Our Bodies Our Blog has invited the folks at Breast Cancer Action to write monthly guest posts on breast cancer and related issues.
by Barbara A. Brenner
As everyone familiar with breast cancer knows, there is no available cure for metastatic breast cancer (breast cancer that has spread beyond the breast to life-sustaining organs). In fact, metastatic breast cancer will kill a woman who has it unless something else kills her first.
The good news is that some treatments can extend the lives of some women with metastatic disease, and additional treatments are available that may keep metastatic breast cancer from advancing, at least for a period of time. These treatments are not without side effects, however –- some of them devastating.
What I find most interesting about this moment is that advances in treatment have led the cancer industry — the oncology community, the pharmaceutical and biotech industries, and the big cancer charities — to begin to talk of breast cancer as a “chronic disease.” While this might be seen as a positive trend, reflecting the fact that some people with breast cancer are living longer, the use of the term “chronic” conveys a misguided attitude about the deadly disease.
A chronic disease is a disease that is long-lasting or recurrent. The term chronic describes the course of the disease, or its rate of onset and development. A chronic course is distinguished from a recurrent course; recurrent diseases relapse repeatedly, with periods of remission in between.
By this definition, metastatic breast cancer is recurrent, not chronic. While this might seem like an academic dispute, it isn’t. Using the term chronic implies that breast cancer is a manageable disease, and downplays the reality that it is far too often fatal. It also diminishes the fact that we are in desperate need of better treatments.
Breast cancer is also sometimes referred to as a chronic disease because the risk of recurrence never completely disappears. Women with early stage disease are followed in medical care for long periods of time (sometimes for as long as they live, even though they may well live a long life and die without a breast cancer recurrence).
In this context, the push to view breast cancer as a chronic disease seems to be an effort by the cancer establishment to turn attention away from the fact that there are still millions of women diagnosed with breast cancer every year. Urging the public to accept the notion of early breast cancer as a chronic disease undermines the demand for true breast cancer prevention.
How we think and talk about breast cancer and other cancers clearly has implications for how we address the disease. We all need to move beyond accepting the notion of breast cancer as a chronic disease if we are to have any hope of truly ending the epidemic.
Barbara Brenner is the executive director of Breast Cancer Action. More on BCA’s view of cancer policy issues can be found here.
A new report criticizes the FDA for ignoring studies questioning the safety of bisphenol A, a chemical found in many household products. From the Washington Post:
The Food and Drug Administration ignored scientific evidence and used flawed methods when it determined that a chemical widely used in baby bottles and in the lining of cans is not harmful, a scientific advisory panel has found.
In a highly critical report to be released today, the panel of scientists from government and academia said the FDA did not take into consideration scores of studies that have linked bisphenol A (BPA) to prostate cancer, diabetes and other health problems in animals when it completed a draft risk assessment of the chemical last month. The panel said the FDA didn’t use enough infant formula samples and didn’t adequately account for variations among the samples.
Taking those studies into consideration, the panel concluded, the FDA’s margin of safety is “inadequate”. The panel is part of the Science Board, a committee of advisers to the FDA commissioner, and was set up to review the FDA’s risk assessment of BPA.
The FDA’s findings were at odds with a report released in September by The National Toxicology Program, which found that there is “some concern” that BPA can affect neural and behavioral development in fetuses, infants and children. Another study found an association between BPA and cardiovascular disease, Type 2 diabetes and liver-enzyme abnormalities in adults.
The possible connection between chemicals such as BPA and cancer was the focus of a Boston Globe op-ed this week. Rita Arditti, one of the founders of the Cambridge, Mass.-based Women’s Community Cancer Project, writes that “because we still do not know what the causes of breast cancer are, primary prevention remains an elusive goal while mammography and early detection are the focus of attention.”
Here’s what we do know:
Since World War II, the proliferation of synthetic chemicals has gone hand-in-hand with the increased incidence of breast cancer. About 80,000 synthetic chemicals are used today in the United States, and their number increases by about 1,000 each year. Only about 7 percent of them have been screened for their health effects. These chemicals can persist in the environment and accumulate in our bodies. According to a recent review by the Silent Spring Institute in Newton, 216 chemicals and radiation sources cause breast cancer in animals.
Nearly all of the chemicals cause mutations, and most cause tumors in multiple organs and animal species, findings that are generally believed to indicate they likely cause cancer in humans. Yet few have been closely studied by regulatory bodies. There is concern about benzene, which is in gasoline; polycyclic aromatic hydrocarbons, which are in air pollution from vehicle exhaust, tobacco smoke, and charred foods; ethylene oxide, which is widely used in medical settings; and methylene chloride, a common solvent in paint strippers and glues.
There is also broad agreement that exposure over time to natural estrogens in the body increases the risk of breast cancer, so it is important to consider the role of synthetic estrogens in breast cancer development. Many other chemicals, especially endocrine-disrupting compounds - chemicals that affect hormones, such as the ubiquitous bisphenol A, which is found in plastic bottles and cans - are also thought to raise breast cancer risk. Endocrine-disrupting compounds are present in many pesticides, fuels, plastics, air pollution, detergents, industrial solvents, tobacco smoke, prescription drugs, food additives, metals, and personal-care products including sunscreens.
