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.

Research on breast cancer disparities has largely focused on screening rates, access to health care, differences in treatment and, increasingly, genetic differences. While such research is important, it ignores other factors — such as social and economic injustices and racism — that also affect health outcomes.

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.

Flesh-Eating Fish Perform “Pedicures”: See what shows up in my in-box from NPR?

Drug Makers’ Push Leads to Cancer Vaccines’ Rise: “In two years, cervical cancer has gone from obscure killer confined mostly to poor nations to the West’s disease of the moment,” begins this lengthy New York Times story by Elisabeth Rosenthal about concerns over the rapid rollout of vaccines against HPV, which have now been used by tens of millions of girls and young women in the United States and Europe.

Some of the issues raised:

Merck’s vaccine was studied in clinical trials for five years, and Glaxo’s for nearly six and a half, so it is not clear how long the protection will last. Some data from the clinical trials indicate immune molecules may wane after three to five years. If a 12-year-old is vaccinated, will she still be protected in college, when her risk of infection is higher? Or will a booster vaccine be necessary?

Some experts are concerned about possible side effects that become apparent only after a vaccine has been more widely tested over longer periods.

And why the sudden alarm in developed countries about cervical cancer, some experts ask. A major killer in the developing world, particularly Africa, where the vaccines are too expensive for use, cervical cancer is classified as very rare in the West because it is almost always preventable through regular Pap smears, which detect precancerous cells early enough for effective treatment. Indeed, because the vaccines prevent only 70 percent of cervical cancers, Pap smear screening must continue anyway.

“Merck lobbied every opinion leader, women’s group, medical society, politicians, and went directly to the people — it created a sense of panic that says you have to have this vaccine now,” said Dr. Diane Harper, a professor of medicine at Dartmouth Medical School. Dr. Harper was a principal investigator on the clinical trials of both Gardasil and Cervarix, and she spent 2006-7 on sabbatical at the World Health Organization developing plans for cervical cancer vaccine programs around the world.

“Because Merck was so aggressive, it went too fast,” Dr. Harper said. “I would have liked to see it go much slower.”

Plus: In a separate story, Rosenthal refers to two articles published in New England Journal of Medicine that conclude the vaccines are being used without knowing for sure that they are worth the high cost or if they are effective in preventing cervical cancer. Read the articles here and here.

HHS Fails to Deliver on Contraception/Conscience Proposal: “The Department of Health and Human Services today formally released proposed regulations that Secretary Michael Leavitt claims are necessary to protect health care providers and institutions who decline to provide certain medical services because those services offend their ‘consciences,’” writes Emily Douglas at RH Reality Check.

“After intense criticism in the mainstream media and from millions of Americans, HHS has removed an explicit redefinition of contraception as abortion from the regulation. In so doing, the agency may have created a much larger problem.”

Plus: Here’s the official version of the regulation, and Rachel’s previous writings on this topic.

Birth of a Movement: “Last month, a seven-judge appellate panel in Pennsylvania ruled that delivering babies is not the practice of medicine. It’s always comforting when the law catches up to history; midwifery is, after all, the second-oldest profession,” writes Roberta Devers-Scott, a Vermont midwife and psychologist who has written an op-ed about the prosecution of midwives, including her own case.

Health Care is the Issue:  Judy Waxman, vice president and director of health and reproductive rights at the National Women’s Law Center, identifies seven questions to ask when looking at health reform proposals to determine whether the proposals help to ensure that all women have access to health care that meets their needs.

The Future of Personalized Medicine: View a webcast of the Kaiser Family Foundation’s series Today’s Topics In Health Disparities, which discusses the potential of race-based medical solutions for improving healthcare and reducing racial/ethnic health disparities. The webcast takes a closer look at efforts to study the interaction between race, genetics and health.

Spinach With a Side of Radiation: “Consumers worried about salad safety may soon be able to buy fresh spinach and iceberg lettuce zapped with just enough radiation to kill E. coli and a few other germs,” reports the AP. “The Food and Drug Administration on Friday will issue a regulation allowing spinach and lettuce sellers to take that extra step, a long-awaited move amid increasing outbreaks from raw produce.”

A leading food safety expert said irradiation indeed can kill certain bacteria safely — but it doesn’t kill viruses that also increasingly contaminate produce, and it isn’t as effective as tightening steps to prevent contamination starting at the farm.

“It won’t control all hazards on these products,” cautioned Caroline Smith DeWaal of the Center for Science in the Public Interest.

She questioned why the FDA hasn’t addressed her agency’s 2006 call to require growers to document such things as how they use manure and ensure the safety of irrigation water. Irrigation is one suspect in this summer’s nationwide salmonella outbreak attributed first to tomatoes and then to Mexican hot peppers.

“We are not opposed to the use of irradiation,” DeWaal said. But, “it’s expensive and it doesn’t really address the problem at the source.”

The Claim: Morning Sickness Means a Girl Is More Likely: “The notion that morning sickness can sometimes indicate that a girl is on the way may be an exception,” to a number of old wives tales about pregnancy that are based more on fantasy than fact, reports The New York Times. “A number of large studies in various countries have examined the claim, and almost all have found it to be true, with caveats. Specifically, studies have found that it applies to women with morning sickness in the first trimester, and with symptoms so severe that it leads to hospitalization, a condition known as hyperemesis gravidarum.”

A True Love Story: “I’m completely smitten with WALL•E, this summer’s Pixar/Disney offering. But the last thing I expected to see in my friendly, heterosexual upper east side Manhattan neighborhood movie theater was a feature length cartoon about a pair of lesbian robots who fall madly in love with each other,” writes Kate Bornstein. “WALL•E is nothing short of hot, dyke Sci Fi action romance, some seven hundred years in the future! Woo-hoo! Isn’t that what you saw? No? What movie were you watching?” Hee. via en|Gender.

