African-American youth exposed to more magazine and television alcohol advertising than youth in general

African-American youth ages 12-20 are seeing more advertisements for alcohol in magazines and on TV compared with all youth ages 12-20, according to a new report from the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health. 

The report analyzes alcohol exposure by type and brand among African-American youth in comparison to all youth. It also assesses exposure of African-American youth to alcohol advertising relative to African-American adults across various media venues using the most recent year(s) of data available.

Alcohol is the most widely used drug among African-American youth, and is associated with violence, motor vehicle crashes and the spread of sexually transmitted diseases. At least 14 studies have found that the more young people are exposed to alcohol advertising and marketing, the more likely they are to drink, or if they are already drinking, to drink more.

"The report's central finding — that African-American youth are being over-exposed to alcohol advertising — is a result of two key phenomena," said author David Jernigan, PhD, the director of CAMY. "First, brands are specifically targeting African-American audiences and, secondly, African-American media habits make them more vulnerable to alcohol advertising in general because of higher levels of media consumption. As a result, there should be a commitment from alcohol marketers to cut exposure to this high-risk population."

The report finds certain brands, channels and formats overexpose African-American youth to alcohol advertisements: • Magazines: African-American youth saw 32 percent more alcohol advertising than all youth in national magazines during 2008. Five publications with high African-American youth readership generated at least twice as much exposure to African-American youth compared to all youth: Jet (440 percent more), Essence (435 percent more), Ebony (426 percent more), Black Enterprise (421 percent more), and Vibe (328 percent more ). Five brands of alcohol overexposed African-American youth compared to all youth and to African-American adults: Seagram's Twisted Gin, Seagram's Extra Dry Gin, Jacques Cardin Cognac, 1800 Silver Tequila, and Hennessey Cognacs. • Television: African-American youth were exposed to 17 percent more advertising per capita than all youth in 2009, including 20 percent more exposure to distilled spirits advertising. Several networks generated at least twice as much African-American youth exposure to alcohol advertising than all youth: TV One (453 percent more), BET (344 percent more), SoapNet (299 percent more), CNN (130 percent more) and TNT (122 percent more). • Radio: African-American youth heard 26 percent less advertising in 2009 for alcohol than all youth on stations with the most advanced measurement data available; however, they heard 32 percent more radio advertising for distilled spirits. In these markets, four station formats delivered more alcohol advertising exposure to African-American youth than to African-American adults: Contemporary Hit/Rhythmic (104 percent more), Contemporary Hit/Pop (14 percent more), Urban (13 percent more) and Hot Adult Contemporary (43 percent more).

"Alcohol products and imagery continue to pervade African-American youth culture, despite the well known negative health consequences," said Denise Herd, PhD, an associate professor with the University of California Berkeley School of Public Health who reviewed the report. "The findings of this report make clear immediate action is needed to protect the health and well-being of young African Americans."

According to the U.S. Centers for Disease Control and Prevention's Youth Risk Behavior Survey, about one in three African-American high school students in the U.S. are current drinkers, and about 40 percent of those who drink report binge drinking. While alcohol use and binge drinking tend to be less common among African-American adults than among other racial and ethnic groups, African-American adults who binge drink tend to do so more frequently and with higher intensity than non-African Americans.

In 2003, trade groups for beer and distilled spirits committed to placing alcohol ads in media venues only when underage youth comprise 30 percent of the audience or less. Since that time, a number of groups and officials, including the National Research Council, the Institute of Medicine and 24 state attorneys general, have called upon the alcohol industry to strengthen its standard and meet a "proportional" 15 percent placement standard, given that the group most at risk for underage drinking — 12 to 20 year-olds — is less than 15 percent of the U.S. population.

Among voters lacking strong party preferences, Obama faces 20 percent handicap due to race bias

An online study of eligible voters around the country revealed that the preference for whites over blacks is the strongest in the least politically-partisan voters. Among these voters, race biases against Barack Obama could produce as much as a 20 percent gap in the popular vote in a contest that would otherwise be equal.