There’s no definitive evidence that these substances cause cancer, but all the information acquired so far makes a strong case for more research and precautionary measures as this research develops. The Massachusetts state Senate this year passed the Safer Alternatives Bill, which would create a program to replace toxic chemicals with safer alternatives when feasible. The bill was not taken up by the House. Advocates for the bill, under the umbrella group Alliance for a Healthy Tomorrow, continue to work on its passage.
Carol Ciancutti-Leyva, director of “Absolutely Safe,” a documentary on the controversy over the safety of breast implants, critiques a recent “Oprah” episode that discussed breast cancer and breast reconstruction surgery without mentioning the health risks associated with implants.
The title refers to something the actress Christina Applegate said during the episode. Applegate, 36, was diagnosed with breast cancer in July and underwent a double mastectomy after also testing positive for the BRCA gene.
Ciancutti-Leyva writes:
I applaud her openness and Oprah’s dedicating her show to this issue. Christina discussed her decision to have a radical mastectomy and her decision to be reconstructed with saline implants. She explained the procedure of getting saline implants after mastectomy, the placement of breast expanders, and the later implantation of saline implants. She then said “I’ll never have to wear a bra again.” That took my breath away for a second.
My mother went to the Mayo Clinic in the early 1970’s and she was told to have a radical mastectomy and have her breasts reconstructed with silicone implants. Her surgeon told her the same thing – “You’ll never have to wear a bra again!” Two years after that surgery her implant ruptured and she had it replaced. Very shortly after that it ruptured again. My mother has suffered a great deal of pain from the several surgeries, complications from the implants, and subsequent health problems. Not having to wear a bra was a very insignificant benefit given the many serious problems she had with her implants.
Now, one might say that this happened years ago and now implants are safer, the surgery has been perfected, and even the FDA has approved both saline and silicone implants. I think this is far from the truth. Somehow, the known risks, the known complications, and unknowns about the long-term safety of both saline and silicone implants are being lost. Don’t forget that the FDA and implant manufacturers fully acknowledge that breast implants carry known risks, like rupture and capsular contracture. The safety dispute emerges regarding the “unknown” risks like severe allergic reaction to the chemicals and platinum salts used in both saline and silicone breast implants.
Ciancutti-Leyva’s post also includes a statement from Our Bodies Ourselves Executive Director Judy Norsigian: “We know breast cancer patients want to make informed decisions, but that just isn’t possible when the necessary long-term research has not been done.”
Our Bodies Our Blog has invited the folks at Breast Cancer Action to write monthly guest posts on breast cancer and related issues.
by Pauli Ojea
Breast Cancer Awareness Month is nearly here. You can probably tell by all of the pink ribbon products you’re starting to see as October draws near. Lipstick, blenders, candy, cars — even toilet paper is being sold in the name of breast cancer awareness.
One pinked-out product you’ve probably noticed is Yoplait yogurt. Yoplait makes a 10-cent donation to a breast cancer organization for every pink lid consumers mail back to the company. Let’s put that in real terms: If you ate three yogurts a day for the four-month duration of the campaign (and sent in all your lids), your donation would equal $36. That’s a lot of yogurt — and not all that much money.
But what’s more troubling is what’s underneath the lid — the yogurt itself might not be that good for your health.
Yoplait yogurt is made with milk from cows that have been injected with a synthetic hormone called recombinant bovine growth hormone (referred to as rBGH or rBST). There are a number of health concerns surrounding the use of rBGH, and breast cancer is one of them.
Here’s a very simple explanation of the science: When rBGH is injected into a cow, that cow’s milk will contain higher amounts of another powerful hormone called insulin growth factor 1 (IGF-1). IGF-1 is natural and necessary, but too much of it may cause health problems. Studies have shown that elevated levels of IGF-1 in humans may increase the risk of breast cancer. More research is needed to better understand whether the elevated levels of IGF-1 in milk make their way into our bloodstream.
Although it hasn’t yet been proven that the use of rBGH will definitively lead to breast cancer, the current evidence is cause for concern — and for action.
Corporations like Wal-Mart and Starbucks do not use milk from rBGH-treated cows in their store brand products. If these companies can do it, Yoplait can too.
When a company puts a pink ribbon on its product’s package, that company is sending the message that it cares about women’s health. And if a company cares about women’s health, shouldn’t it be doing all it can to make sure that its products are not inadvertently contributing to the high number of breast cancer cases? We at Breast Cancer Action sure think so.
Every year we sponsor the annual Think Before You Pink campaign — which demands transparency and accountability on the part of companies that align themselves with breast cancer and urges companies to do all they can to ensure their products don’t contribute to the high rates of the disease. We use the term “pinkwashing” to describe companies — like Yoplait — that participate in breast cancer fundraising or “awareness” campaigns but manufacture products that may be linked to the disease.
This October, we’re asking General Mills — the maker of Yoplait — to do the right thing for women’s health: We’re urging them to go rBGH-free. You can help by sending an e-mail to General Mills telling them to put a lid on rBGH. After all, corporate conscience belongs in a company’s products, not just its marketing.
Pauli Ojea is the community organizer at Breast Cancer Action, where she mobilizes people to do something besides worry. Visit ThinkBeforeYouPink.org for more information and to take action.