Aisha Qaasim, a civil rights attorney, often advocates on behalf of others.

Today, in an essay published at Women’s eNews, Qaasim takes on the insults hurled at women who breastfeed in public and argues that the negativity surrounding breastfeeding is hurting the health of children and mothers, particularly in African-American families, where the rate of breastfeeding is the lowest.

Women who breastfeed lower their risk of developing uterine cancer, osteoporosis, Type 2 diabetes and breast cancer over their lifetimes.

But the irony is that in today’s ambitious parenting climate — where millions of dollars are being spent on educational toys and organic baby products — breastfeeding as the most important developmental head-start is often neglected.

Among African American women that’s particularly true. In 2004, 74 percent of U.S. women initiated breastfeeding soon after giving birth. Among black women it was 60 percent.

By the time infants reached 6 months of age — a key health target — only 14 percent of U.S. infants were breastfed exclusively. Among black infants it was 7 percent.

Only 36 percent of U.S. babies received breast milk in combination with formula or other foods at 6 months of age. For African American babies make that 29 percent.

Black women are the least likely to breastfeed, even those of us with a college education, health insurance and a nice paying job. African American women across the spectrum breastfeed less than women who have only a high school education, less than women who live below the poverty line and less than adolescent mothers, according to the Centers for Disease Control 2004 National Immunization Survey.

It’s not an abstract issue for Qaasim. As a black women, she has weathered overtly racist insults, much of which she could brush off. But Qaasim couldn’t shake a comment she heard while breastfeeding her 2-month-old daughter at a suburban Maryland mall.

“That is the most disgusting thing I have ever seen,” the woman said.

“A nameless woman at a mall was somehow the one to find the insult that I could not toss onto the neat pile of words that would never hurt me. It did hurt. And, these attitudes toward breastfeeding are making our children sick, especially African American children, who are the least likely to get the benefit of mothers’ milk,” writes Qaasim.

And when she complained about the ridicule — which she said almost always came from other women — friends and family didn’t offer much support.

The response is not uncommon. Among the many public obstacles women face with regard to breastfeeding — including a lack of privacy and time to pump breast milk at work and a lack of knowledge concerning laws in most states granting mothers the right to breastfeed in public spaces — discouragement from friends and family is also a major deterrent.

A recently published study of 88 new or soon-to-be mothers, mostly Hispanic and African-American, found that the opinions of family and friends are the most significant factor in determining whether low-income mothers breastfeed their children. The study, titled “Breast-feeding Intentions Among Low-Income Pregnant and Lactating Women,” appeared in the March-April 2008 issue of The American Journal of Health Behavior.

Interestingly, researchers found no statistical relationship between positive attitudes held by pregnant women concerning breastfeeding and their intent to breastfeed. The views of family members closest to them mattered the most. The researchers concluded that education about breastfeeding include the “opinion-shapers” as well as pregnant women.

“In the study, women were most significantly influenced by what they perceived to be the opinions of people close to them such as their husband or partner, siblings, friends and parents,” said Gina Jarman Hill, assistant professor of nutritional sciences at Texas Christian University. “Husbands or partners were the most influential.”

Henry Hale gets it. The 25-year-old African-American father of a 3-year-old daughter named Miracle is the first male certified breast-feeding peer counselor at Rush University Medical Center in Chicago. He may even be the first in Illinois (or anywhere?).

“No one knows for sure, because calls to organizations that track this type of thing are met with befuddled silence,” writes Bonnie Miller Rubin in the Chicago Tribune. A photo of Hale is on the Trib’s front page today.

His interest in lactation began after the birth of his now 3-year-old daughter, Miracle, who was born at 24 weeks, weighing only 1 pound, 3 ounces. Hale and Miracle’s mother, Jackie Scott, attended Mother’s Milk Club, a weekly support group for parents of babies in the neonatal intensive-care unit, and learned about the health health benefits of breast feeding.

Although dads may make occasional appearances, Hale never missed a meeting, said Paula Meier, Rush’s director for clinical research and lactation.

“A lot of dads find it repulsive,” she said. “But Henry was just so outspoken and inspiring.”

That’s when Meier had a lightbulb moment: She’d recruit Hale to extol the virtues of breast-feeding — especially to the African-American community, which traditionally nurses at lower rates than other groups. [...]

“When I heard all the good things about breast milk,” Hale said, “my first thought was, ‘C’mon, let’s get it out. Let’s get going.’ ”

So Scott started pumping. For the first seven months, Miracle consumed nothing else.

“At the beginning, it was really hard,” Scott said to the group, which meets weekly to discuss every aspect of lactation, from inadequate milk supply to how nipple-piercing affects the process. “There were a couple of days when I just wanted to stop. But Henry really helped.”

How Hale assisted isn’t immediately clear given the basic anatomy involved. However, he picks up the thread of the discussion smoothly, explaining how he’d bring the pump to Scott at all hours and wash the equipment when she was done.

“It’s about focusing on what we — as men — can do,” he said.

Hale and Scott have a second daughter now, and both completed a five-day certification course that qualified them to volunteer as peer counselors. Rush is now looking at hiring Hale part-time to lead a male-only group.

Can you imagine? Think of how that education might translate to support at home — and more acceptance in public. The results could literally be life-saving.

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.”

Check out the full memo (PDF). Reuters has reaction from family planning groups. NARAL created a letter you can send to members of Congress.

For more reading, see Allison Stevens; Susan Wood; and Christina Page, who notes:

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.”

Are Breast Self-Exams Worth It?: Kate Harding breaks down a new study by the Cochrane Collaboration.

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.

