U N I V E R S I T Y O F M I C H I G A N — S C H O O L O F P U B L I C H E A L T H C R E C H

C E N T E R F O R R E S E A R C H O N E T H N I C I T Y, C U L T U R E, A N D H E A L T H

Fall/Winter eliminating racial and ethnic disparities in public health 2008 Newsletter

Paul B. Cornely Postdoctoral Program in Ethnicity, SPECIAL ISSUE Culture, and Health Celebrates 20 Years!

n the early 1980s, enrollment of racial and ethnic “minority” students at the University of Michigan was moving in the wrong direction -- down. Even more upsetting was Ithe fact that the numbers for faculty of color were moving in the same direction; far too many were leaving the University. In response, campus organizations such as the Black Action Movement II (BAM II) and the United Coalition Against Racism (UCAR) were putting pressure on the University administration to address The fi rst three Paul B. Cornely the situation. As a result, Provost and Postdoctoral Scholars with the Vice President, James J. Duderstadt, program’s founders organized a series of meetings in order to create what came to be known as WWHEREHERE AREARE THEYTHEY the Michigan Mandate. The Michigan NNOW?OW? Mandate was an organizational/ institutional change strategy that would, according to Dr. Duderstadt, “embrace diversity as the cornerstone “The Center for of excellence” (Jane R. Elgass, The Research on University Record, January 25, 1999). Ethnicity, Culture, Among the mandate’s goals was and Health (CRECH) the creation of a student body and a professoriate that refl ected the racial has been supporting and ethnic diversity of the broader and training the U.S. society. To accomplish this, the “next generation” Michigan Mandate focused on faculty recruitment and development, student of scholars for ten recruitment and achievement, and years now – since its (l-r) Scholars Verna Keith, Dawn Smith, (back row) improving the University environment Marshall Becker, Thomas LaVeist, and inception in 1998.” for diversity. In short, the purpose Harold Neighbors of the mandate was to create a —Neighbors community that supported the aspirations and achievements of all individuals, regardless of race, national origin, or gender.

One component of the mandate’s strategy involved committing fi nancial resources to support innovative campus programs. It is within this context that the Paul B. Cornely Postdoctoral Program was created. In effect, the Cornely Postdoctoral Program was see MANDATE, Page 2 SPH Launches Diversity Program

MANDATE, from page 1 support he received from the colleagues he approached within the school of public health. As a result, the idea for this new postdoctoral program began to take shape.

This idea was thoroughly vetted by many faculty members -- UMSPH faculty members who helped Drs. Neighbors and Becker launch the program were Irene Butter, Linda Chatters, Toby Citrin, Arline Geronimus, Jill Joseph, Neal Krause, Jersey Liang, Richard Lichtenstein, and Ken Warner -- who saw the program as a forward- looking opportunity to change, over one of the fi rst (but certainly not the time, the racial and ethnic composition Cornely Program on the wider public last) programmatic responses by the of the public health academic health community is obvious. We University of Michigan School of Public workforce by providing mentored are sure that you will be impressed Health to the Michigan Mandate’s training for postdoctoral scholars with the key leadership positions into call for action. In 1987, Harold W. from underrepresented groups. On which many of the former scholars Neighbors, who had joined the UMSPH February 3, 1988, with funding from have moved over the years. Their as an Assistant Professor in 1985, the UM Offi ce of Minority Affairs under outstanding scientifi c accomplishments approached then UMSPH Senior the direction of Dr. Charles Moody, are also quite notable. By every Associate Dean for Academic Affairs, Vice Provost for Minority Affairs, funds measure, the Cornely Program has Marshall Becker, with an idea that were committed to establish the Paul been a remarkable success. Also in would address the Mandate’s faculty B. Cornely Postdoctoral Program. this issue we introduce the newest development objective. Neighbors The new postdoctoral program was Cornely Postdoctoral Scholar, Dr. proposed, and Becker agreed, that launched immediately in March 1988 Kristopher Chrishon (page 14). We one way the UMSPH should address and by September of that year, the mention this only to underscore the the issue of faculty diversifi cation fi rst class of Cornely scholars was in fact that the UMSPH Dean’s Offi ce was to create a new postdoctoral residence (see photograph of Drs. remains very supportive of the overall research program focused on Neighbors and Becker along with Drs. goals and ideals represented by the identifying and recruiting early career Keith, LaVeist, and Smith on page one). Cornely Postdoctoral Fellowship. In research scientists from traditionally Dr. Moody and the Offi ce of Minority fact, the Cornely Program is now the underrepresented racial and ethnic Affairs continued to support the Cornely longest running postdoctoral program of groups. The central objective was quite program through 1995, at which time this kind in any school of public health. simple; the UMSPH had a responsibility the School of Public Health, under the CRECH takes this opportunity to thank to recruit and train early career leadership of Dean June Osborn as well Dr. Moody, Dr. Osborn, Dr. James and academicians from groups of color in as the support and advocacy of Senior all of the UMSPH faculty who helped order to increase the likelihood that Associate Dean Sherman James, make the program so successful. more scholars of color would become assumed full fi nancial support for all Finally, CRECH especially wants to faculty within public health and related aspects of the program. thank the UMSPH Dean’s Offi ce for fi elds.1 Neighbors noted at the time that their continued support of the Cornely he was very pleased with the universal In this issue of the CRECH Newsletter, we highlight the accomplishments Postdoctoral Program. 1 Neighbors and Becker would also of many of the former Cornely partner later to recruit successfully such noted UM faculty as Sherman James. Dr. Postdoctoral Scholars. In reviewing James is the Founding Director of the the accomplishments of the featured Center for Research on Ethnicity, Culture, scholars, the positive impact of the and Health. 2 The Inspiration Behind The Cornely Program

r. Cornely received his A.B. vision. His studies of the health Practice of the Howard University in 1928, his M.D. in 1931, status of the Negro in our nation’s College of Medicine. Dand his Dr.P.H. in 1934, all capital demonstrated the need for from the University of Michigan. His a new, vigorous approach to our Dr. Cornely’s contributions Department of Specialization was previously unrecognized problems. in the fi eld of health services Hygiene and Public Health. Dr. Belying personal modesty, he was administration have been signifi cant. Cornely’s dissertation title was “A forthright in affi rming the right of the He was director of the Howard disinherited to an optimal physical University Hospital for a period well-being. of eleven years and president of the Community Group Health His major professional activities Foundation, which administered were in medical education, health the Offi ce of Economic Opportunity, services administration, and he serving a population of 50,000 was a consultant to Federal and people. He pioneered the use of voluntary organizations, both neighborhood health workers as domestic and international. He also early as 1958-60. He founded researched the health problems the District of Columbia Public of the disadvantaged. Dr. Cornely Health Association and was its fi rst