Double Dose: An Open Letter to Gov. Sarah Palin; Transgender Employees Find More Workplace Support; High Rate of C-Sections in Washington; Latest Breast Cancer Rates; Videos You May Have Missed from the RNC …
Many Americans agree with your position regarding abortion — they do this as a matter of faith, ethics, personal experience and sometimes politics. I am just wondering though, if you have thought about what would happen if you succeeded in getting your position — that fetuses have a right to life — established as the law of the land? Did you know that it not only threatens the lives, health and freedom of women who might want or need someday to end their pregnancies, it would also give the government the power to control the lives of women — like you who — go to term?
The Privilege of White Woman’hood/ Mommy’Hood: “Sarah Palin wants to put herself out there as ‘every woman.’ She wants to be seen as ‘just your average hockey mom,’ and other mommies see themselves and their reality reflected through Palin, except, mamis of color, that is,” writes Maegan “La Mala” Ortiz at Racialicious (and at her site, Mamita Mala).
What Women Want: There’s video up from the This Is What Women Want speakout in Boston (Aug. 21), including Rita Arditti advocating for health care as a universal right; Cynthia Enloe on lifting the global gag rule; and Kety Esquivel on treating immigrants as human beings.
Smoother Transitions: “Across the country, particularly at larger companies, transgender workers are being protected and assisted in ways that were hardly imaginable a few years ago,” writes Lisa Belkin, author of the Life’s Work column in The New York Times.
Currently, 125 of the Fortune 500 companies include “gender identity” in their nondiscrimination policies, compared with “close to zero” in 2002, according to Jillian T. Weiss, an associate professor of law and society at Ramapo College of New Jersey, and an expert on transgender workplace diversity. [...]
“It is a different world,” said Dr. Weiss, who attributes the change, in part, to the slow adoption of laws banning discrimination on the basis of gender identity (20 states and roughly 100 cities have such laws), but mostly to the work of the Human Rights Campaign, the largest gay, lesbian, bisexual and transgender civil rights organization in the nation.
Yes, HRC, which releases the Corporate Equality Index — a measure of how receptive a company is to diversity. Questions concerning gender-identity protection and transgender benefits have been included since 2002.
High Rate of C-Section Births is Health Concern for Women: “One in four Washington mothers now give birth through C-section, according to the Department of Health, and the rate of the surgical procedure has been increasing by 6 percent every year for nearly a decade,” reports the Seattle Post-Intelligencer.
“The U.S. Centers for Disease Control and Prevention says we should have no more than 15 percent of low-risk births delivered by C-section,” said Joe Campo, director of research at the [state agency's Center for Health Statistics]. “It’s important for us to know what’s driving this increase.”
About 13,300 of the 21,800 total C-sections are first-time procedures and about 8,500 are repeat procedures, Campo and his colleagues found. Of the total, state officials believe at least 2,200 are clearly unnecessary. A fairly sophisticated analysis of the C-section rates allowed for a geographic comparison that found an especially pronounced increase in the use of the surgical procedure in the Puget Sound region.
Plus: In a guest column penned in response to the SI story, Sara L. Ainsworth, senior legal and legislative counsel at Northwest Women’s Law Center, wrote that the high rate of caesarean sections “raises alarms for those who care about women’s reproductive health and patients’ rights.”
In addition to the potential health risks of the surgery, women who have C-sections face consequences that even conscientious health care providers may not recognize or discuss with their patients.
In many parts of this state, having one C-section delivery will require another at a subsequent birth, even over the objection of the pregnant woman and her doctor. Several Washington hospitals refuse to allow doctors to provide labor and delivery services to pregnant women who have had a previous C-section unless those women submit to a second C-section delivery.
Breast Cancer Rates: The Kaiser Family Foundation has published a state-by-state breakdown of breast cancer incidence rate per 100,000 women in 2004. Massachusetts has the highest rate (134 per 100,000 women), followed by Oregon, Washington, Rhode Island and Connecticut. Arizona has the lowest rate (102.9), followed by Idaho, Arkansas, Nevada and Indiana.
Plus: Feminist Peace Network reports on Molecular Breast Imaging (MBI), a new procedure that may be useful for women with dense breasts who have a higher risk of breast cancer. The downside? Patients receive 8 to 10 times more radiation from MBI’s than from mammograms.
With Child, With Cancer: The New York Times Magazine profiles women who are undergoing cancer treatments during pregnancy and covers the medical history of treating pregnancy-associated breast cancer.
Health Reporters Not Helping Readers: A study by University of Missouri journalism professors found that “the majority of health journalists have not had specialized training in health reporting and face challenges in communicating new medical science developments.”
Of the journalists surveyed, only 18 percent had specialized training in health reporting and only 6.4 percent reported that a majority of their readers change health behaviors based on the information they provide. The journalists had an average of 18 years of journalism experience and seven years experience as health journalists.
“Health journalists play an important role in helping people effectively manage their health,” [assistant professor Maria] Len-Ríos said. “However, we found that many journalists find it difficult to explain health information to their readers, while maintaining the information’s scientific credibility. They have to resist ‘bogging down’ the story with too much technical science data and ‘dumbing down’ the story with overly simplistic recommendations.”
Journalists reported quoting medical experts, avoiding technical terms, and providing data and statistics as the three most important elements to making health information understandable. However, understanding numbers is a challenge for many people, [assistant professor Amanda] Hinnant said.
Celebrate the Anti-Wedding: Read what happens when death and taxes decide to get married and stage a protest against weddings. And there’s video.