Check it out:

Last week, as mentioned in the Double Dose, the American Medical Association apologized for more than a century of racial inequality within the organization.

The apology provided a teaching moment of sorts for Chicago Tribune columnist Dawn Turner Trice, who maintains an online forum on race. White readers, she notes, frequently write in to ask why blacks create their own groups, such as the National Association for the Advancement of Colored People, along with black colleges, sororities, etc. After all, if the word “white” were in the title, wouldn’t those groups be considered racist?

Trice responds:

My answer to these questions begins with the American Medical Association’s announcement last week that it was apologizing to black doctors for policies and practices that for years prohibited blacks from joining.

This week in the Journal of the American Medical Association, the group will release the details of the independent group that was commissioned in 2005 to look at disparities in health care and the history of what the AMA called “the racial divide in organized medicine.”

In response to the AMA’s discrimination, black physicians in 1895 founded the National Medical Association. In Chicago, the Cook County Physicians Association was formed. For dentists locked out of the city’s white dental societies, the Lincoln Dental Society was formed. Black pharmacists and nurses created similar groups.

In 2002, Chicago’s Harsh Research collection hosted an extraordinary yearlong exhibit at the Woodson Library on the Far South Side. It was titled, “More Than a Century of Struggle: African American Achievement in Chicago’s Medical History.”

The exhibit explained that until a legal ruling in 1964, 54 of the city’s 57 hospitals didn’t allow black physicians to have attending status. That meant that in order to admit a patient, they had to seek out a white physician.

We’re not talking about Mississippi. This was Chicago just a generation ago.

Meanwhile, the Big Push for Midwives Campaign issued a statement (PDF) in response to the AMA’s apology, drawing attention to the historical role that African American midwives have played:

“Those of us working on maternity care reform have long known that the racial and ethnic disparities in birth outcomes in the U.S. are a national scandal,” said Susan M. Jenkins, Legal Counsel for the Big Push for Midwives Campaign. “We’ve also known that midwives play a critical role in reducing the two most preventable causes of neonatal death, prematurity and low birth weight. Now that the AMA has recognized the problem, perhaps their members will stop trying to outlaw the solution.”

At its annual meeting in June, the AMA issued resolutions opposing the licensure and regulation of Certified Professional Midwives (CPMs), who specialize in out-of-hospital delivery, with a strong focus on preventative care. Historically, African American midwives have played a significant role in minimizing racial disparities in birth outcomes, and they were employed by the World Health Organization to train traditional birth attendants in developing nations. In the first several decades of the 20th century, the AMA and other medical groups launched a racist campaign to outlaw so-called “granny midwives,” which resulted in the closure of the Tuskegee Institute’s state-of-the-art midwifery school and forced African American women into segregated hospitals.

“African American midwives were also a target of racist practices and deserve to be recognized as well; when those midwives were in the community caring for women, we didn’t have such enormous disparity in birth outcomes,” said Jane Peterson, CPM and President of the Wisconsin Guild of Midwives, and Advocacy Trainer with the Big Push for Midwives Campaign. “Immigrant midwives here in Wisconsin and other Midwestern states also struggled against attempts to outlaw them, but they were never subject to the same level of racist animosity.”

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.

And also at RH Reality Check, Miriam Perez looks at “The Myth of the Elective C-Section,” which references “Our Bodies, Ourselves: Pregnancy and Birth.”

A Giant Fumble: Moving on to child care, what’s up with Google?

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.”

Read the full statement.

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 …

Open Letter to Obama: Lynda Waddington of Essential Estrogen and the Iowa Independent offers her personal story about late-term abortion.

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:

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.”

In Europe, Debate Over Islam and Virginity: From The New York Times:

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.”

Landman also links to Breast Cancer Action’s excellent Think Before You Pink campaign.

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.

Wide Disparities in Health Care by Race and Region: “Race and place of residence can have a staggering impact on the course and quality of the medical treatment a patient receives, according to new research showing that blacks with diabetes or vascular disease are nearly five times more likely than whites to have a leg amputated and that women in Mississippi are far less likely to have mammograms than those in Maine,” reports The New York Times.

The study was conducted by researchers at Dartmouth and was commissioned by the nation’s largest health-related philanthropy, the Robert Wood Johnson Foundation, which announced a three-year, $300 million initiative intended to narrow health care disparities across lines of race and geography.

Repairing the Damage, Before Roe: “With the Supreme Court becoming more conservative, many people who support women’s right to choose an abortion fear that Roe v. Wade, the 1973 decision that gave them that right, is in danger of being swept aside,” writes Waldo L. Fielding in this op-ed. “When such fears arise, we often hear about the pre-Roe ‘bad old days.’ Yet there are few physicians today who can relate to them from personal experience. I can.” Read on.

Legal Effects of Marriage for Same-Sex Couples: The San Francisco Chronicle has a comprehensive run-down of the legal and financial changes same-sex couples face if they get married in California.

Plus: What happens to the status of couples already married if the November initiative to ban same-sex marriage passes? Expect heavy litigation and a decision ultimately decided by the California Supreme Court, says UCLA law professor Brad Sears.

Paying for Health Care in Retirement – Good Luck: “I write about health care, and still the realization hit me like a ton of bricks today after I put down a just-released report from the Employee Benefit Research Institute. None of the presidential candidates have been talking about how to fix Medicare," writes Judith Graham at the Chicago Tribune.

Here’s the sobering EBRI report (PDF), effectively titled: “Savings Needed to Fund Health Insurance and Health Care Expenses in Retirement: Findings from a Simulation Model.”

On Becoming a Woman: In case you were looking for some, er, real-life advice, Blinky has excerpts from this 1950′s guide. Here’s analysis from Echidne, who calls it “a fascinating trip into the sexual politics of the past.”

