. The ten Ferguson fellows presented their work on July 24, 2015.

Project IMHOTEP students, participating in Morehouse College's component of the program, presented their poster sessions at Morehouse College on July 28, 2015. Projects ranged from the study of social determinants of health to public health topics, such as HIV, AIDS, TB and STD prevention programs, nutrition and occupational safety and health focused on research and data analysis.

About 38 CDC mentors made this a successful program. Some mentors have collaborated with the OMHHE for years, and continue to participate in the mutually enriching experience.

New Report on Cancer Disparities

This year's Annual Report to the Nation on the Status of Cancer, 1075-2011, from National Institutes of Health (NIH), National Cancer Institute (NCI), shows that mortality and incidence for most cancers continue to decline. The special feature of this year's report highlights the incidence of breast cancer subtypes by race/ethnicity, poverty and U.S. State. For the first time, researchers have used national data to determine the incidence of the four major molecular subtypes of breast cancer by age, race/ethnicity, poverty level, and several other factors. Black men had the highest overall cancer incidence rate

Below are some cancer disparities facts.

Men

  • During the period between 2007 and 2011, observed rates of all cancers combined in all racial groups were lower among women than for men (412.8 vs 526.1 per 100 000).
  • Black men had the highest overall cancer incidence rate (587.7 per 100 000) of any racial or ethnic group. Prostate cancer remains the most common cancer among men in each racial and ethnic group and the rates were substantially higher than any other type of cancer.
  • Lung cancer is the second most common cancer and colorectal the third most common cancer among men of all racial and ethnic groups, except in Hispanic men where these ranks reversed.

Among women, breast cancer is the most common cancer among all racial and ethnic groups by a wide margin Women

  • Among women, whites had the highest overall cancer incidence rate during this period (418.6 per 100 000).
  • Among women, breast cancer is the most common cancer among all racial and ethnic groups by a wide margin.
  • Lung cancer is also the second most common cancer among women, with colorectal cancer being the third most common cancer, except among API and Hispanic women, where the ranks are again reversed.

White and Hispanic children had higher cancer incidence rates than children of other racial and ethnic groups.

Mortality Rates Overall age-adjusted cancer death rates continued to decline, a trend that began in the early 1990s. From 2002 to 2011, death rates decreased by 1.8 percent per year among men, by 1.4 percent per year among women, by 2.1 percent per year among children ages 0-14, and by 2.3 percent per year among children 0-19 years of age. Age-adjusted death rates are the best indicator of progress against cancer, although other measures, such as quality of life, are also important. Know the Science. HR = Hormone Receptor. HR+ means tumor cells have receptors for the hormones estrogen or progesterone, which can promote the growth of HR+ tumors. Hormone therapies like tamoxifen can be used to treat HR+ tumors. HER2 = Human Epidermal Growth Factor Receptor. HER2+ means tumor cells overexpress (make high levels of) a protein, called HER2/neu, which has been shown to be associated with certain aggressive types of breast cancer. Trastuzumab and some other therapies can target cells that overexpress HER2.

Finally, this year's special section on breast cancer sub-types is best described by the infographic.

Meet the Federal Offices of Minority Health

As part of our series to highlight federal offices of minority health, legislated by the Patient Protection and Affordable Care Act, we feature the Office of Behavioral Health Equity (OBHE) at the Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. Department of Health and Human Services, and the director of this office, Dr. Larke Nahme Huang. Larke Nahme Huang, PhD

Larke Nahme Huang, Ph.D., a licensed clinical-community psychologist, is a Senior Advisor in the Administrator's Office of Policy Planning and Innovation at SAMHSA and Director of SAMHSA's Office of Behavioral Health Equity. In her position as Senior Advisor in the Administrator's Office of Policy Planning and Innovation, she provides leadership on national policy for mental health and substance use issues for children, adolescents and families and leads the Administrator's strategic initiative on Trauma and Justice.