Returning for the Final Time to the Republican National Convention: Jon Stewart drives home the hypocrisy of Republican attitudes toward reproductive rights with guest Newt Gingrich, while Samantha Bee tries to remember what that word is …
Our Bodies Our Blog has invited the folks at Breast Cancer Action to write monthly guest posts on breast cancer and related issues.
by Brenda Salgado
Here’s an alarming statistic: African American women are much more likely to die from breast cancer than white women, and the mortality gap has actually widened over the past 20 years.
According to the California Breast Cancer Research Program, in 1980 breast cancer mortality rates were equal for both African American and Caucasian women. By 1990, however, African American women had a 16 percent higher mortality rate than white women, and by 2004 this difference had increased to 36 percent.
We should all be outraged by these figures.
This disturbing trend has led to a much-needed focus on determining why these differences — commonly referred to as “disparities” — exist, and what can be done to alleviate them.
In discussing the differences in outcomes, the Alameda County Department of Public Health in Northern California uses the term health inequities rather than disparities to clarify that “differences in health … are unnecessary, avoidable, unfair and unjust” and related to “discriminatory actions, practices and policies that perpetuate diminished opportunity and hazardous exposures for certain populations.”
As health advocates, we’re engaged in efforts to eliminate these injustices. But in order to succeed, our efforts must be broad enough to include the root causes of breast cancer and go beyond focusing on the usual suspects of health care access and genetics.
In the United States, we seem to be particularly enamored with the idea that we can “unlock” the genetics of disease, and, in doing so, fix most of our health problems. But in going down this path, we must guard against the misuse of this information to stereotype communities.
As we seek to identify genes that may be predictive of disease, we may unknowingly turn our attention from talking about other issues like income, racism, access to healthy foods and neighborhood pollution. Like breast cancer mortality, these issues are not distributed equitably in our society, and there is already clear evidence that these factors affect multiple health outcomes.
Earlier this year, the Center for American Progress issued a report called “Geneticizing Disease: Implications for Racial Health Disparities.” The authors tell the cautionary tale of BiDil, the first race-specific medication targeted at African Americans, and the ethical, research and funding controversies surrounding its approval. They also make the case that placing all our emphasis on medicating disease once it has arisen will come at the cost of preventing disease from occurring in the first place.
We need to make sure our policymakers think more broadly than genetics research and health “disparities.” Resources also must focus on addressing the social injustices that lead to health inequities and on improving the social conditions of everyone in society.
Genetic research and biotechnologies have led to some important medical advances (in addition to creating profits for pharmaceutical companies). We need to make sure these new treatments and health technologies also serve public health and do not undermine our efforts to create a more just and fair society.
If not, we will never reduce that 36 percent difference in mortality. And it’s high time we did.
Brenda Salgado is the program manager at Breast Cancer Action. She manages BCA’s ongoing campaigns, oversees BCA’s legislative and policy work, and represents BCA on environmental and women’s health coalitions.
In case you missed it, recent headlines suggested that women can skip self-examination of their breasts, as a new Cochrane review suggested that the exams may not improve survival. The authors looked at two large studies (conducted in Russia and Shanghai) that compared mortality between women who did and did not regularly perform the exams. They did not find any differences in mortality, but found that women who performed self-examinations underwent more biopsies than those who did not.
An article in Star-Tribune notes that some organizations have backed away from recommending monthly self-exams. Despite concluding that “screening by breast self-examination or physical examination cannot be recommended,” the Cochrane review authors note that “Women should, however, be aware of any breast changes..” and should “be encouraged to seek medical advice if they detect any change in their breasts that may be breast cancer.” It is not clear how women are to be aware of any breast changes without doing self-exams. Another potential limitation of the review is the limited information on how the conclusion might apply to other populations, such as women in the U.S.
As OBOS has previously noted, “BSE, while not ‘proven’ to save lives…is the one detection method that women have control over with their own two hands.” See this companion content for further discussion and instructions for performing self-examination, and Breast Cancer Action’s Policy on Breast Cancer Screening and “Early Detection.”
Our Bodies Our Blog has invited the folks at Breast Cancer Action to write monthly guest posts on breast cancer and related issues.
by Brenda Salgado
Though billions of dollars have been spent on breast cancer research, the incidence of breast cancer is higher today than it was 20 years ago. Inequities in breast cancer mortality continue to increase, and we still can’t definitively figure out what’s causing this disease. Some gains have been made in treatment, but the results are simply not enough.
How can we ensure that research funds are used wisely and effectively? One model for how research should be done is the California Breast Cancer Research Program (CBCRP)
The CBCRP, which funds groundbreaking research, has changed how breast cancer is addressed around the world. Its research includes topics like psychosocial impacts, community-based participatory research, environmental exposures, and racial and ethnic disparities. It is also committed to disseminating research results.
You’d think a program like this would be reaping the rewards of funding, but no. In fact, the University of California Office of the President, CBCRP’s administrative home, wants to gut the program by eliminating the collaborative planning, evaluation and community outreach activities. This would impact the program’s ability to fund the best breast cancer research — and its ability to share these results with the community and health providers.
The CBCRP is funded by a state tobacco tax, donations from a voluntary tax check-off program, and individual contributions. It is the largest state-funded research program in the nation, and 95 percent of the money goes directly to funding research and education efforts.