Courtesy of Bentley Historical Library retired in 1973 as Professor President from 1962-64. Dr. Cornely Emeritus in the Department of was president of the American Community Health and Family Public Health Association in 1970.

He conducted research studies in tuberculosis, venereal diseases, Survey of Postgraduate Medical and scarlet fever, utilization of Education in the United States and physicians’ extenders and their an Inquiry into the Educational His studies effect on the cost and quality of Needs of the General Practitioner.” of the health health care, and the effects of social On August 4, 1968 the University and cultural factors on health and of Michigan Board of Regents status of the health care utilization. He published conferred on this alumnus and over 100 scientifi c and popular medical statesman the honorary Negro in our articles. Dr. Cornely passed away degree of Doctor of Science. nation’s capital on February 9, 2002. Dr. Cornely began his career in a demonstrated manner admired by academicians, The staff at the University of Michigan compiling an enviable record the need for a Bentley Historical Library assisted with this article. For more information on Dr. in three different schools of the new, vigorous Cornely’s UM honorary Doctor of Science University. As a specialist in degree, visit the University of Michigan preventive medicine, he attained approach to Board of Regents Proceedings, dated a commanding professional August 4, 1968 at authority culminating in his our previously http://quod.lib.umich.edu/u/umregproc/. nomination to the presidency of the prestigious American Public Health unrecognized Association. As a responsible problems. public-health physician, anxious that health care be made more widely effi cacious, he subsumed his technical insight into a social

3 The First Three Cornely Scholars

he Paul B. Cornely to discuss any data challenge. Postdoctoral Fellowship was Moreover, as I worked on Tan exciting, intellectually my fellowship project—an stimulating experience that investigation of the connections continues to impact my career. among gender, stress, and Trained in social demography and mental health in older adults— doing research on ethnicity and Neal was an invaluable resource access to health care, I applied to when it came to distilling this the program with the purpose of vast literature and understanding incorporating social psychological the key questions driving the perspectives into my research fi eld. I am also indebted to program and to enhance my scholars associated with the statistical and methodological Program for Research on skills. The program exceeded Black Americans who provided my expectations. It provided substantive expertise in the opportunities to expand my health of racial and ethnic research agenda, time to attend minorities. The application of the Society. The confi dence to take seminars and workshops, and time stress perspective to minority health on such responsibilities stems in to interact with scholars conducting remains the linchpin of my work part from various individuals that I pioneering work in public health, today. After leaving the Cornely met during the years I spent at the University of Michigan School of Public Health. They were excellent “The Paul B. Cornely Postdoctoral role models and I continue to draw Fellowship provided opportunities upon what I learned from them to expand my research agenda, regarding professionalism. I am time to attend seminars and see KEITH, page 14 workshops, and time to interact with scholars conducting pioneering work in public health, gerontology, psychology, and sociology.”

—Verna Keith

gerontology, psychology, and Postdoctoral Program, I went in sociology. After being in a faculty search of sunshine and spent position for several years with the sixteen years at Arizona State responsibilities of both teaching University, eventually becoming and research, a complete focus Associate Chair and then Chair on research seemed like nirvana. of the Department of Sociology. Neal Krause, a social psychologist Over the years, I have served on who served as my primary mentor, numerous committees and/or held was a fi rst-rate teacher and guide. elective offi ce in the Association He generously shared his time, of Black Sociologists and the To learn more about Dr. Keith’s giving advice on how to structure American Sociological Association, research, visit her Web site at an article, and overseeing my and now serve on the editorial introduction to advanced statistical boards of the American Sociological http://fsu.edu/~soc/people/keith/. techniques, and was always willing Review and Gender and

4 HIV Statistics t is a joyful experience to testify to the critical impact that the Paul B. Cornely Postdoctoral Fellowship ESTIMATEDRATESOFNEWHIVINFECTIONS, Iyears have had on my career as a public health BYRACE/ETHNICITY,2006 researcher. I grew up pre-civil rights and pre-women’s Black liberation in an isolated rural Michigan Hispanic community where

I had never seen a White “Negro” or female AmericanIndian/ physician. Like many AlaskaNative