“On the other hand,” she adds, “almost everything in those excerpts is advocated in this country somewhere, right this very moment. Abstinence is the responsibility of girls, for example. Women gentle and home-directed while men are strong and outer-directed? I was just told this by a liberal guy.”

Speaking of Abstinence: The National Abstinence Education Association has launched a $1 million campaign to recruit 1 million parents to “lobby local schools to adopt sex education programs focusing on abstinence and to work to elect local, state and national officials who support the approach,” reports the Washington Post.

The campaign comes as Congress is debating whether to authorize about $190 million in federal funding for such programs, which have come under increasing criticism because of a series of reports that concluded they are ineffective. Such criticism has prompted at least 17 states to refuse federal funding for such programs.

The group hopes to counter that trend, in part with a provocative video that asserts that comprehensive sex education encourages sexual activity by teenagers and a Web site that offers advice to parents about sex education.

Plus: Five days later, the same WaPo reporter, Rob Stein, wrote a page-one story about a new study by the Centers for Disease Control that found “a decade-long decline in sexual activity among high school students leveled off between 2001 and 2007, and that the rise in condom use by teens flattened out in 2003.”

The new figures renewed the heated debate about sex-education classes that focus on abstinence until marriage, which began receiving federal funding during the period covered by the latest survey and have come under increasing criticism that they are ineffective.

“Since we’ve started pushing abstinence, we have seen no change in the numbers on sexual activity,” said John Santelli, chairman of the department of population and family health at Columbia University. “The other piece of it is: Abstinence education spends a good amount of time bashing condoms. So it’s not surprising, if that’s the message young people are getting, that we’re seeing condom use start to decrease.”

Not surprisingly, proponents of abstinence-only programs blamed comprehensive sex-ed.

Hands Up if You’ve Experienced Street Harassment: The F-Word is gathering comments here, in response to comments here.

Breast Cancer News from ASCO Conference: Several breast cancer-related studies presented at the annual American Society of Clinical Oncology conference in Chicago are summarized here by Daily Women’s Health Policy Report. Meeting abstracts from the conference are available here.

Eat Locally, Think …: “The local food movement typically has been about improving the health of the planet,” writes Tara Parker-Pope. “But now researchers are trying to find out if eating locally farmed food is also better for your health. A team of researchers at the University of North Carolina at Chapel Hill has received a grant to study the public health impact of moving toward a local, sustainable food system.”

Chicago can’t hold a carrot stick to California when it comes to the availability of locally grown produce, but the farmers markets rock during the summer and fall. How ’bout where you live?

If I Could Be Anywhere Right Now: It would be here.

There are a number of interesting stories in The New York Times, so let’s do a mini-double dose …

Pain as an Art Form: Well’s Tara Parker-Pope does a nice job describing how art is used to communicate physical pain, from some of Frida Kahlo’s self-portraits (now on exhibit at the Philadelphia Museum of Art) to a new online gallery called the Pain Exhibit.

The gallery is the brainchild of Mark Collen, 47, a former insurance salesman who struggled to explain his chronic back pain to a new doctor.

“It was only when I started doing art about pain, and physicians saw the art, that they understood what I was going through,” Collen said. “Words are limiting, but art elicits an emotional response.”

Taking it a step further, Collen started soliciting art from pain patients around the world. He teamed up with James Gregory, a 21-year-old college student who suffers from chronic pain following a car accident, and together they created the Pain Exhibit.

Parker-Pope writes:

Finding ways to communicate pain is essential to patients who are suffering, many of whom don’t receive adequate treatment from doctors. In January, Virtual Mentor, the American Medical Association Journal of Ethics, reported that certain groups are less likely to receive adequate pain care. Hispanics are half as likely as whites to receive pain medications in emergency rooms for the same injuries; older women of color have the highest likelihood of being undertreated for cancer pain; and being uneducated is a risk factor for poor pain care in AIDS patients, the journal reported.

Some of the images from the Pain Exhibit, like “Broken People” by Robert S. Beal of Tulsa, Okla., depict the physical side of pain. Others, such as “Against the Barrier to Life,” convey the emotional challenges of chronic pain. “I feel like I am constantly fighting against a tidal wave of pain in order to achieve some quality of life,” wrote the work’s creator, Judith Ann Seabrook of Happy Valley in South Australia. “I am in danger of losing the fight and giving up.”

The art is connecting with medical professionals. The journal of the International Association for the Study of Pain features an image from the exhibit on the cover of its November issue, which focuses on women and pain.

Quieting the Demons and Giving Art a Voice: Like sculpture and painting, writing is also a form of expression and release. This review looks at “Madness: A Bipolar Life,” a new memoir by Marya Hornbacher, whom writer Abigail Zuger, MD, describes as “a virtuoso writer: humorous, articulate and self-aware. She is also, as she has now documented in two books, incurably mentally ill.”

Zuger continues:

For scientists trying to parse the mystery of brain and mind, she is one more case of the possible link between mental illness and artistic creativity. With all our scans and neurotransmitters, we are not much closer to figuring out that relationship than was Lord Byron, who announced that poets are “all crazy” and left it at that. But effective drugs make the question more urgent now: would Virginia Woolf, medicated, have survived to write her final masterpiece, or would she have spent her extra years happily shopping?

Ms. Hornbacher brings to the discussion more than the usual pairing of disturbed brain and talented mind. Her talent has created a third self, an appealing, rueful narrator who can look back on three decades of manic-depressive illness, much of it untreated, and spin a story that is almost impossible to put down.

Zuger also considers “Poets on Prozac: Mental Illness, Treatment and the Creative Process,” edited by Richard M. Berlin, M.D. Essays were solicited from published poets with psychiatric illness.