The CBCRP was founded and is run by an unprecedented collaboration of women with breast cancer, advocates, activists, scientists, clinicians and researchers. Because of this collaboration, the program has a deep understanding of what breast cancer research has already been done, and what it needs to focus on next — such as environmental causes.
UCOP bureaucrats think they’re better suited to determine what research gets funded than the women and men working to end this disease. But UCOP can’t provide the insightful funding CBCRP has done for years. The CBCRP has funded important research that simply wouldn’t have seen the light of day otherwise.
UCOP and other research funders need to hear from women’s health advocates that we want effective and efficient use of our financial resources. Innovative health research programs like the CBCRP are about more than just breast cancer. They are models for how women and other affected communities can and must be included in deciding what research is funded and making sure that the results are shared with the public.
Want to help save this innovative and effective program? We’ve put together a letter you can email to U of C President Mark Yudof, asking him to stop this travesty. As we note in the letter, “We do not want or need more breast cancer research funding at the expense of smart breast cancer research funding.”
Brenda Salgado is the program manager at Breast Cancer Action. She manages BCA’s ongoing campaigns, oversees BCA’s legislative and policy work, and represents BCA on environmental and women’s health coalitions.
Double Dose: A Wacky Week for the White House on Abortion; “Hypersegregation” and Racial Disparities in Preterm Birth; Blogging While Brown Conference; Hot Flash Fan on Exhibit; AIDS Conference Coverage …
White House Defines Contraception as Abortion: You know you’re counting down the remaining hours of the Bush presidency when you read that the administration “wants to require all recipients of aid under federal health programs to certify that they will not refuse to hire nurses and other providers who object to abortion and even certain types of birth control,” as reported in The New York Times.
Under the draft of a proposed rule, hospitals, clinics, researchers and medical schools would have to sign “written certifications” as a prerequisite to getting money under any program run by the Department of Health and Human Services. Such certification would also be required of state and local governments, forbidden to discriminate, in areas like grant-making, against hospitals and other institutions that have policies against providing abortion.
And the kicker:
The proposal defines abortion as follows: “any of the various procedures — including the prescription, dispensing and administration of any drug or the performance of any procedure or any other action — that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation.”
Up until now, the federal government followed the definition of pregnancy accepted by the American Medical Association and our nation’s pregnancy experts, the American College of Obstetricians and Gynecologists, which is: pregnancy begins at implantation. With this proposal, however, HHS is dismissing medical experts and opting instead to accept a definition of pregnancy based on polling data. It now claims that pregnancy begins at some biologically unknowable moment (there’s no test to determine if a woman’s egg has been fertilized). Under these new standards there would be no way for a woman to prove she’s not pregnant. Thus, any woman could be denied contraception under HHS’ new science.
Senate Passes PEPFAR: Scott Swenson of RH Reality Check has the live blog on the 80-16 vote to reauthorize the President’s Emergency Plan for AIDS Relief (PEPFAR), a five-year, $50 billion global initiative to combat HIV/AIDS, tuberculosis and malaria.
SEICUS, International Women’s Health Coalition, and other groups issued a response to the vote, noting in part that “policymakers failed to address critical shortfalls in the bill that would have ensured effective use of scarce public funds and a sustainable response to the pandemic.” It continues:
One key change that should have been made in the PEPFAR bill was the abolishment of arbitrary funding guidelines that determine how money can be distributed on the ground. The Senate bill calls for spending at least fifty percent of prevention funds designed to halt the sexual transmission of HIV, in countries with generalized epidemics, only on abstinence and faithfulness programs. PEPFAR recipients that do not meet this requirement must justify their programmatic decisions through an onerous reporting requirement to Congress, potentially facing defunding. [...]
The PEPFAR bill passed by the Senate also failed to fully increase protection for women and young people, two groups increasingly vulnerable to new infections in nearly every region of the world. Women and young people are most likely to use family planning and other reproductive health services, and would benefit greatly from a strategy that integrated HIV prevention and treatment with family planning. Recent studies suggest that upwards of 90 percent of HIV-positive pregnant women in countries such as Uganda and South Africa have unmet need for integrated family planning and HIV services. However, the bill passed by the Senate fails to call for, or even acknowledge, the need to strengthen critical linkages between family planning and reproductive health services and HIV prevention efforts.
Regional “Hypersegregation” May Contribute to Racial Disparity in Preterm Births: Where a mother lives may account for some of the striking racial disparities in preterm birth, according to a new study described in this release and published in the American Journal of Epidemiology.
Written by Northeastern University professor Theresa Osypuk, the study found that regional hypersegregation (residential racial segregation across four or more dimensions*) may contribute to the higher rate of preterm births among black women. Prior research has shown that infants born to Black women in the U.S. are 50% more likely to be preterm than infants born to White women, although the causes remain poorly understood. [...]
“The complexity of residential segregation and its impact on preterm births and related health outcomes has been overlooked by health literature,” said Dr. Osypuk, Assistant Professor in Northeastern’s Bouve College of Health Sciences. “We believe that the association between residential segregation and higher risk of preterm birth is related to the neighborhood environments in which black women live, including neighborhoods characterized by high levels of poverty, violent crime, and worse housing stock.”
Blogging While Brown (and Female): “People consider me the 411 on what goes wrong with black women in America,” Gina McCauley, founder of www.whataboutourdaughters.blogspot.com,” tells Kristal Brent Zook in this article on how women bloggers of color are getting their messages out without having to first get approval through a male power structure.