African Americans, Asian/ I am the fi rst in my PacificIslander extended family to 0 20406080100 obtain a college Casesper100,000population education, and other than my children, still the only one to have a post-graduate degree. Becoming HIV Incidence a family practitioner was achieving my highest professional goals (I thought). But my fi rst practice • New technology and methodology developed by CDC show that the incidence experience was on the Navajo reservation where I of HIV in the United States is higher than was was introduced to applied public health – TB and STD previously known. However, the incidence contact tracing, plague response teams, and “managed has been stable at that higher level for most care” in a cradle-to-grave entitlement health care of this decade. HIV incidence is the number of system. I came home to Michigan to better understand new HIV infections occurring during a certain the many new questions I had about public health. By time period, in this case, the year 2006. the end of my two-year MPH program, I had become engaged in the HIV/AIDS epidemic. Fortunately, the • These fi ndings, published in a special Cornely Postdoctoral Program was newly established HIV/AIDS issue of the Journal of the American and becoming a Fellow allowed me to remain at the Medical Association (JAMA) that was released University of Michigan and gain the perspectives and August 3, 2008, show that in 2006, an estimated 56,300 new HIV infections occurred skills to become a researcher. During the fellowship, I – a number that is substantially higher than completed the On-Job On-Campus (“OJOC”) program the previous estimate of 40,000 annual in Clinical Research Design and Statistical Analysis and new infections. It should be noted that the worked as a GRA at the Institute for Social Research. new incidence estimate does not represent During this time, I wrote my fi rst NIH grant applications an actual increase in the numbers of HIV (one funded, one not) and helped develop one of the infections. Rather, a separate CDC historical trend analysis published as part of this study fi rst training programs to interest minority researchers suggests that the annual number of new in HIV. The opportunity to learn from, and sometimes infections was never as low as 40,000 and work with, Woody Neighbors, James Jackson, Sherman that it has been roughly stable since the late James, Linda Chatters, Arline Geronimus, Toby Citrin, 1990s (with estimates ranging between 55,000 and so many others prepared me to develop a career and 58,500 during the three most recent time that combines clinical and social approaches to HIV periods analyzed). research domestically and in the developing world. Visit the CDC Web site at: http://cdc.gov/hiv/ topics/surveillance/incidence.htm to monitor At the completion of my fellowship, I went to CDC emerging information on HIV incidence in the to become an Epidemic Intelligence Service Offi cer. United States. Based on the strength of my training, I was asked to lead the development of the fi rst multi-site see SMITH, page 15

5 n September 26, 2008, approach and putting it on its head, the Institute for Health, because instead of looking at social O Social, and Community factors as a predictor of outcomes, Research sponsored the what we try to do is control for those 2nd Annual Shaw University social factors using design rather Disparities Conference entitled than using statistical methods. The “Charting the Way to Change: problem is that the United States is Advancements in Health a highly racially segregated country, Disparities Research.” The so when you use these national Institute Director, Dr. Daniel samples, most of the time you’re Howard, invited Dr. Neighbors comparing black and white people to attend this event, during which time he had a chance to and you’re saying, “These are race conduct a brief interview with disparities.” But these people are Dr. LaVeist. The following are living in very different health risk selected excerpts from that environments. So how do we know interview. that the disparities we see in these Thomas LaVeist: At least we can national samples are really something now have a conversation about it. about race and not the fact that race You’re still going to have to convince NEIGHBORS: My first question is determines the risk environment that me that there really are biological about your research center at Hopkins. you’re exposed to? differences across race groups, but at What is your research looking at and least you’ve accounted for these huge what are some of your findings? NEIGHBORS: What would the results social factors that are almost never mean in a study like yours where we accounted for, and they’re certainly not Thomas LaVeist: Well, the Hopkins still find racial disparities? accounted for in national samples. Center for Health Disparities Solutions was founded in 2002 with a grant Thomas LaVeist: There are still NEIGHBORS: It has been my from the National Center for Minority differences, so it may be a different experience that controversies arise Health and Health Disparities. We risk environment, and we can when we combine race with behavior have a focus on social determinants control for as many of the behavioral and health. Can you talk a little bit of health and a heavy involvement in differences as possible. We try to about some of your experiences in community outreach and community- adjust for the environment by the way studying the role of behavior within based participatory research. The we design the sample, and then we try the context of Black-White health focal project is a study called to control for behavior by measuring disparities? EHDIC, which is Exploring Health behavior and adjusting for that Disparities in Integrated Communities. statistically. They may live in the same Thomas LaVeist: The logic of the We’ve identified racially integrated community, but they’re going to work study is we run analysis in the EHDIC communities throughout the country somewhere else. We can measure data set and run similar analysis in where there are no race differences in that and we can do the best we can National Health Interview survey or income status. So those communities to try to control for that statistically as NHANES. Then we say, “Okay, this is do exist and what we’ve done is well. There’s also a trajectory. They how much of the disparity that we find replicate questions from the National may live there now, but where did they in NHANES that we’re able to explain Health Interview survey so we would come from and what would be the in our data set, which is racially be able to have a national comparison. long-term implications of maybe being integrated.” So we argue that that born poor and then being upwardly proportion of the disparity is caused NEIGHBORS: Tell me more about mobile. by differential environments or risk the main motivation for setting up the exposures. We have a paper looking design this way? NEIGHBORS: It seems to me that at hypertension, and there we’re able you’ve been able to narrow the usual to reduce the odds of hypertension by Thomas LaVeist: It was a way of suspects somewhat. On the other about a third in our community versus trying to get at social determinants. hand, what if the disparities do not go the NHANES. It’s taking the social determinants away in a design like this? see LAVEIST, page 7

