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Listen to the Health Policy Symposium, "The 21-Year-Old Drinking Age: Mend It, End It, or Leave it Alone?," presented April 19, 2007.Speakers include: Frank Lombard, will participate in the "Advocacy for a Healthier World," the 2006 Straley Series sponsored by The Community Church in ChapelFrank Lombard, associate director of the Health Inequalities Program at the Center for Health Policy, will participate in the "Advocacy for a Healthier World," the 2006 Straley Series sponsored by The Community Church in Chapel James recently was voted president-elect of the Society for Epidemiologic ResearchAt Duke, he is a professor of public policy studies at the Terry Sanford Institute of Public Policy. James has specialized in analyzing health disparities for blacks versus the rest of society, particularly in hypertension and cardiovascular ailments. After more than a decade of study, the phenomenon still isn't well understood, he said. The Society for Epidemiologic Research is interested in that and a broad range of health issues. "Everything from air pollution, HIV-AIDS, depression, cervical cancer and breast cancer," James said. Avian flu also is an important research priority, along with older communicable diseases, some of which remain serious problems in developing areas of the world. James, who trained as a social psychologist, formerly taught at UNC in its department of epidemiology, where he became involved in investigating racial differences in cardiovascular disease. "It's still quite a mystery why African-Americans have so much more hypertension and heart disease," he said, although it's clear that lack of access to preventive health care and poor diet play a role, along with other factors stemming from poverty. "There continues to be epidemic proportions of hypertension," he said. While at UNC, James helped launch in 1988 the first long-term hypertension study of black Americans. It still monitors its subjects in Pitt County. Before that, he spent a year in Brazil, studying hypertension there. "There's a significant gap between Afro-Brazilians, who are poor," and others. Brazil, where blacks were legally enslaved until 1888, has the largest population of people of African descent in the world after Nigeria. A native of South Carolina, he was on the faculty of the University of Michigan for 14 years before coming to Duke in 2003, where he teaches courses on U.S. racial and ethnic health inequalities and global poverty, inequality and health. He has proposed a theory of "John Henryism" to explain higher rates of cardiovascular disease among blacks. Like the legendary folk hero who dies trying to outperform a new steam-operated driver of railroad spikes, blacks often use "high-effort coping" against economic and social threats, the theory goes. The result, James says, is stress that can exacerbate a heart condition. "It's a personality predisposition to basically persist in engaging difficult problems rather than giving up," he said. "It plays out most importantly in the work arena, sometimes against very difficult odds." Despite economic and social difficulties, blacks historically have had lower suicide rates than whites, although among men and teens, the rate has been increasing in recent years, he said. "There are some very complicated theories about why this pattern exists," he said. Other mechanisms that help black men bounce back include humor and strong friendships with other men, James said. The latter phenomenon is under-appreciated and insufficiently researched, he added. And just maybe, a familiar institution could provide a lab. "All you have to do is spend some time in the black barbershop, and you'll see some very interesting and colorful ways that black men support each other," he said. Don Taylor - SURGEON GENERAL’S REPORT ON SECONDHAND SMOKEIn light of the surgeon general's recent report on secondhand smoke, it's clear that the smokers aren't the only ones who bear the cost of their habit, says a Duke University health policy researcher. The true cost of each pack of cigarettes sold in the United States is $40, and smoker’s families bear more than 13 percent of that cost, says Donald Taylor, Assistant Professor of Public Policy Studies and Community and Family Medicine at Duke and co-author of the book, “The Price of Smoking.” “Children of smokers are the most vulnerable to the harms of secondhand smoke, and are likely to be consistently exposed to this harm,” Taylor says. The cost calculation takes into account the costs to society, broadly defined. The true cost of a pack of cigarettes was estimated by Taylor and his colleagues by identifying how smokers and their families compared to non-smokers and their families in areas such as illness, mortality, wages, and payments such as Social Security and life insurance. Although the majority of the cost -- $32.78 -- is borne by the smoker in shortened lifespan, lower wages, and increased health care costs, Taylor found that families or households of the smoker pay $5.44. Society pays $1.44 of the cost, he said. Donald Taylor can be reached for additional comment at (919) 613-9357 or dtaylor@hpolicy.duke.edu Duke Students to Testify Before Senate Committee on Ryan White CARE ActOn Monday, March 6, a group of Duke University students took center stage in the national debate to reauthorize funding for the Ryan White CARE Act targeted to people with HIV. Testifying before the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP), the 16 Duke health policy certificate students will provide senators and staff an overview of the act and make recommendations on how future funding should be allocated. |
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