For the past 30 years, Dr. Huang has worked at the interface of practice, research and policy. She has assumed multiple leadership roles dedicated to improving the lives of children, families and communities. Most recently she has developed federal policy documents with the Centers for Medicare and Medicaid Services addressing behavioral health service delivery and financing for child and adolescent mental health and substance use prevention and treatment; developed policy and programs based on the emerging research connecting trauma and health/behavioral health disorders; and crafted policies to reduce disparities in access to quality care for diverse populations. Over the course of her distinguished career, she has been a community mental health practitioner, a faculty member at the University of California, Berkeley and Georgetown University, and a research director at the American Institutes for Research. In addition, she has worked with states and communities to build systems of care for children and youth with behavioral health disorders, developed programs for underserved, culturally and linguistically diverse populations, evaluated community-based programs, and authored books and articles on behavioral health.

The Office of Behavioral Health Equity (OBHE) leads efforts within SAMHSA to improve behavioral health and eliminate disparities in the prevention of, treatment for and recovery from mental and substance use disorders for diverse racial, ethnic and sexual gender minority populations. Key OBHE personnel include Roslyn Holliday Moore, Senior Policy Analyst and Juliet Bui, Public Health Analyst.

The work of the office is grouped into four key domains:

Data: The analysis of large scale survey data is used to highlight mental health and substance use issues for disparity-vulnerable populations, such as in the recent chart book Racial/Ethnic Differences in Mental Health Service Use Among Adults.

Policy: The Disparity Impact Strategy links funding to inclusion of disparity populations in all grant activities, expanding the reach of SAMHSA grant programs to more underserved populations. OBHE has provided resources to reach and enroll uninsured diverse populations in health insurance opportunities.

Workforce Development: OBHE created the National Network to Eliminate Disparities in Behavioral Health (NNED) to facilitate capacity building for community-based organizations serving diverse communities. OBHE has trained and coached over 500 NNED members in effective behavioral health practices for their target populations. This year, OBHE also partnered with the American Psychological Association to host the Pathways to Behavioral Health Equity: Addressing Disparities Experienced by Boys and Men of Color conference to connect researchers and practitioners to improve engagement and interventions for this population.

Communications: OBHE works with SAMHSA's Office of Communications to promote awareness and education about behavioral health equity.

"The Office of Behavioral Health Equity works collaboratively with SAMHSA's program, data and operational centers to 'hardwire' into the agency a focus on reducing disparities and better reaching and serving diverse populations. Our intent is to make this the standard way of doing business within SAMHSA. We work with these internal 'extenders' of our office to maximize our impact," said Dr. Huang. "We also work with 'external extenders', that is, national and regional organizations, researchers, and State and local policymakers who are committed to using data and policy strategies to improve behavioral health for underserved diverse communities. It is through this multi-faceted, collective approach that we can move toward equity in behavioral health for all populations."

Community Coalition-Driven Interventions to Reduce Health Disparities

Figure 3. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models.

National Leadership Award

American Indian-Alaska Native Commissioned Officers Advisory Committee

CAPT Craig Wilkins CAPT Craig Wilkins, Senior Advisor on detail to OMHHE from Office for State, Tribal, Local & Territorial Support (OSTLTS), was recently awarded the American Indian-Alaska Native Commissioned Officers Advisory Committee National Leadership Award at the United States Public Health Service (USPHS) Scientific and Training Symposium sponsored by the Commissioned Officers Association of the USPHS and the Commissioned Officers Foundation for the Advancement of Public Health.

The National Leadership Award was established to recognize any ranking officer who has made significant contributions fostering the goals of the AIANCOAC and enhancing the health of American Indians and Alaska Natives. This award is presented for sustained high quality excellence in an administrative or clinical capacity that has resulted in accomplishing a program's mission at the agency and/or national level.

In addition, CAPT Wilkins was also recently nominated and selected to serve as the 2015-2016 Board Chair for the national Commissioned Officers Association (COA) of the USPHS. The COA is the only nationally recognized member-based organization that supports and advocates for over 6000 active PHS Commissioned Corps officers and retired personnel.