"Although they may not determine the election outcome, race biases are having a strong anti-Obama effect among the least politically partisan voters," said Anthony Greenwald, a University of Washington psychology professor who conducted the survey. "If present pre-election polling is accurate, the effect of racial attitudes will have their effect on Barack Obama's winning margin but not on the election outcome."

Most recent polls show Obama in the lead. This suggests that although race biases are a "hill he has to climb, the polls indicate that he's actually climbing it," Greenwald said. "People who have race biases against Obama may still believe he's preferable to Mitt Romney for other reasons, and so race attitudes do not appear to be potent enough to overcome the other sources of favorability for Obama."

About 8,600 eligible voters participated in Greenwald's latest online survey, collected from July through September. Eighty percent of the respondents were white, approximating the electorate. However, because the sample had a substantial majority of liberals it should not be considered representative of the American electorate.

The study included the Implicit Association Test to measure implicit racial attitudes, which are preferences that people may not realize they have. In the past 10 years, various adaptations of the tool have been used to reveal unconscious attitudes about race, gender, sexuality, ethnicities and other topics.

In addition to implicit and self-reported measures on race attitudes and demographic characteristics, Greenwald included various measures of political beliefs, including stances on policy issues such as taxes on the wealthy, immigration and health care.

In his sample of voters, Greenwald found that 25 percent of the most ideologically polarized voters appeared to be already settled on their preferred candidate. In this group, race attitudes appeared to influence votes for only about 2.4 percent of participants.

"These people strongly favor one candidate over another, and race attitudes have only a relatively small effect on their vote," Greenwald said.

But then he took a closer look at the race attitudes for the 25 percent who were least polarized — having no strong affiliations with either political party. The research showed that race attitudes were influencing the choice of candidate for nearly 10 percent of these voters. If 10 percent of voters switched their vote for or against a candidate, that would cause an increase of 20 percent in the gap between candidates.

"Our method was like putting a magnifying glass on the distribution of voters, allowing us a close-up look at various segments," Greenwald said. Those at the far ends strongly favoring Obama or Romney were relatively little affected by racial attitudes. But those closer to the middle of the distribution showed a considerably greater influence of racial biases.

Greenwald points out that any Democratic presidential candidate, including white ones, faces a race attitude handicap. This is because voters with white racial preferences are typically opposed to social and economic policies favored by national Democratic nominees.

Greenwald's findings are consistent with data he released in May, showing that voters' race attitudes leading up to the Republican primary already had a more pronounced role in predicting their vote than in the 2008 presidential contest.

He will continue to collect survey data as part of the year-long Decision 2012 IAT project. Data collected through October will be used to determine whether race attitudes still have as large of an effect on undecided voters.

Other collaborators on the project are Brian Nosek and Sriram Natarajan, at the University of Virginia, and Teri Kirby, Kaiyuan Xu and Sianna Ziegler, all at UW.

Anyone can participate in the online study, which will be available until a few days beyond Election Day, Nov. 6: https://implicit.harvard.edu/implicit/demo/featuredtask.html.

With problem drinking, where you live may matter

 Some people living in disadvantaged neighborhoods may be at increased risk of problem drinking — though much may depend on race and gender, according to a new study in the November issue of the Journal of Studies on Alcohol and Drugs. Researchers found that of nearly 14,000 U.S. adults surveyed, those living in low-income neighborhoods were generally more likely to be non-drinkers than were people in affluent neighborhoods.

That was not true, however, of black and Hispanic men. And among people who did drink, African Americans in disadvantaged neighborhoods were more likely than their better-off counterparts to be heavy drinkers. Also, when black men and white women from poor neighborhoods drank, they were more likely to suffer drinking-related "consequences" — ranging from trouble at work, to physical fights, to run-ins with the police — than their better-off counterparts.

"There are a lot of aspects of your environment that can affect your drinking behavior and what happens when you do choose to drink," says lead researcher Katherine J. Karriker-Jaffe, Ph.D., of the Public Health Institute's Alcohol Research Group in Emeryville, California.

