Communicating Breast Cancer Risk Information to African American Women: Implications for Effective Communication by Health Professionals

Health disparities for breast cancer in African American women have been well documented; although they have a lower incidence compared to Non-Hispanic Whites, they experience a higher mortality and additionally, young African American women (less than 50 years old) experience higher prevalence of a more aggressive subtype called basal-like breast cancer. These disparities are tied to socio-economic, envirornmental and cultural factors. The most effective mechanisms of breast cancer education for this group of women involve culturally-sensitive, direct information provided through a variety of trusted sources, including media, lay community members and health professionals. Although studies have identified specific barriers that impede the relationship and communication between African American women and their health providers, few have examined how health professionals communicate breast cancer risk information to low income and/or African American women. For this reason, the UNC Breast Cancer and the Environment Research Program (UNC BCERP) explored health professionals' communication of breast cancer information with patients, with an emphasis on young African American women. Individual interviews were conducted with 34 health professionals, including physicians, physician assistants, nurses, nurse practitioners, health educators and dietitians. Interviews were transcribed, coded and analyzed based on participants' respective occupations. This paper focuses on how a subset of these professionals, health educators and dietitians, convey breast cancer risk information to African American women, and how they address environmental risk factors with this group. In addition, factors that influenced or hindered their sharing of breast cancer risk information were explored.Master of Public Healt

Genotype-by-Diet Interactions Drive Metabolic Phenotype Variation in Drosophila melanogaster

The rising prevalence of complex disease suggests that alterations to the human environment are increasing the proportion of individuals who exceed a threshold of liability. This might be due either to a global shift in the population mean of underlying contributing traits, or to increased variance of such underlying endophenotypes (such as body weight). To contrast these quantitative genetic mechanisms with respect to weight gain, we have quantified the effect of dietary perturbation on metabolic traits in 146 inbred lines of Drosophila melanogaster and show that genotype-by-diet interactions are pervasive. For several metabolic traits, genotype-by-diet interactions account for far more variance (between 12 and 17%) than diet alone (1–2%), and in some cases have as large an effect as genetics alone (11–23%). Substantial dew point effects were also observed. Larval foraging behavior was found to be a quantitative trait exhibiting significant genetic variation for path length (P = 0.0004). Metabolic and fitness traits exhibited a complex correlation structure, and there was evidence of selection minimizing weight under laboratory conditions. In addition, a high fat diet significantly increases population variance in metabolic phenotypes, suggesting decreased robustness in the face of dietary perturbation. Changes in metabolic trait mean and variance in response to diet indicates that shifts in both population mean and variance in underlying traits could contribute to increases in complex disease

Racism as a public health issue in environmental health disparities and environmental justice: working toward solutions

Abstract Background Environmental health research in the US has shown that racial and ethnic minorities and members of low-socioeconomic groups, are disproportionately burdened by harmful environmental exposures, in their homes, workplace, and neighborhood environments that impact their overall health and well-being. Systemic racism is a fundamental cause of these disproportionate exposures and associated health effects. To invigorate and inform current efforts on environmental justice and to raise awareness of environmental racism, the National Institute of Environmental Health Sciences (NIEHS) hosted a workshop where community leaders, academic researchers, and NIEHS staff shared perspectives and discussed ways to inform future work to address health disparities. Objectives To share best practices learned and experienced in partnerships between academic researchers and communities that are addressing environmental racism across the US; and to outline critical needs and future actions for NIEHS, other federal agencies, and anyone who is interested in conducting or funding research that addresses environmental racism and advances health equity for all communities. Discussion Through this workshop with community leaders and researchers funded by NIEHS, we learned that partnerships between academics and communities hold great promise for addressing environmental racism; however, there are still profound obstacles. To overcome these barriers, translation of research into plain language and health-protective interventions is needed. Structural changes are also needed in current funding mechanisms and training programs across federal agencies. We also learned the importance of leveraging advances in technology to develop creative solutions that can protect public health