“Most of the 16 contributors are decades older than Ms. Hornbacher, but while they may lack her vivid prose style, they do supply a long-term perspective on the terrain,” writes Zuger.

Genes Explain Race Disparity in Response to a Heart Drug: This is a fascinating story. Researchers at Washington University and the University of Maryland found that patients who are non-responsive to a beta-blockers used in the treatment of heart failure may be making what amounts to their version of the drug, all the time, due to a gene variant.

What’s also surprising is that as many as 40 percent of blacks have this altered gene, compared to 2 percent of whites. The website of the journal Nature Medicine published a paper explaining the study.

“Something that occurs with a 40 percent frequency is not something that was a blip on the radar screen,” said Dr. Gerald W. Dorn, a cardiologist at Washington University and principal investigator for the study. “It must have given a survival advantage.” — Though what that advantage is is still the big unknown.

Gina Kolata writes:

The discovery raises questions about whom to treat with beta blockers and how to decide, researchers say. But, they add, its implications go beyond heart failure.

For example, the gene variant may help explain why some healthy people cannot exercise vigorously — they may be making chemicals that act like beta blockers, making their hearts beat less forcefully. And variations in other genes might explain why some people with different conditions, like depression, do not respond to drugs used to treat it. It is possible that those people are already making their own versions of antidepressant drugs, and that adding more may not help.

But researchers say that people who make their own beta blockers are not protected from developing heart failure. That is because beta blockers are helpful only after the disease is established. And beta blockers can slow the disease’s progress but not cure it.

Through Sickness, Health and Sex Change: Finally, here’s a story from the Sunday paper about a married couple in New Jersey who are concerned about the legal status of their relationship, since the male partner underwent a sex change in 2005. The couple, who have three children, are still very much committed to each other. Tina Kelley writes:

Massachusetts is the only state to have legalized same-sex marriage, and the Brunners are two women married to each other in New Jersey. As this state (along with Connecticut, Vermont and New Hampshire) confronts challenges over whether its civil unions fulfill the mandate of providing same-sex couples equal rights and benefits, the Brunners offer themselves as Exhibit A on how the nation’s dizzying patchwork of marriage laws, which include the domestic partnerships of California and other states, may be out of step with people’s lives.

And here’s another mind-blowing breakdown of the complexities state by state:

The Brunners were already married when Donald became Denise. Transsexuals who marry after surgery pose a different set of questions, and there have been a number of custody, probate and other cases with decisions all over the legal map.

Urging the United States Supreme Court to tackle the issue in 2000, lawyers for Christie Lee Littleton, a Texas male-to-female transsexual suing her husband’s doctors for wrongful death, noted the confused landscape: “Taking this situation to its logical conclusion, Mrs. Littleton, while in San Antonio, Texas, is a male and has a void marriage; as she travels to Houston, Texas, and enters federal property, she is female and a widow; upon traveling to Kentucky she is female and a widow; but, upon entering Ohio, she is once again male and prohibited from marriage; entering Connecticut, she is again female and may marry; if her travel takes her north to Vermont, she is male and may marry a female; if instead she travels south to New Jersey, she may marry a male.”

The Supreme Court declined to take the case.

E-Mail Discussed Unapproved Use of Drug: “John C. Lechleiter, an Eli Lilly official who is about to become the company’s top executive, wrote an e-mail message in 2003 that appears to have encouraged Lilly to promote its schizophrenia medicine Zyprexa for a use not approved by federal drug regulators,” reports today’s New York Times. Why is this an issue?

The e-mail message was discussed this week in an Anchorage courtroom in a lawsuit against Lilly by the State of Alaska. The suit seeks reimbursement for the medical costs of Medicaid patients who developed diabetes while taking Zyprexa.

The drug causes severe weight gain and cholesterol problems in many patients and has been linked to diabetes.

Zyprexa is federally approved only for use by adults diagnosed with schizophrenia or bipolar disorder. While doctors are free to prescribe it “off label” for any patients for any use, it would be a violation of federal law for Lilly to actively encourage off-label use of the drug.

Bed Rest: Writing at Feminist Law Professors, David S. Cohen describes his wife being prescribed bed rest for preeclampsia and the questions it raises about medical logic and stereotypes.

Online Records: The Washington Post looks at the pros and cons of trusting your health records to online technology. There are now more than 100 websites offering management of personal health records.

Foes of Sex Trade Stung by Eliot Spitzer’s Fall: Until he was linked to a prostitution ring, the about-to-be-former New York governor was a strong ally of human rights groups, “which credit him with what they call the toughest and most comprehensive anti-sex-trade law in the nation,” reports The New York Times. The Times talked with Taina Bien-Aimé, executive director of Equality Now:

Too often, Ms. Bien-Aimé maintained, the public imagines a huge divide between the kind of glamorous call girl depicted in a movie like “Pretty Woman,” and the lurid, violent world of trafficked women in a film like “Eastern Promises.” But they are all part of a commercial sex industry that buys women’s bodies, she said, citing studies that put the average age of entry into prostitution in the United States at 14.

“There’s no sliding scale in the exploitation of women,” she said. “Either you exploit a woman in the commercial sex trade or you don’t.”

Because Mr. Spitzer seemed to agree, she said, “he was our hero.”