On one hand, disadvantaged neighborhoods may have a lot of bars or other places to get alcohol, Karriker-Jaffe pointed out. On the other hand, there may be factors in those neighborhoods that limit people's drinking — like less disposable income to afford alcohol, or cultural norms that frown on drinking.

The new findings point to a fairly complex relationship between neighborhood disadvantage and drinking. And it's not clear yet why there are racial and gender differences, according to Karriker-Jaffe.

For low-income black men, she speculates, the higher rate of heavy drinking could be related to the multiple stressors in their lives. The higher rate of drinking consequences could have a number of explanations, too — like the bigger police presence in low-income African-American neighborhoods.

Whatever the reasons for the findings, Karriker-Jaffe says they point to opportunities to intervene.

"This can help us figure out strategies to reach the most at-risk people," she says.

It might be wise, for example, to target prevention education or alcohol-abuse treatment programs to certain disadvantaged neighborhoods. But since drinking habits fit into the wider context of people's lives, bigger-picture efforts — like improving job opportunities — will likely be important, too, according to Karriker-Jaffe. It's hard to tell from this study whether cutting down on the typically high number of alcohol outlets in disadvantaged neighborhoods could potentially help. 1"We're not sure what the role of increased alcohol availability might be, but it's likely to be important as well," Karriker-Jaffe says.


Journal Reference:

  1. Karriker-Jaffe, K. Zemore, S. E., Mulia, N., Jones-Webb, R., Bond, J., and Greenfield T. K. Neighborhood disadvantage and adult alcohol outcomes: Differential risk by race and gender. Journal of Studies on Alcohol and Drugs, November 2012; 73 (6): 865

Interest in arts predicts social responsibility

If you sing, dance, draw, or act — and especially if you watch others do so — you probably have an altruistic streak. (Credit: © Sandra Cunningham / Fotolia)

— If you sing, dance, draw, or act — and especially if you watch others do so — you probably have an altruistic streak, according to a study by researchers at the University of Illinois at Chicago.

People with an active interest in the arts contribute more to society than those with little or no such interest, the researchers found. They analyzed arts exposure, defined as attendance at museums and dance, music, opera and theater events; and arts expression, defined as making or performing art.

"Even after controlling for age, race and education, we found that participation in the arts, especially as audience, predicted civic engagement, tolerance and altruism," said Kelly LeRoux, assistant professor of public administration at UIC and principal investigator on the study.

In contrast to earlier studies, Generation X respondents were found to be more civically engaged than older people.

LeRoux's data came from the General Social Survey, conducted since 1972 by the National Data Program for the Sciences, known by its original initials, NORC. A national sample of 2,765 randomly selected adults participated.

"We correlated survey responses to arts-related questions to responses on altruistic actions — like donating blood, donating money, giving directions, or doing favors for a neighbor — that place the interests of others over the interests of self," LeRoux said. "We looked at 'norms of civility.' Previous studies have established norms for volunteering and being active in organizations."

The researchers measured participation in neighborhood associations, church and religious organizations, civic and fraternal organizations, sports groups, charitable organizations, political parties, professional associations and trade unions.

They measured social tolerance by two variables:

  • Gender-orientation tolerance, measured by whether respondents would agree to having gay persons speak in their community or teach in public schools, and whether they would oppose having homosexually themed books in the library.
  • Racial tolerance, measured by responses regarding various racial and ethnic groups, including African-Americans, Hispanics, and Asian Americans. Eighty percent of the study respondents were Caucasian, LeRoux said.

The researchers measured altruistic behavior by whether respondents said they had allowed a stranger to go ahead of them in line, carried a stranger's belongings, donated blood, given directions to a stranger, lent someone an item of value, returned money to a cashier who had given too much change, or looked after a neighbor's pets, plants or mail.

"If policymakers are concerned about a decline in community life, the arts shouldn't be disregarded as a means to promote an active citizenry," LeRoux said. "Our positive findings could strengthen the case for government support for the arts."