6 LAVEIST, from page 6

NEIGHBORS: You mentioned earlier Brazilians, or Afro Caribbeans, and sociology. What I learned at Michigan in our conversation that one of your they all came from these different was that what public health aimed to hypotheses is that Black Americans cultures. In order to survive the do was to take the knowledge from and White Americans are on different madness of the oppression that they the social and the biological and the social trajectories. were enduring, they had to form a medical sciences and put it to use in new culture to take advantage of a way that had always been difficult Thomas LaVeist: I think that’s part of what resources they did have at their as a sociologist. I had always felt it. This is the uncomfortable piece disposal. And this very new culture that there are people dying in the that I thought you were alluding has been massively successful, streets. The social sciences have to earlier when you asked about because they survived and we’re a lot to offer in terms of helping us behavior--which is this cultural factor. still here in the western hemisphere understand why they’re dying in the Because even though some of us may because of the culture that they streets and what might be done to have higher education, higher income, created to make it through the stop that from happening. It had and live in a very nice environment madness of slavery and residential always been frustrating to me that the where we are advantaged in many segregation. It’s an incredibly idea of applying that knowledge was ways, we may still be engaging in successful culture that we should all not respected as much as I thought culturally-related behaviors that place be extremely proud of. Because how it should be in sociology. So the us at increased risk. So eating a many cultures have had to endure that Cornely Fellowship gave me training diet high in sodium, as the African and actually be formed in the midst in public health, which really helped American cultural diet is, high in of that madness? The problem now me to make that transition into the fats, high in sugar, certainly would is that the environment has changed field where I think I really belong. be associated with worse health and the culture is now operating in a It’s Michigan’s influence and what outcomes. You still may have these different environment. The challenges I learned there that I took to Johns behaviorally-related risks that you’re have changed and the culture needs Hopkins. This is why we now have the bringing with you because of the to evolve to the new reality. And there largest number of African American culture. are aspects of that culture, some of faculty of any school of public health the same aspects that caused us to and largely it comes out of what I NEIGHBORS: As a psychologist, survive, that are now harmful to us in wanted to try to create, which was I am very interested in behavior. I the new reality that we’re operating in. something similar to the Program for like behavior because it is closer Research on Black Americans (PRBA) to constructs like personal efficacy. NEIGHBORS: My last question at the Institute for Social Research. So from a personal empowerment focuses on the fact that you spent So I founded the Hopkins Center perspective, a behavioral analysis time here at the University of for Health Disparities Solutions and gives me hope that behavior is Michigan School of Public Health in modeled it after the PRBA. That’s something that we as Black Americans the first cohort of the Paul B. Cornely something that we are proud of at have an opportunity to change. But postdoctoral program. I’d like to close Hopkins, but it’s something that really you’re also correct in that it makes by having you say a few words about was influenced by what Michigan had people uncomfortable. Why is it that how your postdoctoral experience and the feeling that Hopkins should disparities become more controversial contributed to your research program. have something like this too. And when people think about behavior that’s one of the most valuable within the context of racial differences? Thomas LaVeist: Oh, well, my things--one of the most impressive primary public health training came things about Michigan and the School Thomas LaVeist: Because people in the Cornely program. It’s really of Public Health. think that you’re attacking the culture. the experience that’s defined what Thomas LaVeist is the William C. and But my perspective is this: African my career has become. I mean, Nancy F. Richardson Professor in American culture is a very young my background and training are in Health Policy, and Director, Center for culture. African American culture was sociology and it was after doing the Health Disparities Solutions at Johns formed to help Africans who were Cornely postdoctoral program that it Hopkins University. For details, Visit http://www.jhsph.edu/healthdisparities/ being brought across the Atlantic to became clear to me that my future index.html. become African Americans, or Afro was going to be in public health, not in

7 Cornely Postdocs — Where Are They Now?

aniel L. Howard, Ph.D. “The growing recognition that is a Professor of Health predictors of health status, DPolicy and Director of the Institute for Health, Social, the distribution of diseases, and Community Research at patterns of utilization, and health Shaw University. Dr. Howard outcomes are determined by received his Bachelor’s Degree in Economics from the University social factors indicates the need of Michigan in 1987 and his to develop minority scholars Ph.D. in Policy Development and who are sensitive to the range Program Evaluation from the Vanderbilt University Peabody College of Education and Human Development in 1992. of diversity in health issues in He completed a two-year postdoctoral fellowship at the U.S. society. It is of great import University of Michigan School of Public Health and School to mentor scientists who will of Social Work as a Paul Cornely and Ford Foundation begin to examine issues of health Postdoctoral Scholar in 1994. within the context of there being Dr. Howard’s research during his Cornely Fellowship variation of culture and ethnicity resulted in an article entitled “Disaggregating the Effects in health attitudes, behavior, and of Race on Breast Cancer Survival,” published in Family Medicine (with Roy Penchansky). Also during medical decision-making.” his postdoctoral fellowship, Dr. Howard developed an interest in substance abuse research while working with Dr. Thomas D’Aunno. This association has resulted in identifying individual and institutional role models. In several articles over the years. In fact, Dr. Howard remains 2001, he received the Historically Black College and active with Dr. D’Aunno on an NIDA-funded grant and has University Spotlight on Excellence Administrator/Faculty recently submitted his own NIDA Center application. His Award from Black Voices Quarterly Magazine and General career goals involve continued research on the impact Motors Corporation. of race on the quality of medical care received by African Americans. His work has identified racial disparities that Dr. Howard is best known for his development of one of are attributable to attitudes and behaviors. Dr. Howard the first EXPORT research centers at a historically Black is committed to the development of young, extraordinary, institution. In 2002, Shaw University, with Dr. Howard as minority social scientists in the area of public health. Principal Investigator, was the only university in the nation to hold two NIH NCMHD Project EXPORT grants. It was Dr. Howard is a founding member of the executive noted by the 2004 NIH external scientific program advisory committee for the Academy for Health Equity, a national committee that “Shaw University should be viewed as the organization dedicated to creating a social movement ‘showcase’ model for addressing health disparities.” His designed to ensure equal opportunity for health. He center has been extremely important in developing a solid was invited to serve on and elected chairman of the foundation in order to ensure that Shaw, a minority-serving external advisory board of the Winston-Salem State institution, can take a primary role in conducting research University Center of Excellence for the Elimination of Health on minorities. In this way, he has developed the capacity of Disparities, funded by the NIH Centers of Excellence in Shaw, its faculty and students, to conduct rigorous scientific Partnerships for Community Outreach, Research on Health research. Disparities and Training (EXPORT), 2007- 2012. In 2006, To learn more about Dr. Howard’s research, visit: he received the National Role Model Researcher Award http://www.ihscr.org/x/basicinfo/ihscr_home.html. from Minority Access, Inc., a nonprofit organization that increases the pool of minority biomedical researchers by

8 Research at Michigan State University. The fellowship made such an impact While completing my dissertation I on my career plans that I decided to started working for Ken Warner at the pursue a career in Public Health. When University of Michigan School of Public I finished the fellowship, I applied for a Health as a Research Associate on a faculty position at Michigan’s SPH and project to study the cost effectiveness then joined the department of Health of radon mitigation. That project Management and Policy, where I have awakened my interest in Public Health been ever since. I am currently an and the desire to learn more about Associate Professor in the department the field. I then applied for a Cornely and, following my fellowship work, I Fellowship which was awarded when I continue to do research on tobacco finished my dissertation. The fellowship control. The Cornely fellowship gave allowed me to learn and explore the me a rewarding career opportunity that breadth of Public Health topics. I used I would not have been able to pursue the fellowship to continue working otherwise. on the radon project with Ken while was trained as a Civil Engineer starting to research the area of tobacco during my undergraduate studies control. I attended several courses in David Mendez is an Associate I in the Dominican Republic. After SPH that allowed me to understand Professor in the Department of working for a few years as a computer the wide scope of Public Health topics Health Management and Policy at the University of Michigan School of analyst for the government’s natural and taught a quantitative analysis Public Health. To obtain additional resources conservation project, I came course in Health Management and information about Dr. Mendez, visit the to the US to pursue graduate studies Policy which put me in direct contact Department’s Web site at in Systems Science and Operations with Public Health Master’s students. http://www.sph.umich.edu/hmp/.