Plus: The first ever “Blogging While Brown” conference takes place July 25-27 in Atlanta.
Return of the C-Word for Departing Trib Editor: From Romenesko: “In 2004, Ann Marie Lipinski had her Chicago Tribune staff manually pull 600,000 copies of the WomenNews section out of preprinted packages because of the headline, “You c_nt say that.” (The story explored usage of the vulgar term for a woman’s anatomy.) On Thursday, the departing editor showed the newsroom a reader’s e-mail that said, “You C_nt Leave.”
Dissecting the Diets: I caught a frustratingly superficial TV news segment on a long-term Atkins Foundation-funded study (published in the New England Journal of Medicine) that concluded participants on the Atkins Diet lost more weight compared to people on low-fat or Mediterranean diets. Tara Parker-Pope notes, however, that none of the diets resulted in much weight loss (though there were other health benefits), and she takes a closer look at what eating low-carb meant for the purpose of this study — while some commenters discuss whether the low-fat diet was low enough to be effective. Parker-Pope’s most concise critique of the study may be found here.
AIDS Conference Coverage: Kaisernetwork.org will provide daily coverage of AIDS 2008 from Mexico City, Aug. 3-8. Coverage will include live and tape-delayed webcasts and transcripts of each day’s sessions, including the opening and closing sessions, all plenary sessions, and selected other sessions and press conferences; English- and Spanish-language audio podcasts of select sessions; slide presentations from select conference sessions; a daily update email with links to the latest coverage; and more.
Plus: Here’s information on how you can syndicate Kaiser’s coverage on your own website.
Hot Flash Fan Heats Up Exhibit: Lucinda Marshall points to an exhibit at the Huff Gallery at Spalding University in Louisville: “The Hot Flash Fan, Then and Now: Celebrating 160 Years of Feminism.” The Hot Flash Fan, an 8’ x 16’ wall hanging, was created by Ann Stewart Anderson in collaboration with more than 50 women artists. From the exhibit website:
The Hot Flash Fan was created in 1985 and facilitated by renowned feminist artist, Judy Chicago. The Hot Flash Fan, an immense wall hanging, encompasses various media and materials including: elaborate knotting, roping, beading and stitching. In addition, the piece is swathed in vibrant colors, which enhances the viewer’s image of the realities and experiences of menopause.
This specific piece has particular historical significance because it was one of the first artworks to ever visualize the subject of menopause. Through its vivid colors and intricate detailing the Hot Flash Fan depicts the various myths, stereotypes, as well as lived experiences of women transitioning through the multiple phases of menopause. Though historically, representations of menopause have largely focused on the decaying of women’s bodies, as the piece indicates, there are also many reasons to celebrate menopause as one of the important phases in women’s lives.
Double Dose: Black Maternal Health in the United States; Google Fumbles on Childcare; AMA Apologizes for Past Racism; Doctors Discussing Weight; Open Letter to Obama on Late-Term Abortion; Postcards From Vermont …
U.S. Black Maternal Health Tied to Social Stress: Writing in Women’s eNews, June Ross looks at how advocates for black women are redefining maternal health — the period from pregnancy through the first six months after delivery — to include a woman’s overall well-being. It’s the first in a series on black maternal health.
“Regardless of their age, marital status, education or early prenatal care, African American women are more likely to bear premature and low-birth-weight infants, those under 6 pounds, whose survival odds are below the U.S. norm,” writes Ross. “Nationwide, black women are three to four times more likely to die giving birth than either white or Latina women. Their infants’ mortality risk is doubled, according to the Centers for Disease Control and Prevention. The disparity has persisted even as infant mortality rates for the nation as a whole have fallen.”
“Prenatal care alone doesn’t solve the problem,” said Eleanor Hinton Hoytt, president of the Black Women’s Health Imperative. “It’s the life course of women in our communities that is making us give birth prematurely to sick babies. The gap (between black and white women) persists because we haven’t done enough. We need to reframe the policy issues. We need to address maternal health first, then talk about infant mortality.”
It’s a great piece that also looks at the work of Byllye Avery, who stresses the intergenerational aspects of black women’s health and who founded the first Black Women’s Health Imperative. She now runs the Avery Institute for Social Change, which brings together health activists, strategists, community advocates and scholars for constructive dialogue on health disparities and health care reform.
Plus: Also from Women’s eNews, a look at the call for billions to reduce maternal mortality at the G-8 economic summit — Pat Sheffield at RH Reality Check reports on how it went; and an article in a series on the status of U.S. women looks at the growing ranks of poor single mothers since the 1996 welfare overhaul.
AMA Apologizes for Past Racism: The American Medical Association on Thursday “formally apologized for more than a century of policies that excluded blacks from a group long considered the voice of American doctors,” writes AP medical writer Lindsey Tanner. “The apology is among initiatives at the nation’s largest doctors’ group to reduce racial disparities in medicine and to recruit more blacks to become doctors and to join the AMA.”
When a Mammogram Isn’t Enough: The Wall Street Journal reports on the use of MRIs and ultrasounds to help detect breast cancer in women who have a higher risk of the disease. These methods are more sensitive, but the downside is that they also have a higher rate of false-positives, which can lead to unnecessary stress and biopsies.