The study was based on data from 2002, the most recent year in which the General Social Survey covered arts participation. LeRoux plans to repeat the study with results from the 2012 survey, which will include arts data.

Politics and prejudice explored

Research has associated political conservatism with prejudice toward various stereotyped groups. But research has also shown that people select and interpret evidence consistent with their own pre-existing attitudes and ideologies. In this article, Chambers and colleagues hypothesized that, contrary to what some research might indicate, prejudice is not restricted to a particular political ideology.

Rather, the conflicting values of liberals and conservatives give rise to different kinds of prejudice, with each group favoring other social groups that share their values. In the first study, three diverse groups of participants rated the ideological position and their overall impression of 34 different target groups.

Participants' impressions fell in line with their ideology. For example, conservatives expressed more prejudice than liberals against groups that were identified as liberal (e.g., African-Americans, homosexuals), but less prejudice against groups identified as conservative (e.g., Christian fundamentalists, business people).

In the second and third studies, participants were presented with 6 divisive political issues and descriptions of racially diverse target persons for each issue. Neither liberals' nor conservatives' impressions of the target persons were affected by the race of the target, but both were strongly influenced by the target's political attitudes.

From these findings the researchers conclude that prejudices commonly linked with ideology are most likely derived from perceived ideological differences and not from other characteristics like racial tolerance or intolerance.


Journal References:

  1. J. B. Luguri, J. L. Napier, J. F. Dovidio. Reconstruing Intolerance: Abstract Thinking Reduces Conservatives' Prejudice Against Nonnormative Groups. Psychological Science, 2012; 23 (7): 756 DOI: 10.1177/0956797611433877
  2. J. B. Luguri, J. L. Napier, J. F. Dovidio. Reconstruing Intolerance: Abstract Thinking Reduces Conservatives' Prejudice Against Nonnormative Groups. Psychological Science, 2012; 23 (7): 756 DOI: 10.1177/0956797611433877

Race may play significant role in presidential election, survey finds

Voters' racial attitudes, both conscious and unconscious, may be a significant factor in this year's U.S. presidential election, particularly since whites tend to prefer people of their own race, according to research presented at the 120th Annual Convention of the American Psychological Association.

"People may not even be aware that they have certain racial attitudes and that could be why, even with an African-American president in the White House for nearly four years, race continues to play a role in electoral politics," Anthony G. Greenwald, PhD, said in an interview. Greenwald was lead researcher on a Anthony G. Greenwald, PhD, survey of 15,000 voters.

The survey asked respondents about their political beliefs, how "warmly" they felt toward black and white people, and which presidential contender they preferred. The survey was done between January and April 2012, while the Republican hopefuls included Herman Cain, Newt Gingrich, Ron Paul, Mitt Romney and Rick Santorum. The research team also measured unconscious racial attitudes using the Implicit Association Test (IAT), which Greenwald developed more than a decade ago to measure thoughts and biases that people don't realize they have. Variations of the test measure implicit attitudes about topics such as race, gender, sexuality and ethnicity.

The IAT results showed a pattern labeled "automatic white preference" among a majority of eligible white voters. The finding that some candidates are more attractive to voters with pro-white racial attitudes does not mean that those candidates are racist, Greenwald emphasized.

Previous research has shown that both blacks and whites show explicit preferences for their own race, according to Greenwald. However, when it comes to implicit, or unconscious, preferences, blacks tend not to prefer one race over another, whereas close to 70 percent of white Americans show an implicit racial bias, he said.

The research team is continuing to collect data on people's attitudes about the 2012 presidential candidates as part of the Decision 2012 IAT study, with a survey modified to focus on voters' comparisons of Romney with President Obama. Summaries of the data will be posted on the site each month beginning in mid-August. Anyone can take the test at https://implicit.harvard.edu/implicit/demo/featuredtask.html

Other collaborators on the Decision 2012 IAT project are Mahzarin Banaji, PhD, of Harvard University; Teri Kirby, BA, and Kaiyuan Xu, BA, of the University of Washington; and Brian Nosek, PhD, and Sriram Natarajan, PhD, of the University of Virginia.