s a Cornely Postdoctoral Fellow and value placed upon emotions in husband and three children. I decided at the University of Michigan disease among the traditional medical to leave the university to raise my family ASchool of Public Health, I began specialists (i.e., traditional healers) of and to home school my children. It was my career as a scholar of the mind- central and southern Kenya. necessary to postpone a career as an body relationship. The fellowship gave academician to ensure the happiness of me an opportunity to investigate the After the Cornely Postdoctoral period, I my home and children. relationships among psychological took a tenure track position as Assistant factors of thought and emotion and the Professor of Psychology and Pan See CUMMINGS, page 15 incidence and prevalence of disease. African Studies at the University of My dissertation, “Psychosomatic Issues Louisville in Kentucky. My research in Black Women’s Health,” led me to interests there broadened to include formulate a theory of the dynamics biofeedback and the stress response, between emotional and mental stress and blood pressure, asthma prevalence and environmental “As a full-time wife, mother and teacher pollutants, and and part-time community organizer, the relationship I continue to be interested in a life of between prayer research, scholarship, and activism. and health. ” But alas, being untenured and attitudes and physical health status. obligated in two different departments Also, as a Fellow, I traveled to Kenya, at the University, I found it very East Africa to investigate the role of difficult to balance my obligations to my

9 y most recent child health and is to improve strategies for engaging appointment policy analysis and appropriately retaining this Mis the from my mentors population in therapeutic treatment. second most exciting -- Drs. Kristine academic challenge Siefert and Over the years I have maintained my in my career, with the Barry Rabe. connections with my surrogate family Cornely Postdoctoral In addition to from the Cornely Postdoctoral program, Fellowship being my primary as well as the fellows in my cohort— the fi rst. Since mentors, other Drs. Thomas LaViest and Verna Keith. completing the Cornely researchers I found the entire experience to be Postdoctoral Program, I provided academically nurturing and I would have been a very active the support I not be where I am today had there not academic with a range needed to stay been the cadre of African American of activities that accompany a tenure- focused, i.e., Drs. Chatters, Taylor, scholars in both the School of Social track faculty position. I enjoy a joint and Neighbors, who provided support Work and School of Public Health who appointment in the School of Social to help facilitate my research agenda. were telling me, “You can.” Work and Graduate School of Public Other faculty associated with the Health, which represents my long-term fellowship program in the School of Current Positions/ Publications research interest in the health and Public Health and School of Social mental health concerns of women and Work provided instrumental support. It Director, Doctoral Program, School children. My initial work in this area was a collaborative effort! of Social Work focused on community health problems, programs, and policies in maternal and My initial research agenda grew out of Associate Professor, child health populations. I was very my dissertation and as a postdoctoral School of Social Work and Department of Behavioral and interested in child health policies which scholar, I learned that my fi rst Community Health Sciences impact the health status of low income publications should result from my Graduate School of Public Health children. I also spent a great deal of dissertation. This became a reality. Dr. time researching the Early and Periodic Siefert was instrumental in the “carving Associate Director, Center Screening Diagnosis and Treatment out” process and Dr. Rabe provided for Maternal and Child Health Program, a federally-mandated, state- the expertise in policy implementation Leadership, Graduate School of Public Health administered program for Medicaid- which helped sharpen my analytic eligible children. My research interest skills. I was very fortunate to be a Faculty Affi liate, Center for focused on the extent to which Cornely postdoc in that I learned how Minority Health in the children actually benefi ted from the to survive in academia. As a result Graduate School of Public implementation of this program. My of that experience, I have a habit of Health interest in policy implementation was strongly recommending other Ph.D. University of Pittsburgh one of the reasons I sought the Cornely graduates in Social Work to consider Valire Carr Copeland, Ph.D., M.P.H., Postdoctoral Fellowship. a postdoctoral fellowship before taking received her BSW from Livingstone that initial tenure-track position. This College in her hometown of Salisbury, My public health/social work interim position facilitates a more North Carolina, and her MSW, Ph.D., background was well-suited to pursuing effi cient transition into the academy. and MPH from the University of the Cornely Fellowship Program. Pittsburgh. Her publications can Given my research interest, I wanted After tenure, my research expanded be found in Health and Social Work, a postdoctoral experience where there from child health policy to mental health the Journal of Sociology and Social was interdisciplinary work between both disparities in African American women Welfare, Journal of Health and Social a School of Social Work and a School and adolescents with a particular focus Policy, African American Perspectives, of Public Health. This fellowship on therapeutic engagement. One of Research on Social Work Practice, was perfect to nurture my growth my current investigations is entitled Journal of Teaching in Social Work, and development as a researcher. I “African American Adolescents’ Beliefs Mental Health Services Research, and learned a great deal about writing for about Mental Illness, Treatment, and the Child and Adolescent Social Work publication in the areas of maternal and Outcome.” The purpose of this project Journal. http://www.socialwork.pitt.edu/people/ 10 copeland.php. year follow-up study of the Woodlawn neighborhood study.