Feature

The OMHHE’s Response to Largest Ebola Outbreak, 2014-2015
Sonja Hutchins, MD, MPH, DrPH, FACPM, CAPT, USPHS, Senior Medical Advisor, OMHHE, OD, CDC

Sonja S. Hutchins, MD, MPH, DrPH, FACPM CAPT, USPHS
Sr. Medical Advisor, OMHHE, OD, CDC

The Office of Minority Health and Health Equity (OMHHE) created a focus area in 2007 to prepare and respond to the needs of selected vulnerable populations during public health emergencies, such as the H1N1 pandemic influenza response from 2009-2010. A primary function of the OMHHE is to link CDC with OMHHE partners that serve, protect, and promote the health of vulnerable populations and communities. OMHHE Staff, CAPT. Craig Wilkins, deployed to Guinea, West Africa The largest outbreak of Ebola in history began in Guinea in December 2013. As of July 5, 2015, 27, 609 cases (suspected, probable and confirmed) and 11,261 deaths due to Ebola have been reported to the World Health Organization (WHO) from ten countries. Nearly all (99.87%) cases and deaths have been reported from three countries: Guinea, Sierra Leone, and Liberia (CDC, 2014 Ebola Outbreak in West Africa – Case Counts).

In the United States, four cases have been reported (two imported cases and two locally acquired cases in healthcare workers) (CDC, Cases of Ebola Diagnosed in the United States). OMHHE Staff, Eva De Vallescar, deployed to Guinea, West Africa The outbreak slowed considerably by mid-May. In fact, on May 9 WHO declared the outbreak in Liberia over after 42 consecutive days with no new cases following the burial of the last confirmed case. During the week ending July 5, a low of 30 cases was reported. Guinea reported 18 confirmed cases and Sierra Leone reported nine confirmed cases; Liberia reported three cases identified from heightened surveillance. Vaccine studies have been conducted in Guinea, Sierra Leone, Liberia, and other countries (WHO, Ebola R&D–April 22, 2015, News on vaccines, therapies, diagnostics). OWH eNewsletter highlighting CDC's information on screening Pregnant Women for Ebola The OMHHE first responded to partner inquiries about CDC advice on international travel to affected countries in West Africa in July 2014, and the Office of Women’s Health disseminated Ebola information for health professionals serving women via its e-newsletter.

After the At-Risk desk in CDC's Emergency Operations Center (EOC) was activated in September 2014, the OMHHE provided technical assistance to desk teams and to the Joint Information Center (JIC) on barriers, stigma and needs of racial and ethnic minority and low-income populations in following CDC recommendations. OMHHE also facilitated partner participation in teleconferences and other venues for updates on CDC recommendations to prevent and control Ebola in the United States.

OMHHE staff continues to provide technical assistance to support CDC’s outreach to West Africans living in the United States. In addition to working closely with the At-Risk Population teams, State Coordination Task Force team, and the JIC, OMHHE staff have been detailed to the EOC or deployed to West Africa.

In the Next Issue:
OMHHE’s senior program analyst, Benita Harris McBride, MPH, will reflect on staffing the At-Risk desk in the EOC.

Science Speaks

Selected Publications from OMHHE Authors:

Ana Penman-Aguilar, PhD, MPH, (OMHHE Associate Director for Science)
Ramal Moonesinghe, PhD, MPH, (OMHHE Senior Mathematical Statistician)

VitalSigns

MMWR

Kenneth Dominguez, Ana Penman-Aguilar, Man-Huei Chang, Ramal Moonesinghe, Ted Castellanos, Alfonso Rodriguez-Lainz, Richard Schieber
Vital Signs: Leading Causes of Death, Prevalence of Diseases and Risk Factors, and Use of Health Services Among Hispanics in the United States — 2009–2013.
MMWR Weekly May 8, 2015 / 64(17);469-478.

JCER, Vol4, Issue3Sonja Hutchins, MD, MPH, DrPH, (OMHHE Senior Medical Advisor)

Sonja S Hutchins, Cedric Brown, Robert Mayberry, William SollecitoValue of a small control group for estimating intervention effectiveness: results from simulations of immunization effectiveness studies.Journal of Comparative Effectiveness Research, Vol. 4, No. 3, Pages 227-238.