Racial resentment tied to voter ID law preferences, U.S. poll finds

A new National Agenda Opinion Poll by the University of Delaware's Center for Political Communication reveals support for voter identification laws is strongest among Americans who harbor negative sentiments toward African Americans.

Voter ID laws require individuals to show government issued identification when they vote. The survey findings support recent comments by U.S. Attorney General Eric Holder, who portrayed a Texas photo ID law now being challenged as similar to poll taxes used in the Jim Crow era, primarily by Southern states, to block African Americans from voting. Holder pledged to oppose "political pretexts" which, he said, "disenfranchise" black voters.

The national telephone survey of 906 Americans was conducted by the University of Delaware's Center for Political Communication from May 20-June 6, 2012. Research faculty David C. Wilson and Paul Brewer supervised the study, as states and the federal government confront the voter ID issue.

Racial Resentment

To assess attitudes toward African Americans, all non-African Americans respondents in the poll were asked a series of questions (see Appendix). Responses to these questions were combined to form a measure of "racial resentment." Researchers found that support for voter ID laws is highest among those with the highest levels of "racial resentment."

Brewer, the center's associate director for research, said, "These findings suggest that Americans' attitudes about race play an important role in driving their views on voter ID laws."

Ideology, politics shape ID opinion

The survey reveals strong partisan and ideological divisions on racial resentment. Republicans and conservatives have the highest "racial resentment" scores, and Democrats and liberals have the lowest; Independents and moderates are in the middle. In addition, Democrats and liberals are least supportive of voter ID laws, whereas Republicans and conservatives are most supportive. The link between "racial resentment" and support for such laws persists even after controlling for the effects of partisanship, ideology, and a range of demographic variables.

Wilson, the center's coordinator of public opinion initiatives and an expert on race and public opinion, said, "Who votes in America has always been controversial; so much so that the U.S. constitution has been amended a number of times to protect voting eligibility and rights. It comes as no surprise that Republicans support these laws more than Democrats; but, what is surprising is the level at which Democrats and liberals also support the laws."

Here, CPC researchers found an interesting pattern in the data: it is Democrats and liberals whose opinions on voter ID laws are most likely to depend on their racial attitudes. Republicans and conservatives overwhelmingly support voter ID laws regardless of how much "racial resentment" they express. In contrast, Democrats and liberals with the highest "racial resentment" express much more support for voter ID laws than those with the least resentment.

About the study

The National Agenda Opinion Project research was funded by the University of Delaware's Center for Political Communication (CPC) and the UNIDEL Foundation. The study was supervised by the CPC's Coordinator for Public Opinion Initiatives, David C. Wilson, an associate professor in the Department of Political Science and International Relations, and the CPC's Assistant Director for Research, Paul Brewer, a Professor in the Department of Communication.

 

The ever-expanding definition of 'diversity'

Diversity has become a goal for all sorts of institutions — but what it means may depend on who you ask. A new study published in Psychological Science, a journal of the Association for Psychological Science, finds that people's ideologies help determine what they count as "diverse."

Miguel Unzueta, the study's lead author, notes that "diversity" historically meant inclusiveness toward historically disadvantaged groups. Now, however, the term is commonly used to refer to people who are different in any way (even personality traits and food preferences) — and that, Dr. Unzueta argues, may be making the concept useless. Dr. Unzueta saw this play out first hand at the universities he was part of and the organizations he studied. "It seemed like everyone was very comfortable talking about diversity, but not really race and gender," says Unzueta, of the Anderson School of Management and University of California, Los Angeles, who co-wrote the paper with Eric Knowles of the University of California, Irvine, and Geoffrey Ho of UCLA. "The problem is, we could all be talking about diversity and we could all mean different things. It's a very abstract, euphemistic catch-all."