Silence Will Not Protect You: “On this day, National Women and Girls HIV/AIDS Awareness Day, AIDS now bears a black female face,” writes Diary of an Anxious Black Woman. “Unlike gay men in the ’80s, however, we are conspicuously silent (or rather “silenced”) in mainstream media and within the national conscience.” She continues:

Unlike gay men in the ’80s, who broke the silences surrounding their sexuality – promoting condom use through newsletters and even in gay porn (even though gay porn and personal relationships of late have dangerously resorted back to “bareback sex”) – black women, who now comprise 70% of new AIDS cases and, if aged between 19 and 44, will most likely die by this disease, have not rallied publicly through collective rage (I’m very angry to see such high statistics among my sisters, aren’t you?). We have not promoted, in TLC fashion (remember when they used to sport those condoms in their clothing?), condom use among women and girls through our erotic fiction, music, and videos (I know at least one porn star who gave out “goodies” at the Harlem Book Fair last summer but didn’t bother to distribute condoms) nor have we staged walkouts at various church services when they promote violent homophobia and “wives submit” type sermons. We have not stormed through the Stock Exchange to demand affordable drugs for black women here and overseas, nor have we staged sit-ins at various corrections facilities and hospitals and schools, which have all colluded in the silent devastation of our communities through the spread of HIV/AIDS.

We have not figured out, as the gay men of the ’80s did, that there is an insidious agenda to let us die.

Expert Hired to Guide Title IX Effort: “The University of Colorado appointed one of its staunchest critics Monday to advise the school on women’s safety issues, fulfilling the final requirement of a $2.85 million settlement with two former students,” reports the Denver Post. “Nancy Hogshead-Makar, an educator and 1984 Olympian, will independently oversee Title IX compliance, including matters regarding sexual harassment, sexual assault and gender discrimination.”

CU, you may remember, made headlines after a former student was raped during a high school recruitment party. The school overhauled its athletic program and several school officials were ousted. Best quote: “The best way to prevent a sex harassment or a sex assault claim is to prevent sexual harassment and sexual assault,” said Hogshead-Makar.

The Long-Term Cost of Childhood Abuse: Middle-aged women who suffered physical or sexual abuse as children spend up to one-third more than average in health care costs, according to a long-term study of more than 3,000 women (mean age: 47 years) that appears in the March issue of the Journal of General Internal Medicine.

After accounting for women’s age and education, the health care costs for women who were sexually abused were 16 percent higher than non-abused women; physically abused women’s costs were 22 percent higher. For women who suffered both types of abuse, their costs rose 36 percent above average.

“What’s remarkable is that women with an average age in their late 40s still suffer consequences from abuse that occurred decades ago,” said Amy Bonomi, associate professor of human development and family science at Ohio State University, who led the study at Group Health in Seattle. “No other study has found that before.”

Pre-schoolers Discuss Body Image, Diversity: Because it’s never too soon.

Celebrate International Women’s Day: Happy IWD to everyone! Here’s the 100-year history and hundreds of events taking place in more than 50 countries.

Lucinda Marshall has reflections on the importance of IWD — and plenty more at Feminist Peace Network. Women’s eNews’ weekly Cheers & Jeers focuses on equality gains and disappointments around the world. Carolyn Byerly writes about the lack of U.S. media coverage.

State of Black America: The State of Black America report was issued this week by the National Urban League. The 2008 edition is subtitled “In the Black Woman’s Voice” and includes essays on the economic, social, psychological and medical challenges that black women face. An executive summary, abstracts and order form can be found in the Urban League’s publication section.

This AP story describes some of the essays. Julianne Malveaux’s “The Status of African-American Women” was republished in Diverse: Issues in Higher Education.

Legislation on Drive-By Mastectomies Stuck in Neutral: “Despite an online petition with 20 million signatures supporting federal legislation that could prevent insurance companies from covering only these so-called drive-through — or outpatient — mastectomies, Congress has been slow to act,” reports the Chicago Tribune. “But after more than 10 years of proposing similar legislation, proponents of the Breast Cancer Patient Protection Act are hoping that with Democrats controlling Congress, the measure might finally be approved.”

Conflict of Interest Much?: “A dispute over food industry influence has resulted in the resignation of the incoming president of the Obesity Society,” reports The New York Times. It seems that Dr. David B. Allison came under fire after the society, which represents obesity doctors and researchers, learned Allison had written an affidavit “as a paid consultant on behalf of the restaurant industry, which is trying to block new rules in New York City that at the end of March will require fast-food and other restaurant chains to list the calories of menu items.”

Plus: “According to some experts whose views are public health heresy, the jury is still out on how dangerous it is to be fat. ‘The obesity epidemic has absolutely been exaggerated,’ said Dr. Vincent Marks, emeritus professor of clinical biochemistry at the University of Surrey,” reports the AP.

Maternal Instinct Wired into the Brain: That’s the headline, anyway, on this incomplete New York Times summary of a study that appeared in Biological Psychiatry. On the upside, it’s a great example of the added-value of commenters, who smartly question the lack of context and potential implications.

Texas Twofer: Rachel points to two Texas stories — the first about a woman kicked out of a mall’s salon for breastfeeding (a violation of company policy and a state statute), and the other about a mother pushing for a policy change after the teenager who raped her now 12-year-daughter was allowed to return to school.

What’s in a Name?: Last month, the Rape Crisis & Abuse Center in Ohio switched back to its old name – Women Helping Women, with the added tagline “Serving Women & Men Who are Victims of Domestic Violence, Sexual Assault & Stalking.”

The change was originally made because the agency also helped male victims of domestic violence, but the new name was considered too off-putting and fundraising dropped, reports the Cincinnati Enquirer. “It was the word,” said Executive Director Ann McDonald. “The word rape scares people.”

An editorial in support of the agency’s decision reads in part:

Besides clouding the fact that the center also works heavily with victims of domestic violence, the old name created distance – the very thing a victims’ advocacy group can’t afford. “We need people to hear us,” McDonald says.

Critics may say the center should have maintained its name on principle, that refusing to back off the word is one way to shatter the stigma. But in this case, a challenge to semantics isn’t as important as keeping a vital service viable and alive.