As a Faculty Associate in the Center for Research on Health Disparities at Clemson, Dr. Breeden plans to study differences between suicidal behaviors and mental health services use among college students from rural versus urban areas in South Carolina. He hopes to replicate his fi ndings in similar African or Caribbean populations and to explore ethnic and cultural differences related to r. Gregory Breeden is currently improving mental health services for an Assistant Professor in Blacks in the United States, especially ince my time as a CRECH the Department of Public D those living in the south. Postdoctoral Fellow, I have Health Sciences at Clemson Shad a number of rewarding University in South Carolina. A social In terms of preparing him for his opportunities and exciting events take and behavioral scientist trained in academic career, Breeden notes that place. The most signifi cant change public health at the Johns Hopkins the Cornely Postdoctoral Fellowship that has taken place in my life is Bloomberg School of Public Health, not only helped to jumpstart his becoming a new mom! The new his research explores the inter- research career by allowing him to addition to my family has changed my relationships among perceived create a clear and focused research life for the better. The word “busy” discrimination, mental health, gender, agenda, but also prepared him for a takes on new meaning, but every and race over the life course among successful teaching career. Last year, minute with my son is extremely minority populations. As the 2004-07 Dr. Breeden taught a course in Theory gratifying and fulfi lling. He’s such Paul B. Cornely Postdoctoral Fellow, of Health Behavior Change, where he a great baby! I’m entering my fi fth Dr. Breeden continued his research in was nominated Teacher of the Year. year as an Assistant Professor at perceived discrimination, especially in While at Clemson, Breeden intends the University of South Florida in the relation to health and social outcomes to develop and maintain his own School of Aging Studies. I continue such as suicidal behaviors among research program in minority health, to conduct research on disparities in African Americans, using the NIMH- both domestically and abroad. chronic pain and pain management funded National Survey of American among older adults from diverse Life. In a paper published in JAMA Gregory Breeden, PhD racial groups, with an emphasis on on the suicidal behaviors of African Assistant Professor intra-race group variability. My work Americans and Caribbean Blacks in Department of Public Health Sciences continues to be recognized nationally the United States, Breeden and his Clemson University and internationally and I have been Michigan colleagues found that the invited to speak at a number of greatest lifetime prevalence for suicide venues, including Cornell University, attempts occurred among Caribbean the Center for Health Equity Research black males. Given this important and Promotion [CHERP], and the fi nding, Breeden is now revising a American Psychological Association’s racial discrimination measure he Science Leadership Conference (APA developed in graduate school for the SciL). The APA SciL conference was old follow-up study to capture cultural of particular importance because I was notions of discrimination that may recognized by agency offi cials at the explain suicidal behaviors within the National Institute on Aging (NIA) as Caribbean Black population. This being an up and coming scholar in my new measure will be used in a 40- see BAKER, page 12

11 BAKER, from page 11 to my experience with Dr. Chatters, Dr. Green was defi nitely a motivating area of research (chronic pain among factor in my success as a CRECH diverse elderly populations). As a Postdoctoral Scholar. As a “postdoc” result of this recognition, I was asked on Dr. Green’s MPOST research team, to present my research in Washington, I was afforded the opportunity to be a DC to local policymakers, APA co-author and fi rst author on several board members, and congressmen. manuscripts with her. Dr. Green was I was also invited to speak on race also very instrumental in the design and disability at the International and methods of my research on Conference and Research Center chronic pain among older adults during for Computer Science at Dagstuhl my stint as a postdoctoral fellow. My in Saarland, Germany. Other experiences as a Cornely Postdoctoral accomplishments since my years as a Scholar, along with my mentor-mentee postdoctoral scholar include receiving relationships with Drs. Chatters and a Minority Supplement funded by Green, are well cherished, and I can he fi rst half of this year has the National Institute on Arthritis and only hope that other junior scholars been one full of excitement Musculoskeletal and Skin Diseases are as fortunate as I was to have and transition. By the end of (NIAMS), and submitting a K01 had such an invaluable postdoctoral March 2008, my term as the application to the National Cancer experience. T Paul B. Cornely Fellow at CRECH was Institute. My research continues to coming to an end and I was preparing be published in mid and top-tiered to embark on a research career with referred journals and has been cited Northrop Grumman Corporation, a in the New York Times, Pain Medicine contractor for the Centers of Disease News, and the USF News. I have also Control and Prevention (CDC) in been interviewed (as a “health expert”) Atlanta, Georgia. My new role as a on Bay News 9 (Tampa Bay’s local Health Research Analyst focuses on news channel) on arthritis and pain diabetes risk factors, diagnosis, and among older adults. I attribute much of complications for the CDC Division of my success to my experiences as the Diabetes Translation. Paul B. Cornely Postdoctoral Scholar. Working with Drs. Linda Chatters In addition to my work with the CDC, I and Carmen Green defi nitely helped continue to collaborate with colleagues me to refi ne my research interests at the University of Michigan on and skills. Dr. Chatters, for example, So, in a nutshell…life is good (and projects related to mental health. provided invaluable feedback on my busy), the weather in Tampa is great Current manuscripts on which I am manuscripts (all of which have been (yes, the sun does shine at least 350 working include those with Dr. Robert published), and grant applications. days out of the year), and being a new Taylor of the School of Social Work on She was a signifi cant resource in my mom is wonderful! What more could family support and the prevalence of submitting a grant application to the one possibly ask for? mental disorders in African Americans, Michigan Center for Urban African and with Dr. Amanda Toler Woodward American Aging Research, which was of Michigan State University on the funded during my second year as a Tamara Baker, PhD use of complementary and alternative Cornely “postdoc.” Findings from that Assistant Professor medicine. While working with Dr. project have since been published and School of Aging Studies Harold Neighbors, I was able to further presented at numerous venues. Dr. University of South Florida develop my analytic skills with projects Chatters has and continues to be a For more details, visit http:// addressing racial and ethnic disparities wonderful mentor (and friend)! Similar agingstudies.usf.edu/faculty/tbaker/. in mental health. One such project

see BULLARD, page 13

12

Diabetes: Facts on Risk Factors and Prevention BULLARD, from page 12

Diabetes is a serious, life-long disease. It cannot be cured, but investigated patterns of how informal social control of blood glucose, blood pressure, and cholesterol can networks and professional help sources are prevent or delay the complications of this disease. A great deal used in combination to cope with serious of research is underway to fi nd out exactly what causes diabetes emotional problems. Another study explored and how to prevent it. racial comparisons in the exposure to and impact of stressful life events on vulnerability At present, scientists do not know exactly what causes the body’s immune system to attack the cells, but they believe that both genetic factors and for depressive symptoms. Our plans are to environmental factors, such as viruses, are involved. Studies have begun continue this work and submit the papers for to try to identify these factors and prevent type 1 diabetes in people at risk. publication.