Public Health Reports, Vol 130, No 2, CoverYvonne Green, RN, CNM, MSNc, (OWH Director)

Caira M. Woods, Bethany Applebaum, Yvonne Green, Deborah L. Kallgren, Evelyn KappelerWomen’s Health: 30 Years of Progress in the U.S. Department of Health and Human Services..
Public Health Reports, March/April 2015, Vol. 130, No. 2, Pages 123-127.

See Publications of OMHHE Authors page for more.

Conversations in Equity

Sick & Tired of being Sick & Tired
Our blog Conversations in Equity shares and exchanges perspectives and progress in the science and practice of health equity.

See the latest post and add your comments today!

Health Equity Champion


Shiriki K. Kumanyika, PhD, MPH, MSW

Shiriki K. Kumanyika, PhD, MPH, MSW
Professor Emerita, University of Pennsylvania, Perelman School of Medicine

In 1990, I attended a minority health workshop hosted by the Office of Minority Health – now the National Institute on Minority Health and Health Disparities - at the National Institutes of Health. The workshop was a relatively small gathering of promising minority health researchers and practitioners, several of whom would rise to play a defining role in framing the future direction of racial and ethnic health disparities research and practice. For example, Dr. David Williams (Harvard School of Public Health), Dr. Aida Giachello (Northwestern University), and Dr. Shiriki Kumanyika (Emeritus Professor of Epidemiology, University of Pennsylvania) were among those promising scholars. Time has borne the fruit of their brilliance and leadership, and we are honored to single out the unique and pioneering contributions of Dr. Shiriki Kumanyika, a tried and true Health Equity Champion! She is not only a scholar, but also an advocate, change agent, and national leader in public health whose voice and influence have advanced health equity in the academy, at the highest levels of government, and globally.

On behalf of the Office of Minority Health and Health Equity and the Centers for Disease Control and Prevention, we are pleased to recognize Dr. Kumanyika as a Health Equity Champion.

--Leandris C. Liburd

Shiriki K. Kumanyika received her PhD in human nutrition from Cornell University (1978) and MPH from Johns Hopkins (1984). Prior to her PhD studies she earned a Master’s degree in Social Work from Columbia (1969) and worked as a social caseworker and community organizer. From 1999 through June 2014 she was a Professor of Epidemiology and an Associate Dean for Health Promotion and Disease Prevention at the University of Pennsylvania, School of Medicine. She transitioned to Professor Emerita at Penn on July 2014. When asked why she now seems to be even more engaged in public health and health equity related activities than before she retired, she replies, “you can retire from the job but you can never retire from the mission.” Baltimore, Marlyand

During her childhood and adolescent years in then, legally segregated Baltimore and while in college in the early ‘60s, Dr. Kumanyika participated actively in the civil rights movement and was exposed to civil rights activists (including her mother) who marched, raised bail funds, organized boycotts, and spoke out in support of equal rights for all. “It was obvious that I was and wanted to be part of the movement—to somehow achieve meaningful changes in the lives of black people. My father was a general practitioner who spent long hours doctoring in the black community, and I was motivated to work on health issues. Yet, it was not until I learned about public health did I see how I could translate my civil right commitments into meaningful actions.”

Over more than three decades, Dr. Kumanyika has contributed to epidemiology and public health nutrition and to the conceptualization and study of ways to mitigate factors that predispose black Americans and other ethnic minority populations to higher than average risks of diet-related chronic conditions. She has published more than 300 articles, book chapters, monographs, and commentaries, given hundreds of talks at scientific meetings, and served on dozens of advisory committees and expert panels in the US and abroad. Five comprehensive reviews on cardiovascular disease and other nutrition-related health disparities developed HP2020 at the request of the Secretary’s Task Force on Black and Minority Health (DHHS, 1984-85), were among her most influential early contributions. From 2008 to 2011, while Vice-Chair of the Secretary’s Advisory Committee on the Healthy People 2020 Objectives she helped advance the national conversation on health equity issues.