Call for Abstracts: The Black Women’s Health Imperative invites abstracts from individuals interested in presenting a workshop at the national black women’s health conference, June 20, 2008. The abstract must address topics within one of the three conference tracks: mental health, HIV/AIDS and overweight and obesity. The deadline is March 28.

A Year of Notable Setbacks: Columnist Ellen Goodman celebrates Women’s Equality Day — the anniversary of Aug. 26, 1920, when the 19th Amendment giving women the right to vote became law — with the Equal Rites Awards, her annual tribute to “those who have labored over the last 12 months to set back the cause of women.” Among the many highlights:

Patriarch of the Year Prize. It goes with disappointment to US Supreme Court Justice Anthony Kennedy, whose opinion restricting abortions rested on the retro notion that women needed to be protected from “regret,” “grief,” and “sorrow,” even if it meant protecting them from their rights. We send the paternalistic justice a hook to bring him back to the 21st century.

and …

The Our Bodies/Our Daughters Award goes to Mattel. The folks who brought you Barbie are collaborating on a new line of make-up — for 6- to 9-year-olds. For this we award them and all their ilk a special cosmetic for the next year: egg on their face.

Plus: Gloria Feldt discovers it’s easier to find a card celebrating National Toilet Paper Day than women’s suffrage.

Pour Me Another Cup: “The caffeine in three cups of coffee or tea a day may help maintain mental sharpness in older women, but caffeine consumption appears to have no effect in men,” reports The New York Times. The study appears in the journal Neurology.

The Skinny on Hollywood: Rachel Abramowitz begins this L.A. Times story with a search for body fat in Hollywood. “It’s the 2007 MTV Movie Awards, and judging by the standards of the youth-obsessed network’s magenta carpet, blubber, let alone curves, or even softness is out of fashion. Girls — and I mean girls, given their lack of womanly heft, glide by.”

It’s a good story, but the photos meant to portray the shrinking body size of Hollywood stars manages to fetishize them at the same time — yet another indication that the incredible shrinking woman is something to envy.

“‘Glamour’ Editor To Lady Lawyers: Being Black Is Kinda A Corporate ‘Don’t'”: Just go read Jezebel — it’s all there.

New Primer on Health Care Costs: The Kaiser Family Foundation has released a primer on health care costs (PDF) that examines “the rapid growth in the nation’s health care costs since 1970, when the average growth in health spending exceeded the growth of the economy as a whole by an average of 2.5 percentage points.”

“It also examines the impact of health care costs on families, with insurance premiums rising 87% between 2000 and 2006, more than four times the growth in wages,” continues KFF. “The primer describes the types and sources of health care spending and the demographic factors associated with higher or lower levels of spending. It also discusses other factors that influence health care spending growth, including the use of new medical technology, population changes, and changes in disease prevalence.”

Human Trafficking and HIV: A United Nations report released Wednesday notes that tens of thousands of women forced to work as sex slaves in Asia are at risk of contracting HIV and spreading the virus, reports the AP. If nothing is done to stop human trafficking in the region, “there is just going to be an explosion” of infections, said Caitlin Wiesen of the United Nations Development Program. More from Reuters.

More Doctors Banning Vaginal Births After C-Sections: NPR’s “All Things Considered” last week covered the increase in the number of cesarean births, in part because more and more medical centers have policies against vaginal birth if the mother has already had a c-section.

Plus: Rachel points to CNN’s list of five ways to avoid a c-section.

Monkeys Use “Baby Talk” to Interact With Infants: And you thought only cutesy humans communicated this way. Researchers have found female rhesus monkeys on an island off the coast of Puerto Rico use special vocalizations while interacting with infants, too. When a baby wanders away from its mother, the other female monkeys use the vocalizations, suggesting they are trying to get the infant’s attention.

“The acoustic structure of particular monkey vocalizations called girneys may be adaptively designed to attract young infants and engage their attention, similar to how the acoustic structure of human motherese, or baby talk, allows adults to visually or socially engage with infants,” said Dario Maestripieri, associate professor in comparative human development at the University of Chicago. The study, “Intended Receivers and Functional Significance of Grunt and Girney Vocalizations in Free-Ranging Rhesus Macaques,” appears in the journal Ethology.

Guest blogger Rachel Walden of Women’s Health News is posting here this week, while Christine is on vacation.

The Washington Post is reporting on a new study of physicians’ attitudes and treatment of patients and how racial bias affects their decision-making.

Emergency and internal medicine physicians in Boston and Atlanta were surveyed about their biases, and presented with a case scenario of a hypothetical male patient, who some were told was white, and others were told was African-American.

The physicians demonstrated a number of unconscious biases, including judging the hypothetical black patients to be less cooperative with medical treatment and a decreased likelihood of providing appropriate anti-clot treatment to African-Americans, despite being more likely to identify those patients as having heart attacks.

As the CDC reports, death rates from heart disease were 30% higher in 2002 for African Americans than whites, prompting questions about whether the differences come from biological or treatment disparities. Despite heart disease being the number one killer of women, and African American women suffering from higher rates of death from heart disease than their white counterparts, no female hypothetical patients were included in the study. However, it does suggest that there is work to be done in making sure all patients receive appropriate, evidence-based care free of physician bias.

The Washington Post article requires registration; try BugMeNot if you have trouble logging in. The full-text of the study is freely available online.

Related to this topic, the Department of Health and Human Services’s Hospital Compare tool allows you to search for hospitals in your area and see how they perform on measures such as providing aspirin or other anti-clotting therapy to heart attack patients upon arrival, although this data is not broken down by race.

Also check out OBOS’s Judy Norsigian’s op ed, “Women and Heart Disease: Selling Statins”. The authors challenge the prevailing view that women at risk of heart disease, but who don’t actually have heart disease or diabetes, should take cholesterol-lowering drugs, and examines how the pharmaceutical industry promotes unproven treatments.