Type 2 diabetes -- the most common form -- is linked to obesity, high blood pressure, and abnormal cholesterol levels. About 80 percent of people with The UMSPH Paul B. Cornely Postdoctoral type 2 diabetes are overweight. Being overweight can keep your body from Fellowship created a fantastic opportunity using insulin properly. for me to work with my mentors on preparing and submitting manuscripts for publication.

Being over 45 years of age and overweight or The Cornely Fellowship also afforded me obese raises the risk of developing type 2 the time to forge new collaborations with diabetes. Other risk factors include: colleagues across the University of Michigan. ►having a fi rst-degree relative -- a parent, brother, or sister -- with I cannot think of a better bridge between the diabetes doctoral program and my current career than ►being African American, American Indian or Alaska Native, Asian the Paul B. Cornely Postdoctoral Fellowship, American or Pacifi c Islander, or Hispanic American/Latino and my gratitude for the opportunity is ►having gestational diabetes, or giving birth to at least one baby sincere. weighing more than 9 pounds ►having blood pressure of 140/90 or higher, or having been told Kai McKeever Bullard, PhD MPH that you have high blood pressure Northrop Grumman Corporation ►having abnormal cholesterol levels -- an HDL cholesterol level Health Research Analyst of 35 or lower, or a triglyceride level of 250 or higher Division of Diabetes Translation ►being inactive or exercising fewer than three times a week Centers for Disease Control and Prevention ►having polycystic ovarian syndrome, also called PCOS (women only) ► on previous testing, having impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) ►history of cardiovascular disease

Before people develop type 2 diabetes, they usually have pre-diabetes, a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes.

People with pre-diabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Pre-diabetes is common in America, according to new estimates. In 2002, about 54 million people in the U.S. had The CRECH newsletter is also pre-diabetes. available online. Some women develop gestational diabetes during the late stages of Please e-mail the articles you pregnancy. Although this form of diabetes usually goes away after read on these pages to others the baby is born, a woman who has had it and her child are more who care or are interested in likely to develop type 2 diabetes later in life. Gestational diabetes is racial and ethnic disparities in caused by the hormones of pregnancy or a shortage of insulin. public health.