In 2002, Dr. Kumanyika founded the African American Collaborative Obesity Research Network (AACORN). AACORN Her objective was, and still is, to address the need for more high impact research to inform solutions to obesity and related health problems in black communities. Concurrently, she’s adamant about the need to expand the number of black scholars in the obesity research community, to mentor and position them for success, and to assure that their contributions to the scientific discourse about the human rights struggle are not neglected. AACORN held its first national workshop in 2004, with CDC as its main sponsor. It has since evolved into a national network of scholars, scholars-in-training, and community research partners, convened many more workshops and undertaken many research initiatives.

Dr. Kumanyika has received awards from the American Journal of Health Promotion (2006), the American Heart Association (2003; 2005), the Association of Black Cardiologists (2005), and the American Public Health Association’s Food and Nutrition Section (1994; 1998) and Epidemiology Section (2011), and the NIH (2015), among others. She was elected to membership of the Institute of Medicine in 2003. She considers her election as President of the American Public Health Association (APHA) for 2015 as both an honor and a mandate “to think harder about how to achieve health equity and generate support for doing what needs to be done.”

Commentary

Task Force Recommends Behavioral Interventions to Reduce Kids TV Time and Obesity

Screen Time - Kid playing video games The Community Preventive Services Task Force (Task Force) recommends behavioral interventions to reduce recreational sedentary screen time among children aged 13 years and younger. This finding is based on strong evidence of effectiveness in reducing recreational sedentary screen time, increasing physical activity, improving diet, and improving or maintaining weight-related outcomes. The Task Force finding is based on evidence from a systematic review completed in 2008 combined with an updated search for evidence in 2013.

Kids playing Outside This recommendation is important because time spent watching TV increases the risk of childhood obesity. Behavioral interventions that aim to reduce recreational (i.e., neither school-related nor work-related) sedentary screen time teach behavioral self-management skills to begin or maintain behavior change. Interventions may include one or more of the following components: use of an electronic monitoring device to limit screen time; TV Turnoff Challenge; screen time allowed based on physical activity; or small media.

Behavioral screen time interventions are effective for children in high and low socioeconomic status. Among the studies included in this review, one conducted at Women, Infants, and Children (WIC) clinics found that the intervention was even more successful at encouraging parents who did not graduate from high school to limit their children's TV viewing time to 2 hours or less per day than for parents who graduated from high school. Kids playing Soccer outdoors with family

Family-based social support was the most common intervention component. This highlights the importance of family and parental support in monitoring and limiting sedentary screen time behavior among children.

The Community Preventive Services Task Force (Task Force) — an independent, nonfederal, nonpartisan, unpaid panel of public health and prevention experts—bases its findings on systematic reviews of the scientific literature. All Task Force findings and the systematic reviews on which they are based are compiled in The Guide to Community Preventive Services (The Community Guide).

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Statistics Highlight

Persons Reporting Fair or Poor Health, by Race & Hispanic Origin, United States, 2003–2013

The figure above is a line graph showing that during 2003-2013, non-Hispanic black and Hispanic persons were more likely than non-Hispanic white persons to report fair or poor health. Fair or poor health status ranged between 14%-15% for non-Hispanic black persons and 13%-14% for Hispanic persons, and was 8% for non-Hispanic white persons, with no significant changes during the decade in the percentage of those reporting fair or poor health within each of the three groups. During 2003–2013, non-Hispanic black and Hispanic persons were more likely than non-Hispanic white persons to report fair or poor health (categories were combined).

Fair or poor health status ranged between 14%–15% for non-Hispanic black persons and 13%–14% for Hispanic persons, and was 8% for non-Hispanic white persons, with no significant changes during the decade in the percentage of those reporting fair or poor health (combined) within each of the three groups.

For More Information: QuickStats: Age-Adjusted Percentage of Persons Who Reported Fair or Poor Health, by Race & Hispanic Origin — National Health Interview Survey, United States, 2003–2013 MMWR Weekly, June 12, 2015 / 64(22);622.

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