Lethal Injections Offer Legal Shield, But Doctors Debate Safety: “In response to the Supreme Court decision upholding the Partial-Birth Abortion Ban Act, many abortion providers in Boston and around the country have adopted a defensive tactic. To avoid any chance of partially delivering a live fetus, they are injecting fetuses with lethal drugs before procedures,” writes Carey Goldberg at the Boston Globe. “That clinical shift in late-term abortions goes deeply against the grain, some doctors say: It poses a slight risk to the woman and offers her no medical benefit.”

Another side-effect of the decision is the impact on medical education. Dr. Mark Nichols, professor of obstetrics and gynecology at Oregon Health & Science University, told the Boston Globe there is great concern among faculty and staff that anyone watching a late-term abortion could potentially misinterpret the procedure and file a criminal complaint. Medical and nursing students, therefore, are no longer invited to watch. The federal ban, writes Goldberg, “is broadly written, does not specify an age for the fetus, and carries a two-year prison sentence.”

Plus: Read Adam Liptak’s column (TimesSelect) about a South Dakota law that quite simply puts the government’s words in a doctor’s mouth. “South Dakota’s solution — to mandate a set of disclosures — stops short of Justice Kennedy’s, which was to uphold a ban on an abortion procedure on the apparent theory that women cannot sort things out for themselves even with full information,” writes Liptak. “But there is, according to the federal courts that have so far blocked the South Dakota law, a constitutional flaw in how the state seeks to go about informing women of its views. The problem with the law, the courts said, is that it would hijack the doctor-patient relationship.”

The Gay Presidential Debate: E.J. Graff has the scoop on how the answers provided by the Democratic presidential candidates who attended the LOGO/Human Rights Campaign debate went over with viewers at the predominantly gay Club Cafe in Boston.

Reproductive Health Pop Culture Sampler: RH Reality Check has put together another good collection of posts, this time looking at the treatment of reproductive health in books, television and film. Check out Andi Zeisler’s reflection on “The Book of Phoebe,” a young adult novel by Mary-Ann Tirone Smith; Joanna Lipper shares the story of how she made a documentary about teenage moms; and Andrea Lynch offers praise for “Sex and the City” and lists the “Top Ten Movies that Deal Honestly with Abortion, Unintended Pregnancy, Sex Ed, and Related Issues.”

Editorial on the Failure of Abstinence Ed: “Congress has spent $1.5 billion in the last 10 years on programs that deliver a single message: Abstain from sex until you marry. That’s a good message for young people about how to stay healthy and safe. Taken alone, though, it doesn’t appear to be a terribly effective message,” begins this Chicago Tribune editorial.

Mo’Nique’s Real Appeal: “Now, after making her way from loud-mouthed, often profane stand-up comedian who embraced the subjects of sex and her size to playing Nikki Parker on the UPN show “The Parkers” from 1999 to 2004, Mo’Nique Imes Hicks presides over a small but growing empire,” reports The New York Times. “Like Oprah Winfrey, Mo’Nique positions herself as an Everywoman, trying to inspire women through her example. She believes fat women need to exercise and stay healthy (as she does), implores black women to embrace psychotherapy as needed (as she did) and asks those moaning about their weight to figure out what is going on in their heads so they can take control of their lives (as she has).”

The Numbers Aren’t Great, But It’s Progress: “According to preliminary figures, 87 women are entering a freshman class of 206 students in September. That 37% share is Caltech’s highest since it began admitting undergraduate women in 1970, when pioneering females comprised 14% of the entering class. (Female doctoral candidates first arrived in the 1950s.),” according to the L.A. Times. Also read Samhita’s post on a Computer World article about the experiences of four successful women in the IT profession.

Growth of Prostitution in China: “No longer limited to well-known bars or a growing number of karaoke parlors, prostitutes are everywhere in China today, branching out onto college campuses, moving into private residential compounds and approaching customers on mobile phone networks,” reports the Washington Post. “There was no open prostitution 25 years ago,” said Jing Jun, a sociology and AIDS policy professor at Tsinghua University. “Among government officials, Chinese social scientists, health professionals, they are coming around to see that prostitution is not fundamentally connected to a lack of values but a lack of jobs, choices, opportunities and education.”

Abortion Legalized in Portugal: Until last month, abortion was not only illegal in Portugal, but women who had abortions could be criminally prosecuted, along with their doctors. Now abortion is available without restriction up to 10 weeks of pregnancy, but women may still have trouble finding someone to perform the procedure, reports the L.A. Times. “Even with the law, numerous doctors are refusing to perform the procedure and are declaring themselves ‘conscientious objectors.’ Several public hospitals said they would not be able to offer abortions, despite the legal obligation to do so, because they lacked the doctors or necessary equipment.”

Heather Stephenson, in a commentary for Women’s eNews, has some good words of advice — and a plan for activism — as we enter the primetime of the summer sun-tanning season.

She believes “a middle path between worshipping the sun and staying indoors altogether does exist” — and she gives plenty of practical advice for negotiating the pros and cons of sunscreens.

But Stephenson also realizes that what prevents women from enjoying this time of year has as much to do with body image as with health concerns. With this in mind, she praises the work of the Dressing Room Project, through which young women offer encouragement to other women “when most women need it: as they’re trying on clothes.”

Stephenson explains:

Female teens involved in the project write messages of affirmation on colorful small cards and post them around the edges of dressing-room mirrors. My favorite says, “Worry about the size of your heart, not the size of your body.”

Like missives from a secret sisterhood, these positive messages catch your eye with their perky colors and interrupt negative self-talk before it starts.

The project’s website includes cards you can view download and other resources — just in time for the hottest days of the year.