Should Doctors Lecture Patients About Their Weight?: Well looks at a recent blog post by “Dr. Rob” (Dr. Robert Lambert of Georgia) at Musings of a Distractible Mind. A whopping 600-plus comments follow. Here’s one of the good ones, as is the one that follows it.
Father’s Age Also a Factor in Fertility: Also from Well. Ah, the cultural implications …
Death of an Activist: Via Viva La Feminista, news of the death of Jana Mackey, a 25-year-old law student and feminist activist who wanted to be an advocate for victims of domestic violence. She was murdered by her ex-boyfriend.
Plus: New York’s domestic violence law is about to be expanded. According to The New York Times: “The new law would make it possible for people in dating relationships, heterosexual or gay, to seek protection from abusers in family court. As it stands, New York has one of the narrowest domestic violence laws in the country, allowing for civil protection orders only against spouses or former spouses, blood relations or the other parent of an abused person’s child.”
Eating at the Farm: I’m in Vermont this week — trying to eat locally as much as possible, same as we do in Chicago during the short-but-sweet growing season — and I have to give a shout-out to Pizza On Earth, where not only does the pizza come topped with farm-fresh ingredients, but you can pick up your share of fruit and vegetables from Stony Loam Farm when you pick up your pie. Or stay and eat outdoors overlooking the rows of vegetables, flowers and herbs.
We ordered the week’s pizza special, curry squash (sounds awful but it was good) and left with a bunch of (free!) garlic scapes.
The New York Times yesterday looked at the growth of community supported agriculture (or CSA) groups around the country and the benefits to members and farmers. One of the unexpected benefits is being introduced to seasonal food you might not otherwise try. If it’s in my bag, I’m going to try to use it, whereas at the farmers market or supermarket I’m more likely to skip over foods I don’t recognize.
You can find a local CSA and other farm subscriptions at Local Harvest. Here’s the view at Stony Loam:
Our Bodies Our Blog has invited the folks at Breast Cancer Action to write monthly guest posts on breast cancer and related issues.
by Pauli Ojea
Women facing a life-threatening illness like breast cancer often have very difficult decisions to make about whether they can live with the side effects of what could be a helpful drug. Deciding whether the benefits outweigh the risks can happen only if all the information on side effects is available. All too often it’s not.
In an effort to remedy this situation, Breast Cancer Action (BCA) just released a report on women’s experiences with side effects of aromatase inhibitors (AIs), a common class of drugs for breast cancer treatment. In doing so, we hope to encourage additional research on how AIs affect women.
For women living with estrogen-receptor-positive breast cancer, AIs are a relatively new class of drugs that have quickly become the standard of care. Limited information about AI side effects is available, but there’s still a lot we don’t know.
Arimidex, the first AI, was approved by the FDA in 1996 for breast cancer treatment. Soon after, BCA started hearing from women whose doctors were recommending Arimidex, asking what the known side effects were and how long they should stay on the drug.
Knowing that the FDA couldn’t — and the drug industry wouldn’t — collect this information in a way that’s helpful to patients, we decided to do it ourselves. We wanted to make sure that this information was being captured somewhere. So, with an online survey we launched in 2005, we began collecting information from women about their experience on the three AIs approved for use in breast cancer: anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin).
In 2007, we released a preliminary report based on the first 612 responses to the survey. Our new release, “Side Effects Revisited: Women’s Experiences with Aromatase Inhibitors,” is based on nearly 1,200 responses. The most common side effects reported continue to be hot flashes, bone pain, tiredness, muscle pain and insomnia. We also found that more than 25 percent of respondents experienced side effects so severe they decided to stop taking their AI. This is particularly troubling, because it means that the side effects were so bad that women felt they would rather risk a breast cancer recurrence than experience such poor quality of life.
The report also found that the women who took our survey (which is not necessarily a representative sample of all women taking an AI) are on average much younger than the women who have been studied in clinical trials of these drugs. These younger women — and by younger we mean under 60 — are experiencing more and worse side effects than older women on AIs. This is particularly true for younger women whose menopause was induced.
As a result, they’re experiencing very real quality-of-life issues that aren’t reflected in clinical trial data thus far. These results tell us that it will be crucial for future studies to look at how AIs are affecting younger women.
Here at BCA, we understand that patients almost always know before the medical community does what side effects they are experiencing. Through these reports on AI side effects, we hope to encourage additional research on the long-term side effects for all women taking these drugs. After all, this information is what allows people to make informed decisions about their health care — a value that’s critically important to all of us.
Pauli Ojea is the community organizer at Breast Cancer Action, where she mobilizes people to do something besides worry. Read BCA’s full report on women’s experiences with side effects of aromatase inhibitors, including quotes from the women themselves. Visit http://community.breastcancer.org to join online discussions on the topic.
Double Dose: Abstinence-Only Funding Survives Another Vote; Statement of Black Men Against the Exploitation of Black Women; UN Addresses Rape as War Crime; Debate Over Islam and Virginity; Shopping for Breast Cancer and More …
Best Headline: “Abstinence-only funding is like an evil Energizer Bunny,” courtesy of Vannesa at Feministing. Why the evil? The House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies voted to continue funding the Community-Based Abstinence Education (CBAE) program, an abstinence-only education funding stream, despite all the research that’s it’s a waste of money and resources. Scott Swenson of RH Reality Check has a good wrap-up here.