Unzueta and his colleagues designed an experiment to look at how people think about diversity. They recruited 300 people, mostly students and staff members at UCLA, to take an online survey. Each person saw a profile of a company, showing how many people there were of four different racial groups and four different occupations. Different people saw different combinations, such as low racial diversity and low occupational diversity (mostly white and mostly engineers), low racial diversity but high occupational diversity, and so on. Then they were asked if the company was "diverse" or not.

How people responded depended on their ideology, particularly something called "social dominance orientation." This is a basic motivation to either maintain the status quo or decrease inequality. People who score high in social dominance orientation are less egalitarian. When these people saw a company that was mostly white, but had fairly even numbers of engineers, accountants, consultants, and marketers, they declared it to be diverse. In the next phase of questions, they also said the company didn't need affirmative action policies to improve its racial diversity. "By calling the company diverse, that allows them to oppose race-based affirmative action," Unzueta says. People with low social dominance orientation thought occupationally unbalanced companies lacked diversity — even if the company had high racial diversity. This allowed egalitarian-minded people to legitimize support for race-based affirmative action policies since the organization in question was seen as lacking diversity. Thus, across the range of social dominance orientation, people leveraged demographic ambiguity in ways that justified their preexisting policy preferences.

It's clear that some people thought having a roughly equivalent number of engineers, accountants, consultants, and marketers made a company "diverse." That has nothing to do with what "diversity" was originally used to describe, and accountants aren't a group that needs policies to make up for historical disadvantages. "One thing I hope this work is starting to make clear is that to talk about issues of fairness, social justice, and group-based equality, we can't be using euphemisms," Unzueta says. "If a company really does want to have a racially diverse workforce, talk about race. Don't hide behind diversity."


Journal Reference:

  1. Miguel Unzueta et al. Diversity Is What You Want It to Be: How Social-Dominance Motives Affect Construals of Diversity. Psychological Science, 2012
 

First-time divorce rate tied to education, race

New research from the National Center for Family and Marriage Research (NCFMR) at Bowling Green State University shows there is substantial variation in the first-time divorce rate when it is broken down by race and education. But, there is also evidence that a college degree has a protective effect against divorce among all races.

The data for the family profile, "First Divorce Rate, 2010" were gathered by the U.S. Census Bureau in 2010. At that time, the rate of first divorce in the U.S. was 17.5 per 1,000 women 18 years old and older in a first marriage. According to the research, recent declines in the probability of divorce largely reflect an increase in marital stability among the more educated.

Among women in a first marriage, the rate of first divorce is highest for those who received some education after high school, but have not earned a bachelor's degree — 23 per 1,000. The association between education and divorce is also curvilinear. The least (no high school diploma or GED) and the highest (college degree) educated women share the lowest rate of first divorce, with 14.4 and 14.2 per 1,000, respectively.

Broken down by race and ethnicity, the study found Asian women have the lowest first divorce rate at 10 divorces per 1,000 women in a first marriage. The first divorce rates of white and Hispanic women were similar at 16.3 and 18.1, respectively. African-American women have substantially higher rates of first divorce compared to all other racial and ethnic groups, at 30.4 divorces per 1,000 women in a first marriage.

Once education was factored in, the NCFMR found, with the exception of Asians, the highest rate of first divorce was among women with some college, regardless of race or ethnicity.

"Contrary to the notion that women with a college degree face the lowest chances of divorce, those without a high school degree actually have similar low odds of divorce," explained Dr. Susan Brown, NCFMR co-director. "The relationship between education and divorce is not straightforward."

However, according to co-director Dr. Wendy Manning, these patterns are consistent with patterns they are finding in other national data sources.

The association between education and the first-divorce rate held up even when race was factored in. Among African-Americans, Asians and Hispanics, women with less than a high school degree had a similar divorce rate to women who graduated from college. Among African-American and Hispanic women, the lowest first-divorce rates were found among women with less than a high school diploma.

"Among white women, there were few differences according to education, but those with a college degree experienced lower divorce rates than any other education group," Manning said. "These findings showcase that the association between education and divorce differs for racial and ethnic groups, and it is important to consider this variation."