Visit www.crech.org/. To learn more: http://nihseniorhealth.gov/

13 Cornely Postdoctoral Fellow: 2008-2010

implicating clinicians’ use of race- In keeping with a commitment to based stereotypes to inform diagnostic interdisciplinary research, Diane Brown judgment, further research is necessary and I edited a volume, In and Out of to clarify how clinicians incorporate Our Right Minds: African American cultural information into the diagnostic Women’s Mental Health, dedicated assessment process. to analyzing how the triangulation of race, class, and gender promotes both Kristopher Chrishon, PhD '08 mental health risk and resiliencies for CRECH Cornely Postdoctoral Fellow black women, which brings together Kristopher Chrishon recently completed scholars of varying backgrounds. After his doctoral studies in Epidemiology at editing the book, Skin Deep: How Race Columbia University’s Mailman School of and Complexion Matter in the Color Public Health. Before entering Columbia, he Blind Era with colleagues, I continue y dissertation explored the received an MA in General Psychology from to do research on the consequences infl uence of hospital factors The Catholic University of America in 1999 of variations in phenotypic appearance Mon racial differences in and an MPH in Health Behavior and Health among ethnic and racial groups. I also diagnostic patterns within inpatient Education from The University of Michigan am conducting research to determine if settings. Specifi cally, I investigated in 2001. Dr. Chrishon’s research interests differences in complexion and related whether there were racial differences focus generally on African American mental physical features are associated with in primary discharge diagnoses of health and specifi cally on the impact of race variations in race-based discrimination psychotic and mood disorders. I on the psychiatric diagnostic assessment and, in turn, such outcomes as also investigated whether hospital process. depression and substance use among characteristics had an independent African Americans and those of infl uence on diagnostic patterns. Mexican origin. I made many lasting Black Americans had a signifi cantly KEITH, from page 4 friends and professional contacts during higher likelihood of being diagnosed now Professor of Sociology and a my years as a Cornely Fellow, and with a psychotic disorder while White faculty member in the Center for those relationships continue to guide Americans were more likely to receive Demography and Population Health and sustain my career. a diagnosis of mood disorder. Gender, at Florida State University. Although age, insurance status, and length of the Center is interdisciplinary and I have spent most of my career in stay had little infl uence on this basic CRECH FACULTY and STAFF diagnostic pattern. Similarly, hospital sociology, I was well prepared for Harold W. Neighbors characteristics such as ownership, bed the mix of scholars. My years at the Director size, teaching/non-teaching, region, University of Michigan taught me the and urbanicity did not infl uence the value of attacking a problem from the Amy J. Schulz pattern. These fi ndings suggest two perspective of many disciplines and I Associate Director interpretations. First, it could be that have always gone about my research Cleopatra H. Caldwell Black Americans indeed have higher in that way. With an ongoing focus Associate Director rates of psychotic disorders and lower on race, class, and gender disparities rates of mood disorders than White in health and mental health, I am Trivellore E. Raghunathan Americans. However, equally plausible currently working with colleagues on Associate Director is the idea that Black Americans are a study of the physical and mental misdiagnosed and that Black and White health of Katrina survivors, funded by Derek M. Griffi th Americans instead have equivalent the National Science Foundation. The Assistant Director rates of mood and psychotic disorders. project brings together the disciplines Lynda Fuerstnau Though each proposition is tenable, of geography, nursing science, history, Center Administrator the latter is problematic, since it and sociology to investigate evacuation implies that Black Americans receive and resettlement of an eastern New Newsletter Design/Illustration/ inappropriate and ineffective treatment. Orleans zip code inhabited by African Online Editor Despite a substantial literature Americans and Vietnamese Americans. Lynda Fuerstnau [email protected] 14 SMITH, from page 5 CUMMINGS, from page 9 observational study to assess the from my time at ISR and contribute to Currently, I teach part time and on-line effects of HIV infection on US women, a very underdeveloped area in clinical for my former employer. In addition, I HIV Epidemiology Research study. trial-related research. am active in home school community After several productive years with groups, organizing a support group, that study and other years addressing Now that I am back in Atlanta, my new developing an annual history and the growing racial/ethnic disparities role as Associate Chief for Science science fair, and a debate club for in HIV/AIDS, I changed focus in the Epidemiology Branch of the children. I am also politically active from epidemiology and treatment Division of HIV/AIDS Prevention, and remain interested in improving the issues to prevention science. My continues my focus on prevention health and social conditions of poor colleagues and I developed the research for heavily affected Americans. As a full-time wife, mother CDC research agenda for testing communities, both in developing and teacher and part-time community biomedical prevention interventions, countries and domestically. In organizer, I continue to be interested beginning with a five-year plan for addition, my portfolio includes planning in a life of research, scholarship, and topical microbicide research. While for implementation of biomedical activism. I look forward to having we were building that capacity, I interventions (e.g., male circumcision, time to pursue a career again when began to do some international work pre-exposure prophylaxis) in ways my children are on their own. My where combining social and clinical that can maximize their impact on mission now is to fi gure out whether research is especially critical. The the incidence of HIV. This includes that career will be in the academy early work included a study of how research (e.g., focus groups with or in forging alliances between the best to counsel discordant couples in potential users, cost effectiveness academy and the politics of Uganda, as well as an assessment analyses), building effective advocacy change. of how best to include HIV post- in a variety of communities, and exposure prophylaxis into the sexual soliciting the planning needs of public assault clinics in South Africa. Then health providers and policymakers. •Carol Marie Cummings, Ph.D. I spent four years in Botswana, one Also, as CDC increasingly turns its University of Michigan, Social Psychology -- 1991 of the world’s most heavily infected resources to reducing the domestic countries, building a clinical trial site racial/ethnic disparities in HIV, I am •Cornely Postdoctoral Fellow 1991- 1993 for CDC to evaluate microbicides blessed to be able to mentor young and pre-exposure prophylaxis. In minority researchers in our Minority •University of Louisville, Assistant addition to developing laboratories AIDS Research Initiative and help Professor of Psychology and Pan African Studies 1993 – 1998 and data management systems, shape the prevention research agenda this work required every sociology/ for African Americans and Hispanics. social psychology and public health engagement skill that I had learned in my years at Michigan. Building When I first set foot on the ground “research literacy” in the community, in mother Africa, I remember hoping setting up structures to garner ongoing that whatever I contributed there input from several layers of the local would be a “value-added” return of and national community, learning how what was stolen when my great-great to explain trial goals and procedures grandparents were brought to America to participants and incorporate their as slaves from Guinea. And like all sentiments and ideas into the trial of us, I want my accomplishments design, and establishing a media in life to be a realization of what the strategy are a few of the many ways generations of my family invested in its in which clinical science skills alone young. I believe that the opportunities were insufficient. Designing surveys, and training provided by the Paul B. qualitative interviews, and rapid Cornely Fellowship encompass a large ethnographic assessments allowed part of what I am able to contribute me to use training and experience through my work.

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CRECH C A L E N D A R CRECH News Highlights Fall 2008 Former CRECH Cornely October 14, 2008 Postdoctoral Fellow 3:30-5 pm Publishes In Journal Of 1655 SPH Crossroads Gerontology Vence Bonham, Jr., J.D., Chief, Education and Community Involvement Branch, Senior Advisor to the Director of Former CRECH Cornely Postdoctoral Societal Implications on Genomics, National Human Fellow, Tamara Baker, in collaboration Genome Research Institute (NHGRI/NIH). with Jessica M. McIlvance, and Chivon BONHAM A. Mingo, have published an article entitled “Racial Differences in Arthritis- “The Role of Race in the Genomic Era: Policy Related Stress, Chronic Life Stress, Implications and Clinical Decision Making“ and Depressive Symptoms Among Women With Arthritis: A Contextual Edward Ramos, PhD., Science Policy Analyst, National Perspective.” Jounal of Gerontology: Human Genome Research Institute (NHGRI/NIH). Social Sciences. To read the article, visit www.crech.org.

RAMOS November 18, 2008 3:30-5 pm Aud II, SPH II October 25-29, 2008 “Disentangling Race and Socioeconomic Status: APHA Annual Meeting Advancing Understanding of Race Disparities in Health” The Mental Health Thomas A. LaVeist, PhD Section of William C. & Nancy F. Richardson Professor in Health the American LAVEIST Policy, Director, Hopkins Center for Health Disparities Public Health Solutions, Johns Hopkins Bloomberg School of Public Association Health (APHA) has awarded December 2, 2008 CRECH 3:30-5 pm Darrell Hudson and 1690, SPH 1A Harold Neighbors at the scholar, 2008 APHA. Darrell “The NIH Health Disparities Research Agenda” Hudson, the Ken Lutterman award. This award is Health Scientist Administrator in the Extramural for the best student presentation paper HILL Associates Program, National Institute of Child Health at the Annual APHA Convention. Each and Human Development, NIH year, the Mental Health section honors several leaders in the fi eld of mental health research and treatment. The awards are presented during the Annual Meeting. Mr. Hudson’s presentation at CRECH Fall/Winter 2008 Newsletter APHA was held on Monday, October 27, 2008. The title of Mr. Hudson’s University of Michigan School of Public Health paper is “Costs of Mobility: Examining Center for Research on Ethnicity, Culture, and Health Room 2858 the Effects of Racial Discrimination and 109 South Observatory John Henryism on Depression among Ann Arbor, Michigan 48109-2029 African Americans in a Nationally Representative Sample.” To read the summary, visit www.crech.org.