Share This: Via Brownfemipower, I found an online petition — Statement of Black Men Against the Exploitation of Black Women — written in the wake of R. Kelly’s acquittal. The petition and related useful books, films and organizations are also listed on Mark Anthony Neal’s blog, which itself is a terrific resource on issues on issues of race and masculinity.
UN Addresses Rape as a War Crime: “In Sudan, girls as young as four are raped by rebel forces and government-backed militias. In Democratic Republic of Congo, women are sexually mutilated by roving gangs. In Burma, they are systematically raped as part of a military offensive,” writes Olivia Ward in the Toronto Sun. “[Thursday], the United Nations Security Council agreed that sexual violence against women and girls in war zones is a threat to international stability, opening the way for action against countries that condone or promote atrocities.”
Here’s more from the BBC, and the full text of UN Resolution 1820, which states that “rape and other forms of sexual violence can constitute war crimes, crimes against humanity or a constitutive act with respect to genocide.” The 15-member Security Council also demanded the “immediate and complete cessation by all parties to armed conflict of all acts of sexual violence against civilians.”
As Europe’s Muslim population grows, many young Muslim women are caught between the freedoms that European society affords and the deep-rooted traditions of their parents’ and grandparents’ generations.
Gynecologists say that in the past few years, more Muslim women are seeking certificates of virginity to provide proof to others. That in turn has created a demand among cosmetic surgeons for hymen replacements, which, if done properly, they say, will not be detected and will produce tell-tale vaginal bleeding on the wedding night. The service is widely advertised on the Internet; medical tourism packages are available to countries like Tunisia where it is less expensive.
“If you’re a Muslim woman growing up in more open societies in Europe, you can easily end up having sex before marriage,” said Dr. Hicham Mouallem, who is based in London and performs the operation. “So if you’re looking to marry a Muslim and don’t want to have problems, you’ll try to recapture your virginity.”
A 23-year-old French student of Moroccan descent who paid $2,900 for the procedure, said: “In my culture, not to be a virgin is to be dirt … Right now, virginity is more important to me than life.”
Plus: Read Judith Warner’s column, which links hymen surgery, father-daughter purity balls and other news stories related to patriarchy and female chastity.
World Refugee Day: In recognition of the 8th Annual UN World Refugee Day on June 20, Worldview looked at the plight of Iraqi refugees.
Cervical Cancer Screenings Lacking in Developing Countries: “A study published in the open-access journal PLoS Medicine has found that women in the developing world are not getting the cervical cancer screenings that they need,” according to Medical News Today. “Researcher Emmanuela Gakidou (University of Washington) and colleagues report that although women in the developing world have the highest risk of developing cervical cancer, few are effectively screened. Additionally, there exist severe inequalities between and within countries concerning the access to cervical cancer screening.”
Plus: A survey of 38,000 Canadian women found that obese women are significantly less likely (30 to 40 percent, depending on the degree of obesity) to be tested for cervical cancer than women of average body weight, according to CBC News. Breast and colon cancer screening are unaffected by a woman’s body mass.
Shopping for Breast Cancer: The Center for Media & Democracy’s PRWatch recently posted an article about “Pinkwashing” — which is what happens when corporations try to boost sales by associating their products with the fight against breast cancer. “The worst pinkwashers exploit the intense emotions associated with breast cancer while selling products that actually contribute to breast cancer,” writes Ann Landman, who goes on to offer some key examples, including a Ford 2008 V-6 Mustang with Warriors in Pink Package, which proclaims to “add more muscle to the fight.”
Study Finds Drop in Use of HRT: “Fewer older women in Canada are using hormone-replacement therapies to treat the symptoms of menopause, turning instead to natural remedies, says a study released Thursday,” reports The Vancouver Sun.
“The Canadian Institute for Health Information has found only five per cent of women in five provinces who are 65 years and older use hormone-replacement therapies — a drop from 14 per cent six years ago, when a report found the risks of using the menopause therapies outweigh the benefits.”
The Number of Underinsured Grows: Via the L.A. Times - A new study published in Health Affairs journal found that 25 million people ages 19 to 64 were underinsured in 2007, up from 16 million in 2003.
Nearly 50 million additional people have no health insurance at all. In all, “You end up with about 75 million adults who were either underinsured or uninsured at some time during the year,” says study co-author Sara Collins, an assistant vice president of the Commonwealth Fund, a foundation that supports independent healthcare research.
Those who had inadequate insurance coverage were almost as likely as those with no insurance to avoid getting needed care or to suffer medically related financial problems. Some 53% of the underinsured went without needed care, compared with 68% of the uninsured. And 45% of underinsured people had trouble paying medical bills, compared with 51% of uninsured people. “You can have health insurance and still go bankrupt if you get sick,” the authors note.
ACLU Symposium on LGBTQ Rights: Melissa points to a number of pieces posted at the symposium, including her piece on gay marriage written as a LGBTQ ally. I loved what Rachel Maddow had to say in an interview with the ACLU:
So far the state where I grew up (California) and the state where I live (Massachusetts) and the state where I work most of the time (New York) have legalized, legalized, and agreed-to-recognize-other-states’ same-sex-marriages, respectively. I am accepting applications now from other states that want me to relocate, since apparently I am to second-class gay citizenship what Saint Patrick was to snakes.
Eating at the Farm: I’m in Vermont this week — trying to eat locally as much as possible, same as we do in Chicago during the short-but-sweet growing season — and I have to give a shout-out to 