This project was supported by a grant from the U.S. Department of Health and Human Services and the Office of the Assistant Secretary for Planning and Evaluation.

Genetics, lifestyle provide clues to racial differences in head and neck cancer

— Why are African Americans more likely than Caucasians to be not only diagnosed with head and neck cancer, but also die from the disease?

While the answer isn't a simple one, differences in lifestyle, access to care and tumor genetics may, in part, be to blame, according to a new study from Henry Ford Hospital.

The study also finds that African Americans are more likely to be past or current smokers, one of the primary risk factors for head and neck cancer.

"We're really trying to understand why African Americans with head and neck squamous cell carcinoma do so poorly," says study lead author Maria J. Worsham, Ph.D., director of research in the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.

"Using a comprehensive set of risk factors that are known to have some bearing on the disease, we're able to gain a better understanding of what contributes to racial differences and work to help improve patient care."

Results from the study will be presented on Sept. 14 in San Francisco at the American Academy of Otolaryngology-Head & Neck Surgery Foundation Annual Meeting. The study was funded by a NIH grant.

This year alone, it's estimated that 52,140 news cases of head and neck cancer will be diagnosed, and roughly 11,460 will die in 2011 from oral cavity, and pharyngeal and laryngeal cancers.

African Americans are more likely to be diagnosed with late-stage head and neck squamous cell carcinoma (HNSCC) and have a worse five-year survival than Caucasians. It's unknown whether significant biological rather than socioeconomic differences account for some of the disparities in outcomes.

To get at the root of these differences, Dr. Worsham and her research team used a large Detroit multi-ethnic group of 673 patients with HNSCC. Most notably, 42 percent of the study group is African American.

The researchers also took a very broad approach to the study, by examining many of the intertwined variables influencing health and disease to look for differences among African Americans and Caucasians.

In all, the study focused on 136 risk factors, including demographics (age, race, gender), smoking and alcohol use, access to care and type of cancer treatment (radiation and/or surgery). Tumor characteristics, including stage, biology and genetics, also were examined.

Much of the disparities seen among African Americans with head and neck cancer can be traced to access to care barriers, including insurance, that prevent them from getting timely and high-quality medical care, often resulting in late stage diagnosis.

Henry Ford researchers found that: • While 88% of African Americans in the study had medical insurance, the majority had Medicare or Medicaid instead of private health insurance. • African Americans also were more likely to be unmarried or living alone, both of which previous studies suggest have a negative impact on quality of life and survival. • In terms of cancer treatment, African Americans in this study were more than two times more likely than Caucasians to receive radiation therapy. Often times, if the tumor is extensive or it is not feasible to completely remove it, radiotherapy is initially given to try to shrink the tumor. The study showed fewer African Americans (43%) opted for surgery than Caucasians (49%). • The tumor tissue samples also held important clues. African American tumors were six to seven times more likely to present with lymphocytic response, which essentially is an entourage of immune system cells. These cells behave not only as first responders against tumors, but can also produce growth factors (chemicals) that feed tumor growth, such as forming blood vessels. • Compared to Caucasian tumors, African American tumors were almost two times more likely to have loss of the CDKN2A (cyclin-dependent kinase inhibitor 2A) gene and gain of the SCYA3 (small inducible cytokine A3) gene. CDKN2A is important to cell cycle regulation, and the SCYA3 gene product has dual roles of tumor lymph node metastasis and local host defense against tumors in HNSCC.

"Understanding and accounting for factors contributing to differences in head and neck cancer racial groups will ultimately aid in eliminating disparities and saving more lives from this devastating disease," says Dr. Worsham.

Along with Dr. Worsham, study co-authors from Henry Ford are Josena Stephen, M.D.; Mei Lu, Ph.D.; Kang Mei Chen, M.D.; Shaleta Havard; Veena Shah, M.D.; and Vanessa G. Schweitzer, M.D.

Research Support: NIH grant R01DE15990.